Neural tube defects (NTDs) are a group of severe congenital birth defects. Germanium (Ge) induces certain neurotoxic effects, and its association with NTDs has been overlooked. We firstly confirmed that hair Ge concentration can indicate the exposure level by a rat model. By using a large case–control study of 285 NTD cases and 543 controls, we found a significantly positive association between maternal hair Ge exposure and NTD risk, with odds ratios (95% confidence interval) of 1.91 (1.24–2.94) and 1.42 (1.00–2.00) for two concerned time windows covering the early pregnancy. Spina bifida subtype developed more frequently after maternal Ge exposure during early pregnancy. In pregnant women, maternal Ge exposure may increase oxidation stress and the likelihood of fever or flu, which were associated with NTD risk. In addition, maternal Ge exposure may increase the risk of preclinical spontaneous abortion during the neural tube closure stage, which was indicated from an in vitro fertilization-embryo transfer cohort study. By integrated these We conclude that maternal exposure to Ge can increase NTD risk.
 

锗,生殖毒性,早期发育,风险