title: In utero exposure to environmental lead and manganese and neurodevelopment at 2 years of age.
abstract: OBJECTIVE
  Manganese, lead, arsenic and mercury are common neurotoxic metals in the environment. Nonetheless, the relationship between prenatal exposure to low doses of neurotoxic metals and neurodevelopment in children is not clear. The objective of this study was to explore the relationship between in utero exposure to environmental neurotoxic metals and neurodevelopment at 2 years of age.
  
  
  METHODS
  The population of this study came from the Taiwan Birth Panel Study. We included 230 pairs of non-smoking mothers without any occupational exposure and their singleton full-term children. The information about exposure during pregnancy was obtained using a structured questionnaire, and the manganese, lead, arsenic and mercury levels in umbilical cord blood samples were analyzed using inductively coupled plasma mass spectrometry. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) to evaluate the developmental status of each child at 2 years of age, and we examined the association of in utero exposure to environmental metals and neurodevelopment using linear regression models.
  
  
  RESULTS
  The median concentrations of manganese, lead, arsenic and mercury in the cord blood samples in this study were 47.90 µg/L (range, 17.88-106.85 µg/L), 11.41 µg/L (range 0.16-43.22 µg/L), 4.05 µg/L (range, 1.50-12.88 µg/L) and 12.17 µg/L (range, 1.53-64.87 µg/L), respectively. After adjusting for maternal age, infant gender, environmental tobacco smoke during pregnancy and after delivery, Home Observation for Measurement of the Environment Inventory results, and arsenic and mercury levels in cord blood, we found that manganese and lead levels above the 75th percentile had a significant adverse association with the overall (β=-7.03, SE=2.65, P=0.0085), cognitive (β=-8.19, SE=3.17, P=0.0105), and language quotients (β=-6.81, SE=2.73, P=0.0133) of the CDIIT.
  
  
  CONCLUSIONS
  In utero exposure to environmental manganese and lead may have an adverse association with neurodevelopment at 2 years of age, and there is an interaction effect between the manganese and lead levels in the cord blood that could aggravate the effect.
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
authors.forename: Ching-Chun
authors.initials: CC
authors.lastname: Lin
authors.forename: Yu-Chuan
authors.initials: YC
authors.lastname: Chen
authors.forename: Feng-Chiao
authors.initials: FC
authors.lastname: Su
authors.forename: Chien-Mu
authors.initials: CM
authors.lastname: Lin
authors.forename: Hua-Fang
authors.initials: HF
authors.lastname: Liao
authors.forename: Yaw-Huei
authors.initials: YH
authors.lastname: Hwang
authors.forename: Wu-Shiun
authors.initials: WS
authors.lastname: Hsieh
authors.forename: Suh-Fang
authors.initials: SF
authors.lastname: Jeng
authors.forename: Yi-Ning
authors.initials: YN
authors.lastname: Su
authors.forename: Pau-Chung
authors.initials: PC
authors.lastname: Chen
mesh_terms: D000328:Adult; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D007854:Lead / Q000009:adverse effects* / Q000097:blood; D008345:Manganese / Q000009:adverse effects* / Q000097:blood; D009420:Nervous System / Q000187:drug effects* / Q000254:growth & development; D009498:Neurotoxins / Q000009:adverse effects; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D055815:Young Adult
chemical_list: D009498:Neurotoxins; D007854:Lead; D008345:Manganese