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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Low-level fetal lead exposure effect on neurobehavioral development in early infancy
K N Dietrich1, K M Krafft, R L Bornschein
1Department of Environmental Health, University of Cincinnati College of Medicine, OH.
Insights
Fetal lead exposure negatively impacts infant neurodevelopment, affecting cognitive scores in 3- and 6-month-olds. Male infants and those from low-income families showed increased sensitivity to these lead-related neurodevelopmental effects.
Area of Science:
- Environmental Health
- Neurodevelopmental Pediatrics
- Toxicology
Background:
- Prenatal and neonatal exposure to lead (Pb) is a public health concern.
- Lead is a known neurotoxin with potential adverse effects on child development.
- Socioeconomic factors may influence vulnerability to environmental toxicants.
Purpose of the Study:
- To prospectively assess the impact of fetal lead exposure on infant neurodevelopment.
- To identify sensitive subpopulations to lead's neurobehavioral effects.
- To explore mediating factors in lead-induced neurodevelopmental deficits.
Main Methods:
- Prospective cohort study of 305 lower socioeconomic status women in lead-hazardous areas.
- Measurement of maternal, cord, and neonatal blood lead levels (BLLs).
- Assessment of infant neurodevelopment using Bayley Scales at 3 and 6 months.
Main Results:
- An inverse relationship was found between prenatal and neonatal BLLs and Bayley Mental Developmental Index scores.
- Male infants and those from the poorest families exhibited heightened sensitivity to lead's effects.
- Lead-related reductions in birth weight and gestation partially mediated neurobehavioral deficits.
Conclusions:
- Fetal and early neonatal lead exposure is associated with poorer neurodevelopmental outcomes in infants.
- Specific subgroups, including males and infants from disadvantaged backgrounds, are more vulnerable.
- Lead's impact on neurodevelopment may be partly explained by its effects on fetal growth and gestational duration.
Abstract:
A prospective method was used in this study to assess the effects of fetal lead exposure on neurodevelopmental status in 3- and 6-month old infants. At their first prenatal medical appointments, 305 lower socioeconomic status women residing in predesignated lead-hazardous areas of Cincinnati were recruited. Lead was measured in whole blood in both the mother and fetal-placental unit (prenatal and cord) and the neonate (ten days and 3 months). All blood lead levels were less than 30 micrograms/dL. Infant development was assessed with the Bayley scales at 3 and 6 months of age. Multiple regression analyses which treated perinatal health factors such as birth weight and gestation as confounders indicated an independent, inverse relationship between both prenatal and neonatal blood lead levels and performance on the Bayley Mental Developmental Index at both ages. Male infants and infants from the poorest families appeared to be especially sensitive to these psychoteratogenic influences. Further study using a structural equations approach indicated that neurobehavioral deficits were partly mediated by lead-related reductions in birth weight and gestation.
