Fetal lead exposure at each stage of pregnancy as a predictor of infant mental development.
Fetal lead exposure at each stage of pregnancy as a predictor of infant mental development.
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DOI：
10.1289/ehp.9067
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发表时间：
2006-11
影响因子：
10.4
通讯作者：
Hernández-Avila M
中科院分区：
文献类型：
--
作者：
Hu H;Téllez-Rojo MM;Bellinger D;Smith D;Ettinger AS;Lamadrid-Figueroa H;Schwartz J;Schnaas L;Mercado-García A;Hernández-Avila M
产前铅暴露对神经发育的影响在一致性、最脆弱的三个月以及估计胎儿铅暴露的最佳方法方面仍不清楚。我们通过重复测量孕妇全血和血浆铅水平所反映的胎儿剂量，研究了产前铅暴露对神经发育的影响。我们测量了墨西哥城 146 名孕妇每个三个月期母体血浆和全血中的铅含量。然后，我们在分娩时测量了脐带血铅，并在后代 12 个月和 24 个月大时测量了血铅并进行了贝利婴儿发育量表。我们使用多变量回归，调整协变量和 24 个月血铅，来比较我们的妊娠测量对胎儿铅剂量的影响。母体铅水平中等偏高，妊娠早期血铅平均值 (± SD) 值为 7.1 ± 5.1 μg/dL，14% 的值≥10 μg/dL。妊娠早期（但不是妊娠中期或晚期）的母体血浆和全血铅都是智力发育指数 (MDI) 评分较差的显着预测因子 (p < 0.05)。在结合所有三个妊娠期测量值并使用标准化系数的模型中，妊娠早期母体血浆铅的影响略大于妊娠早期母体全血铅的影响，并且远大于妊娠中期或晚期血浆铅的影响，以及所有三个妊娠期的平均值。妊娠早期血浆铅的 1-SD 变化与 MDI 评分降低 3.5 分相关。后代出生后血铅水平与 MDI 评分的相关性不太强。胎儿铅暴露会对神经发育产生不利影响，这种影响在妊娠前三个月最为明显，最好通过测量母体血浆或全血中的铅来捕获。
The impact of prenatal lead exposure on neurodevelopment remains unclear in terms of consistency, the trimester of greatest vulnerability, and the best method for estimating fetal lead exposure. We studied prenatal lead exposure’s impact on neurodevelopment using repeated measures of fetal dose as reflected by maternal whole blood and plasma lead levels. We measured lead in maternal plasma and whole blood during each trimester in 146 pregnant women in Mexico City. We then measured umbilical cord blood lead at delivery and, when offspring were 12 and 24 months of age, measured blood lead and administered the Bayley Scales of Infant Development. We used multivariate regression, adjusting for covariates and 24-month blood lead, to compare the impacts of our pregnancy measures of fetal lead dose. Maternal lead levels were moderately high with a first-trimester blood lead mean (± SD) value of 7.1 ± 5.1 μg/dL and 14% of values ≥10 μg/dL. Both maternal plasma and whole blood lead during the first trimester (but not in the second or third trimester) were significant predictors (p < 0.05) of poorer Mental Development Index (MDI) scores. In models combining all three trimester measures and using standardized coefficients, the effect of first-trimester maternal plasma lead was somewhat greater than the effect of first-trimester maternal whole blood lead and substantially greater than the effects of second- or third-trimester plasma lead, and values averaged over all three trimesters. A 1-SD change in first-trimester plasma lead was associated with a reduction in MDI score of 3.5 points. Postnatal blood lead levels in the offspring were less strongly correlated with MDI scores. Fetal lead exposure has an adverse effect on neurodevelopment, with an effect that may be most pronounced during the first trimester and best captured by measuring lead in either maternal plasma or whole blood.
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影响因子：
10.4
作者：
GOYER, RA
通讯作者：
GOYER, RA
影响因子：
8
作者：
Gomaa, A;Hu, H;Hernandez-Avila, M
通讯作者：
Hernandez-Avila, M
影响因子：
10.4
作者：
Hu, H
通讯作者：
Hu, H
影响因子：
9.8
作者：
Gulson, BL;Mizon, KJ;Donnelly, JB
通讯作者：
Donnelly, JB
影响因子：
158.5
作者：
Canfield, RL;Henderson, CR;Lanphear, BP
通讯作者：
Lanphear, BP