摘要:Background: Cadmium (Cd) is a ubiquitous environmental toxicant that can accumulate in the placenta during pregnancy, where it may impair placental function and affect fetal development. Objectives: We aimed to investigate Cd-associated variations in placental DNA methylation (DNAM) and associations with gene expression; we also aimed to identify novel pathways involved in Cd-associated reproductive toxicity. Methods: Using placental DNAM and Cd concentrations in the New Hampshire Birth Cohort Study (NHBCS, n = 343) and the Rhode Island Child Health Study (RICHS, n = 141), we performed an epigenome-wide association study (EWAS) between Cd and DNAM, adjusting for tissue heterogeneity using a reference-free method. Cohort-specific results were aggregated via inverse variance weighted fixed effects meta-analysis, and variably methylated CpGs were associated with gene expression. We then performed functional enrichment analysis and tests for associations between gene expression and birth size metrics. Results: We identified 17 Cd-associated differentially methylated CpG sites with meta-analysis p -values < 1 × 10−5, two of which were within a 5% false discovery rate (FDR). DNAM levels at 9 of the 17 loci were associated with increased expression of 6 genes (5% FDR): TNFAIP2 , EXOC3L4 , GAS7 , SREBF1 , ACOT7 , and RORA . Higher placental expression of TNFAIP2 and ACOT7 and lower expression of RORA were associated with lower birth weight z -scores ( p -values < 0.05). Conclusion: Cd-associated differential DNAM and corresponding DNAM-expression associations were observed at loci involved in inflammatory signaling and cell growth. The expression levels of genes involved in inflammatory signaling ( TNFAIP2 , ACOT7 , and RORA ) were also associated with birth weight, suggesting a role for inflammatory processes in Cd-associated reproductive toxicity. https://doi.org/10.1289/EHP2192