Aluminium (Al) is a non-essential neurotoxicant and there is limited information regarding
exposure to Al in utero. This study sought to evaluate the in utero exposure to Al
in urban South African women, its effects on birth outcomes and possible synergistic
effects between Al, essential and neurotoxic elements such as lead (Pb), mercury (Hg)
and arsenic (As), as well as a a potential sex-dependent response to these elements
in neonates. This study has found elevated levels of Al in urban women at delivery.
The Spearman's rank correlation coefficients (p-value) of the association between
maternal serum Al and birth outcomes (gestational age and parity), and between maternal
serum Al and Cu, Zn and Se, were statistically significant. However, in the general
and the stratified models, no association was found between any of the birth outcomes
and maternal serum Al. The association between maternal serum Al and neurotoxic elements
at delivery showed a significant positive correlation for Pb only (rho = 0.361; p
< 0.001) which was found to be sex-dependent in neonates (males, rho = 0.285; p <
0.004 and females, rho = 0.444, p < 0.001). Our preliminary findings indicate that
in utero exposure to Al is an emerging concern requiring further research and directives
from public health authorities.