RESUMO
BACKGROUND: Prenatal and early childhood lead exposures have been associated with reduced weight in infants and young children, while studies that have examined such associations in children during peripubescence are rare. OBJECTIVES: We investigated the associations of prenatal and early-life exposure to lead with indices of adiposity in peripubertal children living in Mexico City. METHODS: Maternal bone lead (as a proxy for cumulative fetal exposure) was assessed at 1 month postpartum. Blood samples were obtained from children annually from 1 to 4 years. Multivariable linear regression models were used to examine the association between each lead biomarker and BMI z-score, waist circumference, sum of skinfolds and body fat percentage in 248 children aged 8-16 years. RESULTS: After adjusting for covariates, maternal patella lead was associated with lower child BMI z-score (ßâ¯=â¯-0.02, 95% CI: 0.03, -0.01, pâ¯=â¯0.004), waist circumference (ßâ¯=â¯-0.12â¯cm, 95% CI: 0.22, -0.03, pâ¯=â¯0.01), sum of skinfolds (ßâ¯=â¯-0.29â¯mm, 95% CI: 0.50, -0.08, pâ¯=â¯0.007) and body fat percentage (ßâ¯=â¯-0.09%, 95% CI: 0.17, -0.01, pâ¯=â¯0.03). No significant associations were detected from the postnatal exposure period. CONCLUSIONS: We observed a significant and inverse association of prenatal lead exposure with body composition in Mexican children, suggesting the potential role of early lead exposure in the fetal programming of child growth. Further research on the biological mechanisms underlying these associations is needed.
Assuntos
Adiposidade , Poluentes Ambientais/análise , Chumbo/análise , Exposição Materna , Efeitos Tardios da Exposição Pré-Natal , Adolescente , Adulto , Monitoramento Biológico , Criança , Cidades , Feminino , Humanos , Masculino , Troca Materno-Fetal , México , Patela/química , Gravidez , Tíbia/química , Adulto JovemRESUMO
OBJECTIVE: To compare self-report and physician assessments of sexual maturation against serum hormone markers to evaluate the hypothesis that the validity of self-assessed sexual maturation is underestimated in traditional validation studies. STUDY DESIGN: We adapted a self-assessment instrument that 248 Mexican children and adolescents, aged 8-13 years, completed. The participants were examined by a trained pediatrician and provided fasting blood samples for measurement of reproductive hormones (eg, testosterone, estradiol, sex hormone-binding globulin, inhibin B) and other hormones (eg, C-peptide, insulin-like growth factor 1, leptin, dehydroepiandrosterone sulfate) known to change during adolescence. Spearman correlations (r) were calculated among the average rank of all hormones and self-assessed and physician-assessed Tanner stage. The method of triads was used to assess the validity of self-reports by estimating correlations between self-assessments and true but unobservable sexual maturation based on all available data. Bootstrap sampling was used to construct 95% CIs. RESULTS: The validity of self-reported genitalia staging for boys was modest (r = 0.50; 95% CI, 0.31-0.65) and inferior to physician assessment (r = 0.75; 95% CI, 0.56-0.93). Breast stage was well reported (r = 0.89; 95% CI, 0.79-0.97) and superior to physician assessment (r = 0.80; 95% CI, 0.70-0.89). Pubic hair stage reported by boys (r = 0.91; 95% CI, 0.79-0.99) and girls (r = 0.99; 95% CI, 0.96-1.00) was superior to physician assessment (r = 0.79; 95% CI, 0.57-0.97 and r = 0.91; 95% CI, 0.83-0.97, respectively). CONCLUSION: Self-assessment can be validly used in epidemiologic studies for evaluating sexual maturation in children; however, physician assessment may be necessary for accurate assessment of genitalia development in boys.
Assuntos
Hormônios Esteroides Gonadais/sangue , Autoavaliação (Psicologia) , Maturidade Sexual , Adolescente , Desenvolvimento do Adolescente , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Puberdade , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Previous studies suggest that blood lead levels are positively associated with attention deficit/hyperactivity disorder (ADHD) and ADHD-symptoms in children. However, the associations between lead exposure and ADHD subtypes are inconsistent and understudied. OBJECTIVE: The objective of this study was to explore the association of low-level concurrent lead exposure with subtypes of ADHD symptoms in 578 Mexican children 6-13 years of age. METHODS: We measured concurrent blood lead levels using inductively coupled plasma mass spectrometry (ICPMS). We administered the Conners' Rating Scales-Revised (CRS-R) to mothers to evaluate their children's ADHD symptoms. We used imputation to fill missing values in blood lead levels and used segmented regression models adjusted for relevant covariates to model the nonlinear relationship between blood lead and ADHD symptoms. RESULTS: Mean ± SD blood lead levels were 3.4 ± 2.9 µg/dL. In adjusted models, a 1-µg/dL increase in blood lead was positively associated with Hyperactivity and Restless-Impulsivity scores on the CRS-R scale and Hyperactivity-Impulsivity scores on the CRS-R scale of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, but only in children with blood lead level ≤ 5 µg/dL. Blood lead was not associated with Inattentive symptoms or overall ADHD behavior. CONCLUSIONS: In this population of Mexican children, current blood lead level among children with low exposure (≤ 5 µg/dL) was positively associated with hyperactive/impulsive behaviors, but not with inattentiveness. These results add to the existing evidence of lead-associated neurodevelopmental deficits at low levels of exposure. CITATION: Huang S, Hu H, Sánchez BN, Peterson KE, Ettinger AS, Lamadrid-Figueroa H, Schnaas L, Mercado-García A, Wright RO, Basu N, Cantonwine DE, Hernández-Avila M, Téllez-Rojo MM. 2016. Childhood blood lead levels and symptoms of attention deficit hyperactivity disorder (ADHD): a cross-sectional study of Mexican children. Environ Health Perspect 124:868-874; http://dx.doi.org/10.1289/ehp.1510067.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Poluentes Ambientais/sangue , Chumbo/sangue , Adolescente , Criança , Feminino , Humanos , Masculino , México/epidemiologiaRESUMO
BACKGROUND: Increasing scientific evidence suggests that exposure to phthalates during pregnancy may be associated with an elevated risk of adverse reproductive outcomes such as preterm birth. Maternal endocrine disruption across pregnancy may be one pathway mediating some of these relationships. We investigated whether urinary phthalate metabolites were associated with maternal serum thyroid (free thyroxine [FT4], free triiodothyronine [FT3], and thyroid-stimulating hormone [TSH]), and sex (estradiol, progesterone, and sex hormone-binding globulin [SHBG]) hormone levels at multiple time points during pregnancy. METHODS: Preliminary data (n = 106) were obtained from an ongoing prospective birth cohort in Northern Puerto Rico. We collected urine and serum sample at the first and third study visits that occurred at 18 +/- 2 and 26 +/- 2 weeks of gestation, respectively. To explore the longitudinal relationships between urinary phthalate metabolites and serum thyroid and sex hormone concentrations, we used linear mixed models (LMMs) adjusted for prepregnancy body mass index (BMI) and maternal age. An interaction term was added to each LMM to test whether the effect of urinary phthalate metabolites on serum thyroid and sex hormone levels varied by study visit. In cross-sectional analyses, we stratified BMI- and age-adjusted linear regression models by study visit. RESULTS: In adjusted LMMs, we observed significant inverse associations between mono-3-carboxypropyl phthalate (MCPP) and FT3 and between mono-ethyl phthalate (MEP) and progesterone. In cross-sectional analyses by study visit, we detected stronger and statistically significant inverse associations at the third study visit between FT3 and MCPP as well as mono-carboxyisooctyl phthalate (MCOP); also at the third study visit, significant inverse associations were observed between FT4 and metabolites of di-(2-ethylhexyl) phthalate (DEHP). The inverse association between MEP and progesterone was consistent across study visits. CONCLUSIONS: In this group of pregnant women, urinary phthalate metabolites may be associated with altered maternal serum thyroid and sex hormone levels, and the magnitude of these effects may depend on the timing of exposure during gestation.
Assuntos
Hormônios Esteroides Gonadais/sangue , Ácidos Ftálicos/urina , Gravidez/sangue , Gravidez/urina , Hormônios Tireóideos/sangue , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Mães , Ácidos Ftálicos/metabolismo , Projetos Piloto , Porto Rico , Adulto JovemRESUMO
Globally, human exposures to organophosphate (OP) insecticides may pose a significant burden to the health of mothers and their developing fetuses. Unfortunately, relevant data is limited in certain areas of the world concerning sources of exposure to OP insecticides in pregnant populations. To begin to address this gap in information for Puerto Rico, we studied repeated measures of urinary concentrations of 10 OP insecticide metabolites among 54 pregnant women from the northern karst region of the island. We also collected demographic data and self-reported information on the consumption of fruits, vegetables, and legumes in the past 48 h before urine collection and home pest-related issues. We calculated the distributions of the urinary biomarkers and compared them to women of reproductive age from the general U.S. population. We also used statistical models accounting for correlated data to assess within-subject temporal variability of the urinary biomarkers and to identify predictors of exposure. We found that for all but two metabolites (para-nitrophenol [PNP], diethylthiophosphate [DETP]), 50th or 95th percentile urinary concentrations (the metric that was used for comparison was based on the biomarker's detection frequency) of the other eight metabolites (3,5,6-trichloro-2-pyridinol [TCPY], 2-isopropyl-4-methyl-6-hydroxy-pyrimidine, malathion dicarboxylic acid, diethylphosphate, diethyldithiophosphate, dimethylphosphate, dimethylthiophosphate [DMTP], dimethyldithiophosphate) were somewhat lower in our cohort compared with similarly aged women from the continental United States. TCPY, PNP, DETP, and DMTP, which were the only urinary metabolites detected in greater than 50% of the samples, had poor reproducibility (intraclass correlation coefficient range: 0.19-0.28) during pregnancy. Positive predictors of OP insecticide exposure included: age; marital or employment status; consumption of cherries, grape juice, peanuts, peanut butter, or raisins; and residential application of pesticides. Further research is needed to understand what aspects of the predictors identified influence OP insecticide exposure during pregnancy.
Assuntos
Biomarcadores/urina , Inseticidas/urina , Exposição Materna/estatística & dados numéricos , Compostos Organofosforados/urina , Adulto , Feminino , Humanos , Gravidez , Gestantes , Porto RicoRESUMO
BACKGROUND: There are potential adverse health risks to the mother and fetus from exposure to pesticides. Thus, studies of exposure to pesticides among pregnant women are of interest as they will assist with understanding the potential burden of exposure globally, identifying sources of exposure, and designing epidemiology studies. METHODS: We measured urinary concentrations of the insect repellent N-N-diethyl-meta-toluamide (DEET) and two of its metabolites [3-diethyl-carbamoyl benzoic acid (DCBA) and N,N-diethyl-3-hydroxymethylbenzamide (DHMB)], four pyrethroid insecticide metabolites [4-fluoro-3-phenoxybenzoic acid (4-F-3-PBA); 3-phenoxybenzoic acid (3-PBA); trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (trans-DCCA); and cis-3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane carboxylic acid (cis-DBCA)], and two chlorophenoxy herbicides [2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T)] in 54 pregnant women from Puerto Rico at three separate time points (20 ± 2 weeks, 24 ± 2 weeks, and 28 ± 2 weeks of gestation). We calculated the distributions of the biomarker concentrations and compared them to those of women of reproductive age from the general U.S. population where available, and estimated the within-subject temporal variability of these repeated measurements. We also collected questionnaire data on demographics, consumption of select fruits, vegetables, and legumes in the past 48-hr, and pest-related issues, and associations between these variables and biomarker concentrations were examined. RESULTS: We found that 95th percentile urinary concentrations of DEET, 3-PBA, trans-DCCA, and 2,4-D were lower than women of reproductive age on the U.S. mainland, whereas 95th percentile urinary concentrations of 4-F-3-PBA, cis-DBCA, and 2,4,5-T were similar. DCBA, the only urinary biomarker detected in >50% of the samples, showed fair to good reproducibility across pregnancy (intraclass correlation coefficient: 0.60). Women were more likely (p <0.05) to have greater urinary concentrations of pesticide biomarkers if they were less educated (DCBA and trans-DCCA), unemployed (DHMB), or married (2,4-D), had consumed collards or spinach in past 48-hr (2,4-D) or had been using insect repellent since becoming pregnant (DCBA), or were involved with residential applications of pesticides (trans-DCCA). CONCLUSIONS: We identified concentrations and predictors of several pesticides among pregnant women in Puerto Rico. Further research is needed to understand what aspects of the predictors identified lead to greater exposure, and whether exposure during pregnancy is associated with adverse health.
Assuntos
Poluentes Ambientais/urina , Herbicidas/urina , Repelentes de Insetos/urina , Inseticidas/urina , Gravidez/urina , Ácido 2,4,5-Triclorofenoxiacético/urina , Ácido 2,4-Diclorofenoxiacético/urina , Adolescente , Adulto , Biomarcadores/urina , DEET/análogos & derivados , DEET/urina , Monitoramento Ambiental , Feminino , Contaminação de Alimentos/análise , Humanos , Inquéritos Nutricionais , Porto Rico , Piretrinas/urina , Adulto JovemRESUMO
BACKGROUND: Mercury is a global contaminant of concern though little is known about exposures in México. OBJECTIVES: To characterize mercury levels in pregnant women, children, and commonly consumed seafood samples. METHODS: Use resources of the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) birth cohorts to measure total mercury levels in archived samples from 348 pregnant women (blood from three trimesters and cord blood), 825 offspring (blood, hair, and urine) and their mothers (hair), and 91 seafood and canned tuna samples from Mexico City. RESULTS: Maternal blood mercury levels correlated across three trimesters and averaged 3.4 µg/L. Cord blood mercury averaged 4.7 µg/L and correlated with maternal blood from trimester 3 (but not trimesters 1 and 2). In children, blood, hair and urine mercury levels correlated and averaged 1.8 µg/L, 0.6 µg/g, and 0.9 µg/L, respectively. Hair mercury was 0.5 µg/g in mothers and correlated with child's hair. Mean consumption of canned tuna, fresh fish, canned sardine, and shellfish was 3.1, 2.2, 0.5, and 1.0 times per month respectively in pregnant women. Mean mercury content in 7 of 23 seafood species and 5 of 9 canned tuna brands purchased exceeded the U.S. EPA guidance value of 0.3 µg/g. CONCLUSIONS: Mercury exposures in pregnant women and children from Mexico City, via biomarker studies, are generally 3-5 times greater than values reported in population surveys from the U.S., Canada, and elsewhere. In particular, mercury levels in 29-39% of the maternal participants exceeded the biomonitoring guideline associated with the U.S. EPA reference dose for mercury.
Assuntos
Cidades , Exposição Ambiental/análise , Poluentes Ambientais/análise , Contaminação de Alimentos/análise , Mercúrio/análise , Alimentos Marinhos/análise , Animais , Criança , Estudos de Coortes , Monitoramento Ambiental/estatística & dados numéricos , Feminino , Sangue Fetal/química , Cabelo/química , Humanos , Mercúrio/sangue , Mercúrio/urina , México/epidemiologia , Gravidez , Refratometria , Atum/metabolismoRESUMO
Phthalate exposure during pregnancy has been linked to adverse birth outcomes such as preterm birth, and inflammation and oxidative stress may mediate these relationships. In a prospective cohort study of pregnant women recruited early in gestation in Northern Puerto Rico, we investigated the associations between urinary phthalate metabolites and biomarkers of inflammation, including C-reactive protein, IL-1ß, IL-6, IL-10, and TNF-α, and oxidative stress, including 8-hydroxydeoxyguanosine (OHdG) and 8-isoprostane. Inflammation biomarkers were measured in plasma twice during pregnancy (N = 215 measurements, N = 120 subjects), and oxidative stress biomarkers in urine were measured three times (N = 148 measurements, N = 54 subjects) per woman. In adjusted linear mixed models, metabolites of di-2-ethylhexyl phthalate (DEHP) were associated with increased IL-6 and IL-10 but relationships were generally not statistically significant. All phthalates were associated with increases in oxidative stress markers. Relationships with OHdG were significant for DEHP metabolites as well as mono-n-butyl phthalate (MBP) and monoiso-butyl phthalate (MiBP). For 8-isoprostane, associations with nearly all phthalates were statistically significant and the largest effect estimates were observed for MBP and MiBP (49-50% increase in 8-isoprostane with an interquartile range increase in metabolite concentration). These relationships suggest a possible mechanism for phthalate action that may be relevant to a number of adverse health outcomes.
Assuntos
Biomarcadores/urina , Inflamação/urina , Estresse Oxidativo , Ácidos Ftálicos/urina , Adulto , Biomarcadores/sangue , Intervalos de Confiança , Feminino , Humanos , Inflamação/sangue , Modelos Lineares , Ácidos Ftálicos/sangue , Gravidez , Porto Rico , Estatísticas não ParamétricasRESUMO
BACKGROUND: Phthalate contamination exists in the North Coast karst aquifer system in Puerto Rico. In light of potential health impacts associated with phthalate exposure, targeted action for elimination of exposure sources may be warranted, especially for sensitive populations such as pregnant women. However, information on exposure to phthalates from a variety of sources in Puerto Rico is lacking. The objective of this study was to determine concentrations and predictors of urinary phthalate biomarkers measured at multiple times during pregnancy among women living in the Northern karst area of Puerto Rico. METHODS: We recruited 139 pregnant women in Northern Puerto Rico and collected urine samples and questionnaire data at three separate visits (18 ± 2 weeks, 22 ± 2 weeks, and 26 ± 2 weeks of gestation). Urine samples were analyzed for eleven phthalate metabolites: mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-hydroxyhexyl phthalate, mono-2-ethyl-5-oxohexyl phthalate, mono-2-ethyl-5-carboxypentyl phthalate, mono-ethyl phthalate (MEP), mono-n-butyl phthalate, mono-benzyl phthalate, mono-isobutyl phthalate, mono-3-carboxypropyl phthalate (MCPP), mono carboxyisononyl phthalate (MCNP), and mono carboxyisooctyl phthalate (MCOP). RESULTS: Detectable concentrations of phthalate metabolites among pregnant women living in Puerto Rico was prevalent, and metabolite concentrations tended to be higher than or similar to those measured in women of reproductive age from the general US population. Intraclass correlation coefficients ranged from very weak (MCNP; 0.05) to moderate (MEP; 0.44) reproducibility among all phthalate metabolites. We observed significant or suggestive positive associations between urinary phthalate metabolite concentrations and water usage/storage habits (MEP, MCNP, MCOP), use of personal care products (MEP), and consumption of certain food items (MCPP, MCNP, and MCOP). CONCLUSIONS: To our knowledge this is the first study to report concentrations, temporal variability, and predictors of phthalate biomarkers among pregnant women in Puerto Rico. Preliminary results suggest several potentially important exposure sources to phthalates in this population and future analysis from this ongoing prospective cohort will help to inform targeted approaches to reduce exposure.
Assuntos
Ácidos Ftálicos/urina , Poluentes Químicos da Água/urina , Adulto , Biomarcadores/urina , Feminino , Humanos , Gravidez , Gestantes , Estudos Prospectivos , Porto Rico , Reprodutibilidade dos Testes , Inquéritos e Questionários , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND: Previous studies suggest that prenatal phthalate exposure affects neurodevelopment and behavior during the first years of life. OBJECTIVES: To evaluate the effect of maternal urinary concentrations of phthalate metabolites during pregnancy on mental and psychomotor development in children 24-36 months of age. METHODS: This analysis was conducted on the first three years of life among a subsample of 136 mother-child pairs from the ELEMENT cohort studies conducted in Mexico City. Maternal urine samples collected during the third trimester of pregnancy were analyzed for 9 phthalate metabolites: Mono-ethyl phthalate (MEP), Mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP), Mono-3-carboxypropyl phthalate (MCPP), and four di-2-ethylhexyl phthalate (DEHP) metabolites [mono-2-ethylhexyl-phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP)]. Among the 136 children, 135 (99.3%) completed the study period. Child neurodevelopment was assessed using mental and psychomotor development indexes (MDI and PDI) from a Bayley (BSID II) test at 24, 30, and 36 months of age. The effect of prenatal phthalate exposure on neurodevelopment was estimated using linear regression models for longitudinal data clustered at the individual level. RESULTS: No significant associations were observed among all children combined, but differential effects by gender were found. Among girls, there was a negative association between MDI and DEHP metabolites MEHP (ß=-2.11 [95% CI: -3.73, -0.49]), MEHHP (ß=-1.89 [95% CI: -3.64, -0.15]), MEOHP (ß=-1.80 [95% CI: -3.58, -0.03]) MECPP (ß=-2.52 [95% CI: -4.44, -0.61]), and ΣDEHP (ß=-3.41 [95% CI: -5.26, -1.55]); there was no significant effect among boys. Male PDI was positively related to MBzP (ß=1.79 [95% CI: 0.14, 3.45]) and MCPP (ß=1.64 [95% CI: 0.15, 3.12]); there was no significant effect on PDI among girls. CONCLUSION: This study demonstrates that sex plays a role of an effect modifier in the association between prenatal phthalate exposure and neurodevelopment.
Assuntos
Desenvolvimento Infantil/efeitos dos fármacos , Sistema Nervoso/efeitos dos fármacos , Ácidos Ftálicos/toxicidade , Efeitos Tardios da Exposição Pré-Natal , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , México , Sistema Nervoso/crescimento & desenvolvimento , Testes Neuropsicológicos , Ácidos Ftálicos/metabolismo , Gravidez , Desempenho Psicomotor/efeitos dos fármacos , Fatores SexuaisRESUMO
Puerto Rico has higher rates of a range of endocrine-related diseases and disorders compared to the United States. However, little is known to date about human exposures to known or potential endocrine disrupting chemicals (EDCs) in Puerto Rico. We recruited 105 pregnant women in Northern Puerto Rico who provided urine samples and questionnaire data at three times (18 ± 2, 22 ± 2, and 26 ± 2 weeks) during gestation. We measured the urinary concentrations of five phenols and three parabens: 2,4-dichlorophenol (24-DCP), 2,5-dichlorophenol (25-DCP), benzophenone-3 (BP-3), bisphenol A (BPA), triclosan (TCS), butyl paraben (B-PB), methyl paraben (M-PB), and propyl paraben (P-PB). The frequent detection of these chemicals suggests that exposure is highly prevalent among these Puerto Rican pregnant women. Urinary concentrations of TCS, BP-3, and 25-DCP were higher than among women of reproductive age in the US general population, while concentrations of BPA, 24-DCP, and parabens were similar. Intraclass correlation coefficients (ICC) varied widely between biomarkers; BPA had the lowest ICC (0.24) and BP-3 had the highest (0.62), followed by 25-DCP (0.49) and TCS (0.47). We found positive associations between biomarker concentrations with self-reported use of liquid soap (TCS), sunscreen (BP-3), lotion (BP-3 and parabens), and cosmetics (parabens). Our results can inform future epidemiology studies and strategies to reduce exposure to these chemicals or their precursors.
Assuntos
Monitoramento Ambiental , Parabenos/análise , Fenóis/urina , Adolescente , Adulto , Biomarcadores/urina , Intervalos de Confiança , Demografia , Feminino , Humanos , Inquéritos Nutricionais , Gravidez , Porto Rico , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To examine longitudinal associations of prenatal, infancy, and early childhood lead exposure during sensitive periods with height and body mass index (BMI). STUDY DESIGN: A total of 773 participants were recruited between 1994 and 2005 in Mexico City. Lead exposure history categories were constructed for the prenatal period (maternal patellar lead concentration) and for infancy and childhood (mean child blood lead concentration at birth to 24 months and 30-48 months, respectively). Linear regression models were used to study lead exposure history with height and BMI at 48 months. RESULTS: Mean height at age 48 months was significantly lower in children with a blood lead level exceeding the median during infancy (-0.84 cm; 95% CI, -1.42 to -0.25) than in children with a level below the median. Prenatal lead exposure was not associated with height at 48 months. Results for attained BMI generally trended in the same direction as for height. CONCLUSION: Our findings suggest an effect of lead exposure early in life on height attainment at 48 months, with the exposure window of greatest sensitivity in infancy.
Assuntos
Estatura/efeitos dos fármacos , Índice de Massa Corporal , Desenvolvimento Infantil/efeitos dos fármacos , Exposição Ambiental/efeitos adversos , Doença Ambiental/epidemiologia , Intoxicação por Chumbo/epidemiologia , Chumbo/efeitos adversos , Pré-Escolar , Doença Ambiental/fisiopatologia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Intoxicação por Chumbo/fisiopatologia , Masculino , México/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
BACKGROUND: Lead exposure in adults is associated with hypertension. Altered prenatal nutrition is associated with subsequent risks of adult hypertension, but little is known about whether prenatal exposure to toxicants, such as lead, may also confer such risks. OBJECTIVES: We investigated the relationship of prenatal lead exposure and blood pressure (BP) in 7- to 15-year-old boys and girls. METHODS: We evaluated 457 mother-child pairs, originally recruited for an environmental birth cohort study between 1994 and 2003 in Mexico City, at a follow-up visit in 2008-2010. Prenatal lead exposure was assessed by measurement of maternal tibia and patella lead using in vivo K-shell X-ray fluorescence and cord blood lead using atomic absorption spectrometry. BP was measured by mercury sphygmomanometer with appropriate-size cuffs. RESULTS: Adjusting for relevant covariates, maternal tibia lead was significantly associated with increases in systolic BP (SBP) and diastolic BP (DBP) in girls but not in boys (p-interaction with sex = 0.025 and 0.007 for SBP and DBP, respectively). Among girls, an interquartile range increase in tibia lead (13 µg/g) was associated with 2.11-mmHg [95% confidence interval (CI): 0.69, 3.52] and 1.60-mmHg (95% CI: 0.28, 2.91) increases in SBP and DBP, respectively. Neither patella nor cord lead was associated with child BP. CONCLUSIONS: Maternal tibia lead, which reflects cumulative environmental lead exposure and a source of exposure to the fetus, is a predisposing factor to higher BP in girls but not boys. Sex-specific adaptive responses to lead toxicity during early-life development may explain these differences.
Assuntos
Pressão Sanguínea , Osso e Ossos/química , Poluentes Ambientais/toxicidade , Hipertensão/epidemiologia , Chumbo/toxicidade , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Cordão Umbilical/química , Adolescente , Criança , Estudos de Coortes , Feminino , Seguimentos , Humanos , Hipertensão/induzido quimicamente , Estudos Longitudinais , Masculino , México/epidemiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Estudos Prospectivos , Fatores SexuaisRESUMO
BACKGROUND: Cumulative prenatal lead exposure, as measured by maternal bone lead burden, has been associated with smaller weight of offspring at birth and 1 month of age, but no study has examined whether this effect persists into early childhood. OBJECTIVE: We investigated the association of perinatal maternal bone lead, a biomarker of cumulative prenatal lead exposure, with children's attained weight over time from birth to 5 years of age. METHODS: Children were weighed at birth and at several intervals up until 60 months. Maternal tibia and patella lead were measured at 1 month postpartum using in vivo K-shell X-ray fluorescence. We used varying coefficient models with random effects to assess the association of maternal bone lead with weight trajectories of 522 boys and 477 girls born between 1994 and 2005 in Mexico City. RESULTS: After controlling for breast-feeding duration, maternal anthropometry, and sociodemographic characteristics, a 1-SD increase in maternal patella lead (micrograms per gram) was associated with a 130.9-g decrease in weight [95% confidence interval (CI), -227.4 to -34.4 g] among females and a 13.0-g nonsignificant increase in weight among males (95% CI, -73.7 to 99.9 g) at 5 years of age. These associations were similar after controlling for concurrent blood lead levels between birth and 5 years. CONCLUSIONS: Maternal bone lead was associated with lower weight over time among female but not male children up to 5 years of age. Given that the association was evident for patellar but not tibial lead levels, and was limited to females, results need to be confirmed in other studies.
Assuntos
Peso Corporal/fisiologia , Chumbo/toxicidade , Aleitamento Materno , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , México , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Fatores SexuaisRESUMO
OBJECTIVE: Research on the role of environmental lead exposure in the complex etiology of premature birth has yielded inconsistent results. We assessed the trimester-specific effect of prenatal lead exposure on gestational age and risk of premature delivery. METHODS: We used linear and logistic regression to identify critical windows of susceptibility to lead exposure on gestational length. RESULTS: In single-trimester models, decreases in gestational length were most strongly associated with first and second trimester blood lead. In adjusted logistic regression models, a one-standard deviation increase in second trimester blood lead was associated with an odds ratio of prematurity of 1.75 (95% CI: 1.02, 3.02). CONCLUSIONS: Maternal whole blood lead levels measured during first and second trimesters yielded the most prominent inverse association with length of gestation and increased the risk of prematurity.
Assuntos
Idade Gestacional , Chumbo/efeitos adversos , Exposição Materna/efeitos adversos , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/epidemiologia , Adulto , Biomarcadores/sangue , Estudos de Coortes , Feminino , Humanos , Chumbo/sangue , Modelos Logísticos , México/epidemiologia , Gravidez , Resultado da Gravidez , Trimestres da Gravidez , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Presence of Bisphenol A (BPA) has been documented worldwide in a variety of human biological samples. There is growing evidence that low level BPA exposure may impact placental tissue development and thyroid function in humans. The aim of this present pilot study was to determine urinary concentrations of BPA during the last trimester of pregnancy among a small subset of women in Mexico City, Mexico and relate these concentrations to risk of delivering prematurely. METHODS: A nested case-control subset of 60 participants in the Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) study in Mexico City, Mexico were selected based on delivering less than or equal to 37 weeks of gestation and greater than 37 weeks of gestation. Third trimester archived spot urine samples were analyzed by online solid phase extraction coupled with high performance liquid chromatography isotope dilution tandem mass spectrometry. RESULTS: BPA was detected in 80.0% (N = 48) of the urine samples; total concentrations ranged from < 0.4 µg/L to 6.7 µg/L; uncorrected geometric mean was 1.52 µg/L. The adjusted odds ratio of delivering less than or equal to 37 weeks in relation to specific gravity adjusted third trimester BPA concentration was 1.91 (95%CI 0.93, 3.91, p-value = 0.08). When cases were further restricted to births occurring prior to the 37th week (n = 12), the odds ratio for specific-gravity adjusted BPA was larger and statistically significant (p < 0.05). CONCLUSIONS: This is the first study to document measurable levels of BPA in the urine of a population of Mexican women. This study also provides preliminary evidence, based on a single spot urine sample collected during the third trimester, that pregnant women who delivered less than or equal to 37 weeks of gestation and prematurely (< 37 weeks) had higher urinary concentrations of BPA compared to women delivering after 37 weeks.
Assuntos
Exposição Ambiental/efeitos adversos , Poluentes Ambientais/intoxicação , Fenóis/intoxicação , Nascimento Prematuro/induzido quimicamente , Adulto , Compostos Benzidrílicos , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , México/epidemiologia , Fenóis/urina , Projetos Piloto , Gravidez , Terceiro Trimestre da Gravidez/efeitos dos fármacos , Terceiro Trimestre da Gravidez/urina , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/urinaRESUMO
BACKGROUND: Neonatal growth is a complex process involving genetic and environmental factors. Polymorphisms in the hemochromatosis (HFE) iron regulatory genes have been shown to modify transport and toxicity of lead which is known to affect birth weight. METHODS: We investigated the role of HFE C282Y, HFE H63 D, and transferrin (TF) P570 S gene variants in modifying the association of lead and infant birthweight in a cohort of Mexican mother-infant pairs. Subjects were initially recruited between 1994-1995 from three maternity hospitals in Mexico City and 411 infants/565 mothers had archived blood available for genotyping. Multiple linear regression models, stratified by either maternal/infant HFE or TF genotype and then combined with interaction terms, were constructed examining the association of lead and birthweight after controlling for covariates. RESULTS: 3.1%, 16.8% and 17.5% of infants (N=390) and 1.9%, 14.5% and 18.9% of mothers (N=533) carried the HFE C282Y, HFE H63D, and TF P570 S variants, respectively. The presence of infant HFE H63 D variants predicted 110.3 g (95% CI -216.1, -4.6) decreases in birthweight while maternal HFE H63 D variants predicted reductions of 52.0 g (95% CI -147.3 to 43.2). Interaction models suggest that both maternal and infant HFE H63 D genotype may modify tibia lead's effect on infant birthweight in opposing ways. In our interaction models, maternal HFE H63 D variant carriers had a negative association between tibia lead and birthweight. CONCLUSIONS: These results suggest that the HFE H63 D genotype modifies lead's effects on infant birthweight in a complex fashion that may reflect maternal-fetal interactions with respect to the metabolism and transport of metals.
Assuntos
Peso ao Nascer/efeitos dos fármacos , Antígenos de Histocompatibilidade Classe I/genética , Ferro/metabolismo , Chumbo/toxicidade , Proteínas de Membrana/genética , Transferrina/genética , Carga Corporal (Radioterapia) , Estudos de Coortes , Feminino , Variação Genética , Genótipo , Hemocromatose/genética , Proteína da Hemocromatose , Humanos , Recém-Nascido , México , Polimorfismo Genético , Gravidez , Estudos ProspectivosRESUMO
BACKGROUND: Maternal folate nutritional status and prenatal lead exposure can influence fetal development and subsequent health. The methylenetetrahydrofolate reductase (MTHFR) gene is important for folate metabolism, and 2 common polymorphisms, C677T and A1298C, reduce enzymatic activity; C677T is present at high penetrance in Mexican populations. OBJECTIVE: The objective of this study was to examine potential links between maternal and child MTHFR polymorphisms and child neurodevelopment in a lead-exposed population. DESIGN: Data regarding MTHFR polymorphisms C677T and A1298C, peri- and postnatal lead measures, and Bayley Mental Development Index at 24 mo of age (MDI-24) scores were available for 255 mother-child pairs who participated in the ELEMENT (Early Life Exposures in Mexico to Environmental Toxicants) study during 1994-1995. RESULTS: In covariate-adjusted regression models, maternal MTHFR 677 genotype predicted MDI-24 scores, in which each copy of the maternal MTHFR 677T variant allele was associated with lower MDI-24 scores (beta = -3.52; 95% CI: -6.12, -0.93; P = 0.004). Maternal MTHFR haplotype also predicted MDI-24 scores (mean +/- SE: 93.3 +/- 1.2 for 677C-1298A compared with 89.9 +/- 0.8 for 677T-1298A; P < 0.05). MDI-24 scores were not associated with maternal MTHFR 1298 genotype or child MTHFR genotypes. We did not observe significant MTHFR genotype x lead interactions with respect to any of the subject biomarkers of lead exposure. CONCLUSIONS: The maternal MTHFR 677T allele is an independent predictor of poorer child neurodevelopment at 24 mo. These results suggest that maternal genetic variations in folate metabolism during pregnancy may program offspring neurodevelopment trajectories. Further research is warranted to determine the generalizability of these results across other populations.
Assuntos
Transtornos Cognitivos/induzido quimicamente , Transtornos Cognitivos/genética , Deficiências do Desenvolvimento/genética , Intoxicação por Chumbo/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Polimorfismo Genético , Adolescente , Adulto , Osso e Ossos/metabolismo , Pré-Escolar , Deficiências do Desenvolvimento/epidemiologia , Suplementos Nutricionais , Ingestão de Energia , Feminino , Ligação Genética , Genótipo , Haplótipos , Humanos , Chumbo/metabolismo , México , Mães , Paridade , Polimorfismo de Nucleotídeo Único , Período Pós-Parto , Gravidez , Análise de RegressãoRESUMO
BACKGROUND: Rates of preterm birth have been rising over the past several decades. Factors contributing to this trend remain largely unclear, and exposure to environmental contaminants may play a role. OBJECTIVE: We investigated the relationship between phthalate exposure and preterm birth. METHODS: Within a large Mexican birth cohort study, we compared third-trimester urinary phthalate metabolite concentrations in 30 women who delivered preterm (< 37 weeks of gestation) with those of 30 controls (> or = 37 weeks of gestation). RESULTS: Concentrations of most of the metabolites were similar to those reported among U.S. females, although in the present study mono-n-butyl phthalate (MBP) concentrations were higher and monobenzyl phthalate (MBzP) concentrations lower. In a crude comparison before correcting for urinary dilution, geometric mean urinary concentrations were higher for the phthalate metabolites MBP, MBzP, mono(3-carboxylpropyl) phthalate, and four metabolites of di(2-ethyl-hexyl) phthalate among women who subsequently delivered preterm. These differences remained, but were somewhat lessened, after correction by specific gravity or creatinine. In multivariate logistic regression analysis adjusted for potential confounders, elevated odds of having phthalate metabolite concentrations above the median level were found. CONCLUSIONS: We found that phthalate exposure is prevalent among this group of pregnant women in Mexico and that some phthalates may be associated with preterm birth.
Assuntos
Exposição Ambiental , Exposição Materna , Ácidos Ftálicos/urina , Nascimento Prematuro/urina , Adulto , Estudos de Casos e Controles , Feminino , Humanos , México , Gravidez , Terceiro Trimestre da Gravidez , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Fetal lead exposure is associated with adverse pregnancy outcomes and developmental and cognitive deficits; however, the mechanism(s) by which lead-induced toxicity occurs remains unknown. Epigenetic fetal programming via DNA methylation may provide a pathway by which environmental lead exposure can influence disease susceptibility. OBJECTIVE: This study was designed to determine whether prenatal lead exposure is associated with alterations in genomic methylation of leukocyte DNA levels from umbilical cord samples. METHODS: We measured genomic DNA methylation, as assessed by Alu and LINE-1 (long interspersed nuclear element-1) methylation via pyrosequencing, on 103 umbilical cord blood samples from the biorepository of the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) study group. Prenatal lead exposure had been assessed by measuring maternal bone lead levels at the mid-tibial shaft and the patella using a spot-source (109)Cd K-shell X-ray fluorescence instrument. RESULTS: We found an inverse dose-response relationship in which quartiles of patella lead correlated with cord LINE-1 methylation (p for trend = 0.01) and and tibia lead correlated with Alu methylation (p for trend = 0.05). In mixed effects regression models, maternal tibia lead was negatively associated with umbilical cord genomic DNA methylation of Alu (beta= -0.027; p = 0.01). We found no associations between cord blood lead and cord genomic DNA methylation. CONCLUSIONS: Prenatal lead exposure is inversely associated with genomic DNA methylation in cord blood. These data suggest that the epigenome of the developing fetus can be influenced by maternal cumulative lead burden, which may influence long-term epigenetic programming and disease susceptibility throughout the life course.