Shukla R, Dietrich K N, Bornschein R L, Berger O, Hammond P B
Department of Environmental Health, University of Cincinnati College of Medicine, Ohio 45267-0056.
Pediatrics. 1991 Nov;88(5):886-92.
This report is a follow-up of an earlier study of the effects of low to moderate prenatal and postnatal lead exposure on children's growth in stature. Two hundred thirty-five subjects were assessed every 3 months for lead exposure (blood lead level) and stature (recumbent length) up to 33 months of age. Fetal lead exposure was indexed by maternal blood lead level during pregnancy. The adverse effects of lead on growth during the first year of life were reported previously. This analysis covers essentially the second and third years of life. The results indicate that mean blood lead level during this period was negatively associated with attained height at 33 months of age (P = .002). This association was, however, evidenced only among those children who had mean blood lead levels greater than the cohort median (greater than or equal to 10.77 micrograms/dL) during the 3- to 15-month interval. The results also suggest that the effect of lead exposure (both in utero as well as during the first year of life) are transient provided that subsequent exposure to lead is not excessive. It appears that maintaining an average blood lead level of 25 micrograms/dL or more during the second and third year of life was detrimental to the child's attained stature at 33 months of age. Approximately 15% of this cohort experienced these levels of lead exposure. Continued follow-up of this cohort will reveal whether these lead-related deficits persist and whether they continue to be dependent on the level of exposure in an earlier period.
本报告是对一项早期研究的跟踪,该研究探讨了低至中度的产前和产后铅暴露对儿童身高增长的影响。对235名受试者每3个月进行一次评估,直至其33个月大,评估指标包括铅暴露情况(血铅水平)和身高(卧位长度)。胎儿铅暴露通过孕期母亲的血铅水平来衡量。此前已报告了铅对生命第一年生长的不利影响。本分析主要涵盖生命的第二年和第三年。结果表明,这一时期的平均血铅水平与33个月大时的身高呈负相关(P = .002)。然而,这种关联仅在那些在3至15个月期间平均血铅水平高于队列中位数(大于或等于10.77微克/分升)的儿童中得到证实。结果还表明,只要随后的铅暴露不过量,铅暴露(包括宫内暴露以及生命第一年的暴露)的影响是短暂的。在生命的第二年和第三年,维持平均血铅水平在25微克/分升或更高似乎对儿童33个月大时的身高增长不利。该队列中约15% 的儿童经历了这些铅暴露水平。对该队列的持续随访将揭示这些与铅相关的缺陷是否持续存在以及它们是否继续依赖于早期的暴露水平。