Longitudinal Study of Prenatal and Postnatal Lead Exposure and Early Cognitive Development in Al-kharj, Saudi Arabia: A Preliminary Results of Cord Blood Lead Levels
Longitudinal Study of Prenatal and Postnatal Lead Exposure and Early Cognitive Development in Al-kharj, Saudi Arabia: A Preliminary Results of Cord Blood Lead Levels
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DOI：
10.1093/tropej/fmn019
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发表时间：
2008-10-01
影响因子：
2
通讯作者：
Rabah, Abdullah
中科院分区：
文献类型：
--
作者：
Al-Saleh, Iman;Shinwari, Neptune;Rabah, Abdullah
大量的数据表明，在早期发育过程中低水平的铅暴露与儿童后期至青春期明显的神经行为认知表现缺陷之间存在直接联系。我们以前的研究证实了铅从母亲转移到胎儿以及低铅暴露对学龄儿童神经心理行为的影响。这样的结果使我们设计了一个纵向调查，以评估产前和/或产后铅暴露对早期认知发育的影响，在选定的一组儿童从出生到2岁。在这项研究的第一阶段（2004年3月至7月），我们测量了653脐带血样本中的铅含量，这些样本取自在哈立德国王医院分娩的健康沙特母亲。这提供了一个很好的机会来研究脐带血中血铅水平升高的流行情况，并确定产前铅暴露的风险因素。平均脐带铅水平为2.21 +/- 1.691 g/dl，范围为0.284-17.276 μ g/dl。只有1.23%的新生儿血铅水平>10 μ g/dl，这是疾病控制中心关注的水平。为了研究影响脐带血铅水平的危险因素，在多元回归模型中只选择铅水平高于第75百分位数（2.475 μ g/dl）的受试者。我们观察到，脐带血铅水平显着影响母亲的年龄，居住的位置和产前补充剂的摄入量。控制新生儿头围混杂因素后，发现脐带血铅水平与新生儿头围呈显著负相关（β =-0.158，p = 0.036）。产前补充剂的摄入量与脐带血铅水平呈负相关，强调了产前检查在怀孕期间的作用。由于铅暴露导致的新生儿头围的显著减少可能对他们未来的表现和成就产生严重影响。这项研究表明，即使在低产前铅暴露，应采取一切可能的措施，检查铅源在我们的环境和减少铅暴露。
Extensive data shows a direct link between low-level lead exposure during early development and deficits in neurobehavioral-cognitive performance evident late in childhood through adolescence. Our previous studies confirmed the transfer of lead from the mother to the fetus as well as the effect of low lead exposure on neuropsychological behavior in school children. Such results led us to design a longitudinal survey to evaluate the effect of prenatal and/or postnatal lead exposure on early cognitive development among selected group of children from birth to 2 years of age. During the first stage of this study (between March and July 2004), we measured lead levels in 653 umbilical cord blood samples taken from healthy Saudi mothers delivering at King Khalid Hospital, Al-Kharj. This gave a good opportunity to look at the prevalence of increased blood lead levels in umbilical cord blood and to identify risk factors for prenatal lead exposure. The mean cord lead levels were 2.21 +/- 1.691 g/dl in the range of 0.284-17.276 mu g/dl. Only 1.23% of the newborns had blood lead levels >10 mu g/dl, the Center for Disease Control level of concern. To investigate risk factors affecting cord blood lead levels, only subjects with lead levels above the 75th percentile (2.475 mu g/dl) were selected in the multiple regression models. We observed that cord blood lead levels were significantly influenced by maternal age, the location of residence and intake of prenatal supplements. Controlling for newborns head circumferences confounders, it was found that cord blood lead levels were significantly and negatively associated with newborns head circumference (beta = -0.158, p = 0.036). The negative association was seen between intake of prenatal supplements and cord blood lead levels emphasizing the role of prenatal supplementations during pregnancy. The significant reductions in newborns, head circumferences due to lead exposure may have serious implications for their future performance and achievement. This study reveals that even at low prenatal lead exposure, all possible measures to inspect lead sources in our environment and reduce lead exposure should be taken.