Stress, Lead, Iron Deficiency and Neurodevelopment

社会压力、缺铁性贫血和铅暴露都是穷人的环境风险因素。 幼儿的神经发育。所有这三个因素在贫困社区都非常普遍，无论是在 墨西哥或美国。几乎没有关于慢性社会压力和人类 神经发育。此外，以前对儿童发育和神经毒物的研究通常 分析了社会压力的协变量标记作为神经发育的独立预测因素；因此，只有 在他们的数据分析中认为社会因素是潜在的混杂因素。有生物学上的原因 相信压力会加剧缺铁性贫血和铅中毒的毒性。如果是这样，那么 理解这种关系可能是设计有效的公共卫生干预措施的关键，旨在 改善神经发育，并可能解释预防/治疗方案缺乏有效性的原因 铅中毒和缺铁。需要进行大样本量的前瞻性队列研究 联合应激/缺铁性贫血和联合应激/铅的潜在乘数效应 在预测婴儿发育方面的暴露。 这份重新提交的报告包含了120人中关于压力-铅/压力-贫血相互作用的先导研究的新数据。 自先前申请以来进行的母婴配对，证明了研究的可行性和证据 对于假设的相互作用。在这项建议中，我们将测量母亲的压力水平，婴儿的铁 居住在墨西哥城和墨西哥的一对母婴中的缺乏性贫血和铅暴露 纵向测量母体压力、铁储备、铅暴露、唾液皮质醇和神经发育 从产前开始，产后延长3年。这个项目将决定独立的效果 产前和产后母亲应激在预测婴儿发育中的作用及其多重联合效应 母亲应激/缺铁和母亲应激/铅中毒在预测婴儿发育中的作用。

Social stressors, iron deficiency anemia, and lead exposure are all environmental risk factors for poor neurodevelopment in young children. All three factors are highly prevalent in poor communities, whether in Mexico or the U.S. There are scant human epidemiologic studies on chronic social stress and human neurodevelopment. In addition, previous studies of child development and neurotoxicants have typically analyzed covariate markers of social stress as independent predictors of neurodevelopment; and thus, only considered social factors as potential confounders in their data analysis. There are biological reasons to believe that stress potentiates the toxicity of iron deficiency anemia and lead poisoning. If so, then understanding this relationship may be the key to designing effective public health interventions designed to improve neurodevelopment and may explain the lack of effectiveness of prevention/treatment regimens for lead poisoning and iron deficiency. A prospective cohort study with a large sample size is needed to address the potential multiplicative effects of combined stress/iron deficiency anemia and combined stress/lead exposure in predicting infant development. This resubmission includes new data from a pilot study of stress-lead/stress-anemia interactions in 120 mother infant pairs conducted since the prior application, which demonstrates study feasibility and evidence for the hypothesized interactions. In this proposal we will measure maternal stress levels, infant iron deficiency anemia and lead exposure in a cohort of mother-infant pairs living in Mexico City and longitudinally measure maternal stress, iron stores, lead exposure, salivary cortisol and neurodevelopment beginning pre-natally and extending 3 years post-partum. This project will determine the independent effect of pre- and post-partum maternal stress in predicting infant development, and the multiplicative joint effects of maternal stress/iron deficiency and maternal stress/lead poisoning in predicting infant development.