| Summary: | Background: Few epidemiological studies have investigated associations of exposure to multiple metals with thyroid hormone homeostasis, especially for the pregnant women. Methods: Among all the 1644 participants enrolled in Hangzhou Birth Cohort Study (HBCS) at baseline, a total of 915 pregnant women with complete data of interest were analyzed. Eleven metals were measured in blood samples collected around 25 weeks gestation. Serum levels of thyroid hormones including free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4) and thyroid-stimulating hormone (TSH) were abstracted from the medical records. Relationships between tertiles of metal levels (setting the lowest tertile as the reference) and percent changes in thyroid hormones were estimated by multivariable adjusted linear regression models. Results: Five metals [arsenic (As), selenium (Se), manganese (Mn), nickel (Ni), antimony (Sb)] were significantly linked to decreased levels of one or more thyroid hormones based on trend tests in the single-metal models. Percent changes [95% confidence intervals (CIs)] in thyroid hormones for the third tertiles of metals remained significant between FT3 and As [−3.53% (−5.48%, −1.54%)]; and between TT3 and As [−4.19% (−7.00%, −1.31%)]; and between FT4 and Mn [−2.05% (−3.49%, −0.58%)], Sb [−1.99% (−3.44%, −0.52%)] in the multiple-metal models. Conclusions: Thyroid hormone concentrations were reversely related to the levels of blood metals of As, Mn and Sb among Chinese pregnant women. Additional prospective studies are warranted to confirm the causality.Paper capsule: Exposure to multiple metals was reversely associated with one or more thyroid hormones in the Chinese pregnant women. Keywords: Metals, Thyroid hormones, Pregnant women, Cross-sectional study
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