Implications for prenatal cadmium exposure and adverse health outcomes in adulthood

Toxicol Appl Pharmacol. 2020 Sep 15;403:115161. doi: 10.1016/j.taap.2020.115161. Epub 2020 Jul 25.


Cadmium is a ubiquitous, non-essential metal that has earned a spot on the World Health Organizations top 10 chemicals of major public health concern. The mechanisms of cadmium-induced adverse health outcomes, such as cardiovascular disease, renal toxicity and cancer, are well studied in adults. However, the implications for early life exposures to low-level cadmium leading to increased risk of developing diseases in adulthood remains elusive. Epidemiological investigation of the long term implications of cadmium-associated adverse birth outcomes are limited and studies do not extend into adulthood. This review will summarize the literature on the non-lethal, adverse health effects associated with prenatal and early life exposure to cadmium and the implications of these exposures in the development of diseases later in life. In addition, this review will highlight possible mechanisms responsible for these outcomes as well as address the inconsistencies in the literature. More recent studies have addressed sex as a biological variable, showing prenatal cadmium exposure elicits sex-specific outcomes that would otherwise be masked by pooling male and female data. Furthermore, researchers have begun to investigate the role of prenatal and early life cadmium exposures in the development of diet-induced diseases with evidence of altered essential metal homeostasis as a likely mechanism for cadmium-enhanced, diet-induced diseases. Although novel experimental models are beginning to be established to study the association between prenatal cadmium exposure and adverse health outcomes in adulthood, the studies are few, highlighting a major need for further investigation.

Keywords: Birth Outcomes; Cadmium; Developmental Origins of Health and Disease (DOHaD) Hypothesis; Environmental Contaminant; Fetal Development; Prenatal Exposure.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Cadmium / toxicity*
  • Environmental Pollutants / toxicity*
  • Epigenesis, Genetic
  • Female
  • Gene Expression Regulation, Developmental / drug effects
  • Humans
  • Pregnancy
  • Prenatal Exposure Delayed Effects*


  • Environmental Pollutants
  • Cadmium