Elevated concentrations of vanadium in maternal hair and umbilical cord blood with an increased risk of offspring congenital heart disease: a multi-center case-control study

Background: Vanadium is a ubiquitous environmental pollutant derived from anthropogenic activities. Animal studies indicated that excessive vanadium induces fetotoxicity and teratogenicity, but little is known about its effects on humans, particularly regarding congenital heart disease (CHD), the most prevalent birth defect. We aimed to evaluate the association between prenatal vanadium exposure and CHD risk in offspring in China. Methods: A multi-center case-control study was conducted at tertiary maternal and children’s hospitals across six cities in China between February 2010 and December 2014, encompassing 427 CHD cases and 522 controls. Vanadium and other metals in maternal hair and umbilical cord blood samples were measured by inductively coupled plasma mass spectrometry. Random-effects logistic regression models were used to assess the associations of vanadium with the risk of overall CHD and its subtypes in offspring, with adjustment for maternal demographic characteristics and other metals. Restricted cubic spline models were applied to evaluate the dose-response relationships. We also evaluated the interaction effects of vanadium with nickel, arsenic, lead, cadmium, and titanium on CHD risk. Results: The median concentrations of vanadium in the cases were significantly higher than those in the controls (maternal hair: 0.064 ng/mg vs. 0.031 ng/mg; umbilical cord blood: 3.518 µg/L vs. 3.265 µg/L). Vanadium concentration exhibited significant dose-response relationships with the risk of CHD. Relative to the lowest tertile, mothers with medium and high hair vanadium exposure had a significantly higher overall risk of CHD, with adjusted odds ratios (aOR) of 1.973 (95%CI: 1.18–3.292) and 4.845 (95%CI: 2.536–9.256), respectively. High umbilical cord blood vanadium exposure also displayed an increased risk of CHD, with an aOR of 2.735 (95%CI: 1.150–6.503). Significant additive and multiplicative interactions were found between maternal hair vanadium and nickel, arsenic and titanium. Co-exposure to high vanadium and high nickel, arsenic, lead, and titanium potentiated the odds for CHD. Conclusion: Our findings reveal an association between prenatal exposure to elevated levels of vanadium and increased risk of CHD in offspring, suggesting that vanadium may exert toxicity on cardiac development. Further studies are needed to confirm these associations and elucidate the underlying mechanisms.