Association between titanium and silver concentrations in maternal hair and risk of neural tube defects in offspring: A case-control study in north China

- Products containing Ti or Ag had been widely released into the environment.
- We investigated an association of Ti or Ag with risk of neural tube defects (NTDs).
- The recruited pregnant women from north China had a higher exposure level of Ti.
- Concentration of Ti in maternal hair was associated with an elevated risk of NTDs.
- An association of Ag in maternal hair with risk of NTDs was not observed.

Increasing uses of titanium and silver in various products raise concerns for their potential adverse effects on pregnancy outcomes. We aimed to examine the associations between titanium and silver concentrations in maternal hair growing during the periconception period and the risk of neural tube defects (NTDs) in offspring. Our case-control study recruited 191 women with NTD-affected pregnancies and 261 women delivering healthy infants. Metal concentrations in maternal hair were measured by inductively coupled plasma-mass spectrometry. The adjusted odds ratios (AOR) of titanium concentration above the median were 1.46 (95% confidence interval (CI), 0.99-2.13) for total NTDs and 2.10 (95% CI, 1.12-3.94) for anencephaly, while OR of silver wasn't statistically significant. Titanium concentration was positively correlated with consumptions of vegetables and fruits. Maternal exposure to titanium during the periconception period was associated with an increased NTD risk in offspring, which may be partly mediated through maternal dietary habits.