Concentrations of lead in maternal blood,cord blood,and breast milk.

Lead concentrations in maternal blood, umbilical cord blood, and breast milk from 114 women who were not occupationally exposed to lead were determined by graphite atomic absorption spectrophotometry. The mean concentrations of lead in maternal blood, umbilical cord blood and breast milk were 0.7, 0.55, and 0.23 mumol/l, respectively. A significant correlation was observed between maternal and umbilical cord blood (r = 0.63). A lower correlation was noted between maternal blood and breast milk (r = 0.29). These results suggest that lead freely crosses the placental barrier from mother to fetus and the transfer of this heavy metal from maternal tissues to breast milk is possible, but the metabolic mechanisms are more complicated. In addition, a longitudinal study was conducted of concentrations of lead in breast milk in nine lactating women. Results suggested no significant change in the content of lead in breast milk during early lactation.     

Serum zinc and copper levels in the maternal blood and cord blood of neonates

Estimation of serum zinc and copper in the maternal blood and cord blood of neonates was carried out to correlate the trace metals in the neonates and their mothers in relation to gestational age and birth weight. Sixty-five healthy neonates, both term and preterm and their mothers were selected. This cross sectional study was done at Azimpur Maternity Centre, Dhaka Medical College Hospital and Chemistry Division, Atomic Energy Centre, Dhaka, Bangladesh from July 1997 to June 1998. The estimation of trace metals was carried out by Atomic Absorption Spectrophotometry (AAS). The mean serum zinc levels in the maternal blood and cord blood were 0.47 ± 0.24 μg/ml and 0.85 ± 0.33 μg/ml respectively and the mean copper levels in the maternal blood and cord blood were 1.37 ± 0.62 μg/ml and 0.31 ± 0.32 μg/ml respectively. Cord blood zinc level was significantly higher and cord blood copper level was significantly lower than the corresponding maternal blood levels. There was no significant correlation between gestational age and serum zinc levels in the cord or maternal blood. But significant inverse correlation was found between gestational age and serum levels of copper in the maternal and cord blood.     

Ghrelin and adiponectin levels in colostrum,cord blood and maternal serum

Background: Ghrelin and adiponectin, which are considered to take part in the regulation of energy metabolism, have been found in breast milk and cord blood. The aims of this study were to determine ghrelin and adiponectin levels in colostrum, cord blood and maternal serum and to investigate the correlations between colostrum and cord blood levels of these peptides and the anthropometry of newborn infants and their mothers. Methods: Total ghrelin (TGHR), free ghrelin (FGHR) and adiponectin levels were studied in colostrum and the serum samples of 25 healthy lactating women and the cord blood of their healthy full‐term infants. Results: No significant differences could be found among TGHR and adiponectin levels in colostrum, cord blood and maternal serum. The median FGHR level in colostrum was significantly higher than that of maternal serum and cord blood. The colostrum TGHR was negatively correlated with body mass index (BMI) and weight of the infants at birth. TGHR and FGHR levels in colostrum were found to be positively correlated with those of maternal TGHR and FGHR concentrations, respectively. Adiponectin levels in colostrum were not correlated with BMI or birthweight of the infants or BMI of the mothers. Conclusion: These findings suggest that the source of ghrelin in breast milk is probably both breast tissue itself and the serum of the mother. Ghrelin in colostrum seems to be related to the anthropometry of infants even at birth, unlike adiponectin.     

Child health and environmental pollution in the Aral Sea region in Kazakhstan.

Environmental pollutants, which may occur in breast milk and in various food products and drinking water, and which are also transferred to the foetus, constitute a severe threat to the health of infants and children. Among such compounds, various organochlorines, such as pesticides for the control of parasites (DDTs, HCHs), and products of industry and agriculture, such as dioxins and dioxin-like compounds (PCBs), are much discussed, in addition to organic mercury and heavy metals, such as lead and cadmium. The consequences of acute exposure to PCB have been documented in Japan following the ingestion of rice oil contaminated by PCBs. In Sweden birthweight has been found to be reduced and the perinatal mortality rate higher than expected in regions with high consumption of fatty fish from the Baltic Sea. In addition, from studies around Lake Michigan, it has been shown that children who have been exposed to PCBs in utero have retarded cognitive development. In the Aral Sea basin in Central Asia people have been subjected to long-term exposure to various pesticides, which have been distributed over the cotton fields in huge quantities. Organochlorines are resistant to breakdown in nature, thus they enter the food chain, eventually entering the human diet, and they may also be inhaled from dust. Such compounds accumulate in the foetus by placental transport and continue to do so postnatally if the infants are breastfed, as they may be present in high concentrations in human milk. The health of children living in the Aral Sea region is reported to be poor, with high morbidity and mortality and a high rate of chronic diseases and retarded mental and physical development. However, in addition to being subjected to environmental pollution, these children also suffer from health hazards related to poverty. Through epidemiological studies it may be possible to obtain information about to what extent exposure to environmental pollution from organochlorines contributes to the poor health of people living in the Aral Sea region.     

Transfer of antibodies across the placenta and in breast milk from mothers on intravenous immunoglobulin

We studied the levels of immunoglobulins in colostrum, milk and sera from two common variable immunodeficiency (CVID) mothers (M1 and M2), and in sera from their newborn infants. During pregnancy they continued intravenous immunoglobulin therapy (IVIG). Antibody levels from maternal and cord blood collected at delivery and colostrum and milk, collected on the 3rd and 7th post‐partum days, respectively, were analyzed. Although cord/maternal blood ratios of total immunoglobulins and subclasses, as well as specific antibodies differed between M1 and M2, both showed good placental transfer of anti‐protein and anti‐polysaccharide antibodies, despite lower cord/maternal blood ratios in M2. Anti‐Streptococcus pneumoniae antibody avidity indexes were similar between paired maternal and cord serum. Both mothers’ colostrum and milk samples showed only traces of IgA, and IgM and IgG levels in colostrum were within normal range in M1, whereas M2 presented elevated IgG and low IgM levels, when compared with healthy mothers. The study of colostrum and milk activity showed that they strongly inhibited enteropathogenic Escherichia coli adhesion in vitro. CVID patients must be informed about the relevance of regular IVIG administration during pregnancy, not only for their own health but also for their immune immature offspring. Breast‐feeding should be encouraged as colostra from these CVID patients strongly inhibited E. coli adhesion to human epithelial cells thus providing immunological protection plus nutritional and psychological benefits for the infant.     

Clinical laboratory manifestations of exposure to background levels of dioxins in the perinatal period

Pluim HJ, Koppe JG, Olie K, van der Slikke JW, Slot PC, van Boxtel CJ. Clinical laboratory manifestations of exposure to background levels of dioxins in the perinatal period. Acta Pædiatr 1994;83:583–7. Stockholm. ISSN 0803–5253
The effects of exposure to low levels of dioxins in infants (intrauterine and via breast milk) were studied. In a group of 35 babies, specially selected, laboratory tests were performed in cord blood and in blood sampled at 7 days and 11 weeks of age. The outcome of these laboratory tests was related to dioxin concentrations in milk fat and cumulative dioxin intake. At 11 weeks of age, alanine aminotransferase and aspartate aminotransferase activities in plasma were significantly related to cumulative dioxin intake. A significant negative relation was found between platelet count and cumulative dioxin intake. The results of this study suggest that exposure to background levels of dioxins, both intrauterine and via breast milk, may have effects in newborns.     

Fatty acid compositions of colostrum,cord blood,maternal blood and major infant formulas in Japan

Lipid profiles in colostrum, cord blood, maternal blood and major infant formulas in Japan were analyzed. In the first part of the study, colostrum obtained from 36 normal delivery women and six kinds of infant formulas provided by three major milk companies were analyzed for their fatty acid composition using capillary gas-lipid chromatography. Although enriched with docosahexaenoic acid (DHA), the percent composition of DHA in the six infant formulas (0.15–0.21%) was significantly lower than that in the colostrum (1.1 ± 0.54). Arachidonic acid (AA) and eicosapentaenoic acid (EPA) were present in the colostrum but not detectable in the infant formulas. It is recommended that although the exact amount of specific fatty acids needed in the infant diet was not completely known, to be as close as possible to natural breast milk, the level of DHA, EPA and AA should be raised in the infant formulas. In the second part of the study, 19 pairs of maternal and cord blood were analyzed for their lipid profile. All samples were from normal vaginal delivery. The measurement of cholesterol, triglycerides, phospholipids and free fatty acids was performed with commercially available enzymatic methods on an automated discrete random access analyzer. Total fatty acid was determined as described in the first part of the study. The results were analyzed with Spearman's rank correlation coefficient. No correlation could be found between maternal and fetal concentrations of cholesterol, triglycerides, phospholipids or total fatty acids. Correlation could be found in non-esterified fatty acids, in palmitic acids, and oleic acid levels. It was concluded that the lipid transport and metabolism in the fetal-placenta unit is complex and further delicate investigation is required.     

Neurological condition in 42-month-old children in relation to pre- and postnatal exposure to polychlorinated biphenyls and dioxins.

Adverse neurological effects of exposure to PCBs have been found up to 18 months of age. Now we report on the effect of pre- and postnatal exposure to PCBs and dioxins on the neurological condition at 42 months of age. For this purpose, PCB levels were determined in cord and maternal plasma, and used as a measure of prenatal exposure. Breast milk was analyzed for PCBs and dioxins. In addition, PCBs were determined in plasma sampled from the child at 42 months of age. We evaluated the neurological condition of 394 children using the Touwen/Hempel method. After adjustment for covariates, neither prenatal PCB exposure nor postnatal exposure to PCBs and dioxins was found to be related to the neurological condition at 42 months of age.     

Distribution of zinc and copper in maternal and cord blood at delivery

For 17 normal births, the concentrations of trace metals (zinc and copper) and related metalloenzymes, i.e., carbonic anhydrase isoenzymes (CA-I and CA-II) and Cu2Zn2 superoxide dismutase (SOD1) were simultaneously determined in maternal and cord blood at delivery. Eleven healthy nonpregnant women served as controls. CA-I concentration in maternal erythrocytes was higher than in controls (p less than 0.05), whereas the concentrations of both CA isoenzymes in cord erythrocytes were in the range of one seventh to one ninth of those in controls. On the other hand, the erythrocyte SOD1 concentration was constant. A very low total zinc concentration was noted in cord erythrocytes, and this was due to the low concentrations of both CA isoenzymes. Total copper concentration in maternal erythrocytes was significantly lower than in controls (p less than 0.05); in contrast, that in cord erythrocytes was significantly higher than in controls (p less than 0.05). Thus, variations in erythrocyte copper concentrations are due to changes in other forms of copper (not SOD1-derived). Copper concentration in maternal plasma was about three times higher than in controls, while copper concentration in cord plasma was less half of that in control plasma. Conversely, zinc concentration in cord plasma was significantly higher than in controls (p less than 0.05). The concentrations of these metals in maternal erythrocytes and plasma were significantly different from the respective concentrations in cord erythrocytes and plasma. Likewise, the concentrations of these metals in maternal and cord erythrocytes contrasted with the corresponding concentrations in their plasma.     

Chlorinated contaminants, growth and thyroid function in schoolchildren from the Aral Sea region in Kazakhstan

It has been shown by others that offspring of mothers who had been exposed to dioxins and polychlorinated biphenyls (PCBs) during pregnancy have elevated plasma levels of thyroid-stimulating hormone (TSH) for at least 3 months after birth and reduced plasma levels of free and total thyroxine during the second week after birth. As elevated levels of dioxins and PCBs can thus alter thyroid hormone status, the relation between the levels of some polychlorinated organic compounds in the blood lipids and growth and thyroid hormone status was studied in 12 hospitalized schoolchildren from the Aral Sea region known to have high exposure to such compounds. Their level of PCBs was two to four times higher than in healthy Stockholm children. Their height was found to be lower than in healthy Swedish children of the same age mean (SDS -0.52) and the body mass index (BMI) was inversely correlated to the total concentrations of PCBs and dichlorodiphenyltrichloroethane (DDT) and its metabolite dichlorophenyldichloroethylene (DDE) in the blood lipids. As the levels of insulin-like growth factor-1 were reduced to the same extent as the BMI it seems likely that PCBs and DDT cause malnutrition as a result of malabsorption. None of the children had any impairment of thyroid function, as revealed by the plasma levels of TSH and thyroxine. Although the concentrations of β-hexachlorocyclohexane (β-HCH) and DDE were extremely high in some of the children there was no relation between thyroid hormone status and the blood lipid levels of PCBs, hexachlorocyclohexane and DDT. However, the concentration of dioxins was not analysed.     

The significance of PCDD's/PCDF's (dioxins) in pediatrics

No epidemiological data are available up to now which reveal adverse effects induced by dioxins during an exposure through breast milk. Furthermore, very few data on the concentration of PCDDs/PCDFs in the newborn and during the first year of life have been published. Of all PCDDs/PCDFs, the substance with the highest toxicity is 2,3,7,8-tetrachlorodibenzo-p-dioxin. However, in the environment this congener is often only a minor component. A sensitive biological effect triggered by TCDD is the enzyme induction of hepatic monooxygenases. Using a 14CO2-breath-test the apparent enzyme induction by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) of the metabolic conversion of [3-methyl14C]-caffeine was studied during the perinatal period in Wistar rats and in a non-human-primate (marmoset, Callithrix jacchus). It could be shown that the apparent induction of monooxygenase activity by TCDD in rat offspring as measured with the breath-test, is dose-dependent and mainly achieved by postnatal exposure via mothers' milk. Our data indicate that caffeine is a convenient substrate for studying monooxygenase activities (probably P450 IA-dependent) to be induced by TCDD, and very likely also by other congeners. These results, therefore, may provide the rationale for applying a [13C]-caffeine breath-test in human newborn and infants to analyse possible biological effects induced by TCDD and similar pollutants in breast-fed children. Since PCDDs/PCDFs are pollutants without any benefit, strong efforts should be continued to further reduce the output of dioxins, the human exposure, and thereby also concentrations in human milk.(ABSTRACT TRUNCATED AT 250 WORDS)     

Exposure to hexachlorobenzene during pregnancy increases the risk of overweight in children aged 6 years

Abstract Aim: To determine whether prenatal exposure to hexachlorobenzene (HCB) has potential adverse effects on child's weight and body mass index (BMI) in a general population with no local pollution sources. Methods: Starting from mid 1997, all mothers presenting for antenatal exposure in Menorca were recruited. Subsequently, 482 children were enrolled. HCB was measured in cord blood. Weight and height were measured at birth and at age 6.5 years. Results: Children with HCB levels higher than 1.03 ng/mL in cord blood were 1.14 kg (0.38) heavier and had a higher BMI (beta= 0.80 (0.34)) than children with HCB levels lower than 0.46 ng/mL. No statistically significant associations were found in height. Children in the higher exposure group of HCB had an increased risk of 2.5 and 3.0 of being overweight and obese. Children from normalweight mothers also presented an increased risk of having higher BMI with increasing concentrations of HCB in cord serum. Conclusion: Prenatal exposure to HCB is associated with an increase in BMI and weight at age 6.5 years. Further studies with larger samples and longer follow-up are needed to confirm these results.     

Superoxide dismutase activity in the maternal and cord blood.

Superoxide dismutase (SOD) activity was measured in the maternal and cord blood by the modified method of Beauchamp and Fridovich, using a carbonate-buffered (pH 10.2) xanthine-xanthine oxidase system. No great differences between maternal and cord blood in erythrocyte SOD levels were observed, with the exception of whole blood; namely, washed RBC showed a SOD activity of a fairly high level, which was comparable to the activities of crude SOD, but showed no difference between them. In contrast, the SOD activity in the maternal whole blood was significantly lower than that in the cord blood. In measuring SOD activity, the serum factor has a great effect, and serum contains a substance that inhibits NBT reduction. Only one band of SOD has been detected which shows identical Rf values both in maternal and cord blood by polyacrylamide-gel electrophoresis.     

Lead concentrations in maternal and cord blood in women users of surma eye cosmetics

A prospective study was undertaken to analyse the lead concentrations in maternal and cord blood of 71 pregnant Arab women at term who used eye cosmetics, particularly "surma". A total of 64 mothers (90%) used eye cosmetics throughout pregnancy, and, of these, 45% used surma. The lead content of the cosmetics available in the market was found to vary between zero and 88%. The mean lead concentrations in all blood samples were higher than the accepted natural levels of 0.001 mumol/l, but lower than the subtoxic level of 1.9 mumol/l. The mean lead concentration of all samples was lower than the subtoxic level of 1.9 mumol/l but higher than that quoted in the literature and suggested to be a natural level (0.001 mumol/l). This indicates that other lead pollutants may be involved. Lead concentrations in maternal and cord blood correlated well, but did not show any significant difference between surma and non-surma users. None of the newborns showed apparent congenital anomalies and their birthweights were comparable to average Saudi birthweights.     

Association of hexachlorobenzene and other organochlorine compounds with anthropometric measures at birth

The aim of the present study was to assess the association of prenatal exposure to hexachlorobenzene (HCB) and other organochlorine compounds with anthropometric measures at birth. A total of 98 mother-infant pairs (83% of all children born in a specific area polluted with HCB in the period 1997-1999) were recruited after giving written consent. Levels of organochlorine compounds were measured in 72 maternal serum samples at delivery and in 70 cord serum samples. Of the organochlorines measured in cord serum, median levels of HCB were higher than for the other compounds (median of HCB = 1.13 ng/mL, median of dichlorodiphenyl dichloroethylene = 0.85 ng/mL, and median of total polychlorinated biphenyls = 0.27 ng/mL). Premature newborns had higher concentrations of HCB [1.94 ng/mL among prematures versus 1.10 among nonprematures (p < 0.10)], dichlorodiphenyl dichloroethylene [2.40 versus 0.80 (p < 0.05)], and polychlorinated biphenyls in cord serum [0.70 versus 0.14 (p < 0.10)]. Those infants born with a small length for gestational age had higher levels of HCB in cord serum than those with an adequate length for gestational age [1.64 ng/mL versus 1.00 ng/mL (p < 0.05)]. In addition, HCB cord serum levels were negatively associated in a dose-response way with crown-heel length [for each doubling of the dose there was a decrease of 0.46 (SE = 0.22) cm] after adjusting for smoking, gestational age, and other organochlorine compounds. The associations of dichlorodiphenyl dichloroethylene and polychlorinated biphenyls with length were not significant. The results did not vary when stratified for prematurity. These data suggest that HCB reduces intrauterine physical linear growth.     

Helicobacter pylori-specific immune response in maternal serum, cord blood, and human milk among mothers with and without current Helicobacter pylori infection

We assessed the patterns of Helicobacter pylori (H. pylori) specific maternal antibodies in maternal serum, cord blood, and milk, which might play a role in prevention of H. pylori infection because transferred to the infant. Between November 2000 and November 2001, mothers were recruited after delivery of their offspring. H. pylori infection status was determined by 13C-urea breath test (UBT). Specific H. pylori antibody profiles were analysed using commercial H. pylori-specific enzyme-linked immunosorbent assay and Western blots. Among 898 mothers, 23% had a current H. pylori infection. Median H. pylori IgG antibody titers in serum and cord blood of UBT-positive mothers were 23.8 U/mL and 24.0 U/mL, respectively. Whereas prevalences of H. pylori-specific antibodies in serum of UBT-negative mothers were clearly lower than those among UBT-positive mothers, patterns of H. pylori-specific IgA antibodies in milk were similar among UBT-positive and UBT-negative mothers. Neonates born from H. pylori-infected women are provided with large amounts of transplacentally transferred specific IgG H. pylori antibodies. Breast-fed neonates are additionally provided with specific IgA antibodies in human milk. Notably, the latter may also be activated if exposure of the mother to H. pylori might have been long time ago and been cleared in the meantime.     

Association between serum adipocytokine and cholesterol levels in cord blood

Background: Serum leptin and adiponectin levels are strongly associated with lipid metabolism in adults. These adipocytokines play a role in intrauterine and postnatal growth but the association between cord blood levels of these adipocytokines and cholesterol at birth remains unclear. Methods: The study involved 52 appropriate‐for‐gestational‐age (AGA) infants (25 male, 27 female, 37–41 weeks of gestational age) born at Keiai Hospital without any maternal complications. Cord blood concentrations of leptin, total adiponectin, total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), other neonatal characteristics, and maternal factors were assessed to investigate the association between cord blood leptin or adiponectin levels and cholesterol levels. Results: Cord blood leptin levels were significantly higher in girls. Simple regression analysis indicated that cord blood leptin levels were significantly associated with birthweight, gestational age, birthweight SD score, body mass index (BMI), ponderal index, LDL‐C, and TC; but total adiponectin levels were not significantly associated with any neonatal characteristics or maternal factors. A multiple regression analysis indicated that cord leptin levels were significantly associated with BMI (β= 0.407, P= 0.001), LDL‐C (β=?0.345, P= 0.004), and infant's gender (β=?0.332, P= 0.006); adiponectin levels were significantly associated with only gestational age (β= 0.279, P= 0.047). Conclusion: Cord leptin level is significantly associated with cord cholesterol level at birth, anthropometry, and infant gender. The present study suggests that cord blood leptin may be a key hormone for controlling fetal lipid metabolism.     

孕期重金属元素和微量元素水平与子代先天性心脏病相关性的前瞻性队列研究北大核心CSCD

目的探讨孕期重金属元素和微量元素水平与子代先天性心脏病(简称先心病)的相关性,并建立孕期重金属元素和微量元素水平与子代先心病发生概率的预测模型。方法基于2010~2012年在甘肃省妇幼保健院开展的前瞻性出生队列研究,采用巢式病例对照研究方法,对14359名孕妇进行随访观察,以随访观察期内其子代确诊先心病的97名孕妇为先心病组,从队列人群中以1∶2的比例匹配194名子代未患先心病的孕妇为对照组。采用电感耦合等离子体质谱测定孕母孕20~24周时血液样本和胎儿脐血样本中的重金属元素和微量元素水平。采用多因素logistic回归分析评估重金属元素和微量元素水平与子代先心病之间的关联,并构建孕期重金属元素和微量元素水平与子代先心病发生概率的列线图预测模型。结果与对照组相比,先心病组孕妇血液样本中铝(aluminium,Al)、钠(natrium,Na)、钙(calcium,Ca)、钛(titanium,Ti)、硒(selenium,Se)、锶(strontium,Sr)、锡(stannum,Sn)、锑(stibium,Sb)、钡(barium,Ba)、钍(thorium,Th)水平较高,差异有统计学意义(P<0.05);先心病组脐血样本中Al、锌(zinc,Zn)、镁(magnesium,Mg)、钾(kalium,K)、Ca、Ti、铬(chromium,Cr)、铜(copper,Cu)、砷(arsenic,As)、Se、Sr、银(argentum,Ag)、镉(cadmium,Cd)、Sn、铅(plumbum,Pb)水平显著高于对照组(P<0.05)。多因素logistic回归分析显示,孕妇血液样本中Sb水平升高,其子代患先心病的风险显著增加(^(a)OR=4.81,P=0.004);而在脐血样本中,高浓度水平的Al(^(a)OR=4.22,P=0.013)、Mg(^(a)OR=8.00,P=0.014)、Pb(^(a)OR=3.82,P=0.049)与先心病的发生风险增加存在关联。孕期重金属元素和微量元素水平与子代先心病的预测模型中纳入的变量有:孕妇血Al、Th、Sb水平和脐血Al、Mg、Pb水平,绘制的列线图预测模型的校正曲线趋近于理想曲线。结论孕期Al、Th、Sb、Mg、Pb水平升高提示子代罹患先心病的风险增加,联合以上指标构建的列线图预测模型可以预测子代先心病的发生概率。     

Effects of prenatal PCB and dioxin background exposure on cognitive and motor abilities in Dutch children at school age

OBJECTIVE: Our purpose was to evaluate whether effects of exposure to environmental levels of PCBs and dioxins on development in the Dutch cohort persist until school age. STUDY DESIGN: In the Dutch PCB/dioxin study, cognitive and motor abilities were assessed with the McCarthy Scales of Children's Abilities in children at school age. During infancy, half of this population was fully breast-fed for at least > or = 6 weeks and the other half formula fed. Prenatal exposure to PCBs was defined as the sum of PCB118, 138, 153, and 180 in maternal and cord plasma. In breast milk, additional measurements of 17 dioxins, 6 dioxin-like PCBs, and 20 nondioxin-like PCBs were done. RESULTS: Negative effects of prenatal PCB and dioxin exposure on cognitive and motor abilities were seen when parental and home characteristics were less optimal. These effects were not measurable in children raised in more optimal environments. CONCLUSIONS: Neurotoxic effects of prenatal PCB and dioxin exposure may persist into school age, resulting in subtle cognitive and motor developmental delays. More optimal intellectual stimulation provided by a more advantageous parental and home environment may counteract these effects of prenatal exposure to PCBs and dioxins on cognitive and motor abilities.