Association of Polycyclic Aromatic Hydrocarbon Mixtures with Gestational Iron Deficiency: A Cross-Sectional Analysis of the Zunyi Birth Cohort
- 1School of Public Health, Zunyi Medical University, Zunyi 563000, China
- 2Key Laboratory of Maternal & Child Health and Exposure Science, Guizhou Provincial Department of Education, Zunyi 563000, China
Abstract
Background: Maternal iron deficiency is a highly prevalent nutritional disorder during pregnancy and poses substantial risks to both maternal and fetal health. While adequate dietary iron intake and supplementation are critical for maintaining iron balance during pregnancy, emerging evidence suggests that exposure to environmental contaminants, such as polycyclic aromatic hydrocarbons (PAHs), may disrupt iron homeostasis and contribute to iron deficiency. However, epidemiological evidence linking prenatal PAH exposure to gestational iron deficiency remains limited, particularly in populations with low-level exposure. This study aimed to examine the associations of individual and combined PAH exposures during late pregnancy with the odds of iron deficiency. Methods: We conducted a cross-sectional analysis of 1717 pregnant women enrolled in the multicenter Zunyi Birth Cohort and measured ten urinary PAH metabolites. Single-pollutant associations were estimated with weighted quasi-binomial logistic regression using inverse probability weighting (IPW), with restricted cubic spline models used to assess dose–response relationships. Mixture effects were evaluated separately using Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression, and quantile g-computation; these mixture models were fit without IPW. Results: IPW analysis revealed that, compared with pregnant women in the lowest tertile of urinary PAH metabolites, the top three metabolites associated with significantly elevated odds ratios for iron deficiency in those in the highest tertile were 2-OHPhe (OR = 1.96, 95% CI: 1.46–2.63), 3-OHPhe (OR = 1.92, 95% CI: 1.43–2.58), and 1-OHPhe (OR = 1.83, 95% CI: 1.36–2.45). WQS regression found a significant overall mixture index effect (β = 0.28, OR = 1.32, 95% CI: 1.11–1.57, p = 0.002), with 3-OHPhe (48.42%), 1-OHPhe (18.49%), and 1-OHPyr (16.53%) accounting for the largest shares of the total mixture weight. Quantile g-computation also detected a significant positive global mixture association (ψ = 0.13, 95% CI: 0.01–0.26, p = 0.040), with 3-OHPhe (30.39%), 2-OHPhe (29.56%), and 1-OHPyr (24.02%) as the primary positive contributors; these percentages are based on within-direction normalization and are not directly comparable to the WQS weight percentages. BKMR indicated that the estimated mixture association increased monotonically from slightly negative values at lower quantiles to positive values at higher quantiles. Conclusions: These findings provide novel evidence that exposure to specific PAHs, both individually and as a mixture, particularly phenanthrene derivatives like 3-OHPhe, is associated with increased odds of gestational iron deficiency. Given the cross-sectional design, these findings should be regarded as hypothesis-generating and warrant confirmation in prospective studies.
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BibTeX
@article{luo2026association,
title = {{Association of Polycyclic Aromatic Hydrocarbon Mixtures with Gestational Iron Deficiency: A Cross-Sectional Analysis of the Zunyi Birth Cohort}},
author = {Xiangwen Luo and Min Lu and Derong Fang and Ketao Linghu and Hao Huang and Xinyi Xiao and Shimin Xiong and Rong Zeng and Yijun Liu and Xubo Shen and Yuanzhong Zhou},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18213565},
url = {https://www.mdpi.com/2072-6643/18/21/3565},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of Polycyclic Aromatic Hydrocarbon Mixtures with Gestational Iron Deficiency: A Cross-Sectional Analysis of the Zunyi Birth Cohort
AU - Xiangwen Luo
AU - Min Lu
AU - Derong Fang
AU - Ketao Linghu
AU - Hao Huang
AU - Xinyi Xiao
AU - Shimin Xiong
AU - Rong Zeng
AU - Yijun Liu
AU - Xubo Shen
AU - Yuanzhong Zhou
PY - 2026
DA - 2026/10/28
JO - Nutrients
DO - 10.3390/nu18213565
UR - https://www.mdpi.com/2072-6643/18/21/3565
AB - Background: Maternal iron deficiency is a highly prevalent nutritional disorder during pregnancy and poses substantial risks to both maternal and fetal health. While adequate dietary iron intake and supplementation are critical for maintaining iron balance during pregnancy, emerging evidence suggests that exposure to environmental contaminants, such as polycyclic aromatic hydrocarbons (PAHs), may disrupt iron homeostasis and contribute to iron deficiency. However, epidemiological evidence linking prenatal PAH exposure to gestational iron deficiency remains limited, particularly in populations with low-level exposure. This study aimed to examine the associations of individual and combined PAH exposures during late pregnancy with the odds of iron deficiency. Methods: We conducted a cross-sectional analysis of 1717 pregnant women enrolled in the multicenter Zunyi Birth Cohort and measured ten urinary PAH metabolites. Single-pollutant associations were estimated with weighted quasi-binomial logistic regression using inverse probability weighting (IPW), with restricted cubic spline models used to assess dose–response relationships. Mixture effects were evaluated separately using Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression, and quantile g-computation; these mixture models were fit without IPW. Results: IPW analysis revealed that, compared with pregnant women in the lowest tertile of urinary PAH metabolites, the top three metabolites associated with significantly elevated odds ratios for iron deficiency in those in the highest tertile were 2-OHPhe (OR = 1.96, 95% CI: 1.46–2.63), 3-OHPhe (OR = 1.92, 95% CI: 1.43–2.58), and 1-OHPhe (OR = 1.83, 95% CI: 1.36–2.45). WQS regression found a significant overall mixture index effect (β = 0.28, OR = 1.32, 95% CI: 1.11–1.57, p = 0.002), with 3-OHPhe (48.42%), 1-OHPhe (18.49%), and 1-OHPyr (16.53%) accounting for the largest shares of the total mixture weight. Quantile g-computation also detected a significant positive global mixture association (ψ = 0.13, 95% CI: 0.01–0.26, p = 0.040), with 3-OHPhe (30.39%), 2-OHPhe (29.56%), and 1-OHPyr (24.02%) as the primary positive contributors; these percentages are based on within-direction normalization and are not directly comparable to the WQS weight percentages. BKMR indicated that the estimated mixture association increased monotonically from slightly negative values at lower quantiles to positive values at higher quantiles. Conclusions: These findings provide novel evidence that exposure to specific PAHs, both individually and as a mixture, particularly phenanthrene derivatives like 3-OHPhe, is associated with increased odds of gestational iron deficiency. Given the cross-sectional design, these findings should be regarded as hypothesis-generating and warrant confirmation in prospective studies.
SN - 2072-6643
ER -