Prenatal fluoride exposure and cognitive outcomes in children at 4 and 6–12 years of age in Mexico

Morteza Bashash, Deena Thomas, Howard Hu, Esperanza Martinez Mier, Brisa N. Sanchez, Niladri Basu, Karen E. Peterson, Adrienne S. Ettinger, Robert Wright, Zhenzhen Zhang, Yun Liu, Lourdes Schnaas, Adriana Mercado-García, Martha María Téllez-Rojo, Mauricio Hernández-Avila

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

BACKGROUND: Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants. OBJECTIVE: Our aim was to estimate the association of prenatal exposure to fluoride with offspring neurocognitive development. METHODS: We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 6–12 y old, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children’s Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 6–12. RESULTS: We had complete data on 299 mother–child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n = 299) and children with available urine samples (n = 211) were 0:90 (0:35) mg/L and 0:82 (0:38) mg/L, respectively. In multivariate models we found that an increase in maternal urine fluoride of 0:5 mg/L (approximately the IQR) predicted 3.15 (95% CI: −5:42, −0:87) and 2.50 (95% CI −4:12, −0:59) lower offspring GCI and IQ scores, respectively. CONCLUSIONS: In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6–12 y.

Original languageEnglish (US)
Article number097017
JournalEnvironmental Health Perspectives
Volume125
Issue number9
DOIs
StatePublished - Sep 1 2017

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Mexico
Fluorides
Intelligence
Mothers
Urine
Ion-Selective Electrodes
Wechsler Scales
Specific Gravity
Aptitude
Cognition
Pregnant Women
Epidemiologic Studies
Creatinine
Pregnancy
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Prenatal fluoride exposure and cognitive outcomes in children at 4 and 6–12 years of age in Mexico. / Bashash, Morteza; Thomas, Deena; Hu, Howard; Martinez Mier, Esperanza; Sanchez, Brisa N.; Basu, Niladri; Peterson, Karen E.; Ettinger, Adrienne S.; Wright, Robert; Zhang, Zhenzhen; Liu, Yun; Schnaas, Lourdes; Mercado-García, Adriana; Téllez-Rojo, Martha María; Hernández-Avila, Mauricio.

In: Environmental Health Perspectives, Vol. 125, No. 9, 097017, 01.09.2017.

Research output: Contribution to journalArticle

Bashash, M, Thomas, D, Hu, H, Martinez Mier, E, Sanchez, BN, Basu, N, Peterson, KE, Ettinger, AS, Wright, R, Zhang, Z, Liu, Y, Schnaas, L, Mercado-García, A, Téllez-Rojo, MM & Hernández-Avila, M 2017, 'Prenatal fluoride exposure and cognitive outcomes in children at 4 and 6–12 years of age in Mexico', Environmental Health Perspectives, vol. 125, no. 9, 097017. https://doi.org/10.1289/EHP655
Bashash, Morteza ; Thomas, Deena ; Hu, Howard ; Martinez Mier, Esperanza ; Sanchez, Brisa N. ; Basu, Niladri ; Peterson, Karen E. ; Ettinger, Adrienne S. ; Wright, Robert ; Zhang, Zhenzhen ; Liu, Yun ; Schnaas, Lourdes ; Mercado-García, Adriana ; Téllez-Rojo, Martha María ; Hernández-Avila, Mauricio. / Prenatal fluoride exposure and cognitive outcomes in children at 4 and 6–12 years of age in Mexico. In: Environmental Health Perspectives. 2017 ; Vol. 125, No. 9.
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abstract = "BACKGROUND: Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants. OBJECTIVE: Our aim was to estimate the association of prenatal exposure to fluoride with offspring neurocognitive development. METHODS: We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 6–12 y old, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children’s Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 6–12. RESULTS: We had complete data on 299 mother–child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n = 299) and children with available urine samples (n = 211) were 0:90 (0:35) mg/L and 0:82 (0:38) mg/L, respectively. In multivariate models we found that an increase in maternal urine fluoride of 0:5 mg/L (approximately the IQR) predicted 3.15 (95{\%} CI: −5:42, −0:87) and 2.50 (95{\%} CI −4:12, −0:59) lower offspring GCI and IQ scores, respectively. CONCLUSIONS: In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6–12 y.",
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AU - Thomas, Deena

AU - Hu, Howard

AU - Martinez Mier, Esperanza

AU - Sanchez, Brisa N.

AU - Basu, Niladri

AU - Peterson, Karen E.

AU - Ettinger, Adrienne S.

AU - Wright, Robert

AU - Zhang, Zhenzhen

AU - Liu, Yun

AU - Schnaas, Lourdes

AU - Mercado-García, Adriana

AU - Téllez-Rojo, Martha María

AU - Hernández-Avila, Mauricio

PY - 2017/9/1

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N2 - BACKGROUND: Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants. OBJECTIVE: Our aim was to estimate the association of prenatal exposure to fluoride with offspring neurocognitive development. METHODS: We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 6–12 y old, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children’s Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 6–12. RESULTS: We had complete data on 299 mother–child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n = 299) and children with available urine samples (n = 211) were 0:90 (0:35) mg/L and 0:82 (0:38) mg/L, respectively. In multivariate models we found that an increase in maternal urine fluoride of 0:5 mg/L (approximately the IQR) predicted 3.15 (95% CI: −5:42, −0:87) and 2.50 (95% CI −4:12, −0:59) lower offspring GCI and IQ scores, respectively. CONCLUSIONS: In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6–12 y.

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