Effects of Prenatal Arsenic, Cadmium, and Manganese Exposure on Neurodevelopment in Children: A Systematic Review and Meta-Analysis

作者：Rui Su, Yi Jiang, Weikun Li, Wencheng Ding, Ling Feng · 发表于：Medicina · 年份：2025 · DOI：10.3390/medicina61071143 · 被引用次数：10 · 研究领域：Heavy Metal Exposure and Toxicity、Trace Elements in Health、Air Quality and Health Impacts

Objective: The aim of this study was to investigate the effects of prenatal heavy metal (arsenic, cadmium, manganese) exposure on infant neurodevelopment through a systematic review and meta-analysis, elucidating the toxicological mechanisms and dose–response relationships for consideration in environmental risk assessment. Methods: Following the PRISMA guidelines, systematic searches were conducted in PubMed, Embase, and other databases, ultimately resulting in 17 observational studies involving 6907 participants. Results: Arsenic (As): A 50% increase in arsenic exposure was associated with a reduction of 0.51 points in the Mental Development Index (MDI; 95% CI: −1.43 to 0.4) and 0.15 points in the Psychomotor Development Index (PDI; 95% CI: −0.96 to 0.65). However, these results did not achieve statistical significance (p > 0.05). Cadmium (Cd): Prenatal cadmium exposure significantly decreased the Full-Scale Intelligence Quotient (FSIQ) in children aged 5–9 years. A 50% increase in cadmium exposure resulted in a 0.44-point drop in the FSIQ (95% CI: −0.67 to −0.21, p < 0.05), with stable effects (I2 = 0%). Manganese (Mn): Manganese exposure showed a negative association with the MDI (β = −0.11) and PDI (β = −0.18). However, a high degree of heterogeneity was observed (I2 = 20.89–73.35%), and some studies suggested potential risks even at low exposure levels. Sensitivity analyses indicated that the heterogeneity in the arsenic and manganese results mainly stemmed from individ...