Prenatal maternal stress in relation to the effects of prenatal lead exposure on toddler cognitive development |
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| Institution: | 1. National Council of Science and Technology, Avenida Insurgentes Sur 1582, Benito Juárez, Crédito Constructor, 03940 Ciudad de México, D.F., México;2. National Institute of Public Health, Universidad No. 655 Colonia Santa María, Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, México;3. National Institute of Perinatology, Calle Montes Urales #800, Miguel Hidalgo, Lomas Virreyes, 11000 Ciudad de México, D.F., México;4. Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States;5. Department Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States;6. Department of Pediatrics, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, United States;7. Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, United States;1. General Systems Division, Centre for Addiction and Mental Health, University of Toronto, 33 Russel St., room 1071, Toronto ON M5S 2S1, Canada;2. Geriatric Psychiatry Division, Centre for Addiction and Mental Health, 80 Workman Way, 6th Floor, Toronto ON M6J 1H4, Canada;3. Office Room BF12, Oakfield House, Oakfield Grove, Clifton BS8 2BN, Bristol, UK;4. Developmental Psychology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol BS8 2BN,UK;5. Psychiatric Epidemiology, Office BF11, Oakfield House, Oakfield Grove, Clifton, Bristol BS8 2BN, UK;6. Division of Psychiatry, University College London, London W1T 7NF, UK Department of Psychiatry, University of Ioannina School of Medicine, Ioannina 45110, Greece;7. Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Office Room BG6a, Oakfield House, Oakfield Grove, Clifton, Bristol BS8 2BN, UK |
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| Abstract: | ObjectiveTo evaluate the effects of maternal lead exposure during pregnancy on toddler cognitive development and the potential effect modification by maternal stress.MethodsWe conducted a prospective birth-cohort study in Shanghai from 2010 to 2012 and investigated 225 mother-infant pairs. The mothers were recruited in mid-to-late pregnancy and children were followed up until 24–36 months old. A self-administered Symptom Checklist-90-Revised Scale (SCL-90-R) was used to assess maternal emotional stress during pregnancy. Maternal whole blood lead levels were measured during gestational weeks 28–36. The toddlers’ cognitive levels were assessed using the Gesell Development Scale. Multiple linear regression models were established to explore the main effects of prenatal lead exposure on toddlers’ cognitive abilities and the modifying effects of maternal stress. Covariate information was collected through interviews, questionnaires and medical records.ResultsThe mean maternal blood lead concentration was 3.30 (95%CI: 3.05, 3.57) μg/dL. After adjusting for relevant confounders, no significant associations of maternal blood lead concentrations with toddlers' cognitive levels were observed in all five domains of the Gesell scale (P > 0.05). However, the interaction between prenatal maternal blood lead and stress was significant in the domains of adaptive behavior, language and social behavior. When stratified by maternal stress levels, compared with non-significant associations (P > 0.05) among low (P1-P75) prenatal stress group, adverse associations between maternal blood lead concentrations (log10-transformed) and toddlers’ cognitive levels were observed among high (P75-P100) prenatal stress group in the domains of language (β = ?33.82, 95%CI: ?60.04, ?7.59), social behavior (β = ?41.00, 95%CI: ?63.11, ?18.89) and adaptive behavior (β = ?17.93, 95%CI: ?35.83, ?0.03).ConclusionPrenatal maternal stress may exacerbate the deleterious effects of prenatal exposure to lead on toddler cognitive development. |
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| Keywords: | Prenatal exposure Lead Maternal stress Toddler Interaction effect Cognitive level |
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