title: Associations between prenatal mercury exposure and early child development in the ALSPAC study.
abstract: BACKGROUND
  There is evidence that high levels of mercury exposure to the pregnant woman can result in damage to the brain of the developing fetus. However there is uncertainty as to whether lower levels of the metal have adverse effects on the development of the infant and whether components of fish consumption and/or the selenium status of the woman is protective.
  
  
  METHODS
  In this study we analysed data from the Avon Longitudinal Study of Parents and Children (ALSPAC) (n=2875-3264) to determine whether levels of total blood mercury of pregnant women collected in the first half of pregnancy are associated with the development of the offspring at ages 6, 18, 30 and 42 months. The developmental measures used maternal self-reported scales for individual types of development (fine and gross motor, social and communication skills) and total scores. Multiple and logistic regression analyses treated the outcomes both as continuous and as suboptimal (the lowest 15th centile). The statistical analyses first examined the association of prenatal mercury exposure with these developmental endpoints and then adjusted each for a number of social and maternal lifestyle factors; finally this model was adjusted for the blood selenium level.
  
  
  RESULTS
  Total maternal prenatal blood mercury and selenium ranged from 0.17 to 12.76 and 17.0 to 324μg/L respectively. We found no evidence to suggest that prenatal levels of maternal blood mercury were associated with adverse development of the child, even when the mother had consumed no fish during pregnancy. In general, the higher the mercury level the more advanced the development of the child within the range of exposure studied. For example, the fully adjusted effect sizes for total development at 6 and 42 months were +0.51 [95%CI +0.05, +1.00] and +0.43 [95%CI +0.08, +0.78] points per SD of mercury. For the risk of suboptimal development the ORs at these ages were 0.90 [95%CI 0.80, 1.02] and 0.88 [95%CI 0.77, 1.02]. In regard to the associations between blood mercury and child development there were no differences between the mothers who ate fish and those who did not, thus implying that the benefits were not solely due to the beneficial nutrients in fish.
  
  
  CONCLUSIONS
  We found no evidence of adverse associations between maternal prenatal blood mercury and child development between 6 and 42 months of age. The significant associations that were present were all in the beneficial direction.
authors.affiliation: Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK. Electronic address: jean.golding@bristol.ac.uk.
authors.forename: Jean
authors.initials: J
authors.lastname: Golding
authors.affiliation: Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK. Electronic address: Steven.Gregory@bristol.ac.uk.
authors.forename: Steven
authors.initials: S
authors.lastname: Gregory
authors.affiliation: Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK. Electronic address: cdylic@bristol.ac.uk.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Iles-Caven
authors.affiliation: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA. Electronic address: jhibbeln@mail.nih.gov.
authors.forename: Joseph
authors.initials: J
authors.lastname: Hibbeln
authors.affiliation: Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK. Electronic address: alan.emond@bristol.ac.uk.
authors.forename: Alan
authors.initials: A
authors.lastname: Emond
authors.affiliation: Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK. Electronic address: Caroline.M.Taylor@bristol.ac.uk.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Taylor
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005506:Food Contamination; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D017669:Mercury Compounds / Q000009:adverse effects* / Q000097:blood; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012643:Selenium / Q000097:blood; D011795:Surveys and Questionnaires
chemical_list: D017669:Mercury Compounds; D012643:Selenium
keywords: ALSPAC; Child Development; Fish; Maternal blood mercury; Prenatal exposure; Selenium