Hong Yun-Chul, Kulkarni Surabhi Shah, Lim Youn-Hee, Kim Eunjeong, Ha Mina, Park Hyesook, Kim Yangho, Kim Bung-Nyun, Chang Namsoo, Oh Se-Young, Kim Young-Ju, Park Chooghee, Ha Eun-hee
Institute of Environmental Medicine, Medical Research Center.
Departments of Preventive Medicine, and.
Pediatrics. 2014 Dec;134(6):1151-9. doi: 10.1542/peds.2014-1658.
The effects on postnatal growth of maternal exposure to low levels of lead during pregnancy have not been well established. In addition, information is limited regarding the protective effect of dietary calcium intake during pregnancy against the effect of lead for fetal and postnatal growth. We investigated the relationship between prenatal exposure to lead and growth at birth and 6, 12, and 24 months postnatal, and evaluated the role of calcium intake against the effect of lead.
A total of 1150 pregnant women, and their subsequent offspring, enrolled in a prospective birth cohort study (Mothers and Children's Environmental Health Study), were evaluated. Multivariable regression analysis was conducted to estimate the effects of prenatal maternal blood lead levels on growth at each follow-up.
The blood lead levels of participating mothers were <5.0 μg/dL and mean levels were 1.25 μg/dL during the early (before 20 gestational weeks) and late (at delivery) gestational periods. Prenatal exposure to lead, particularly in late pregnancy, was significantly associated with a reduction in infantile growth at 24 months. When pregnant women had dietary calcium intake at mean or upper level, the association was not significant. In contrast, lower than mean level of calcium intake intensified the adverse effect of prenatal lead exposure on growth in children.
Prenatal lead exposure <5.0 μg/dL adversely affects postnatal growth and low calcium intake aggravates the effect, indicating more stringent control of lead and sufficient intake of calcium are necessary to help children's health.
孕期母亲接触低水平铅对产后生长的影响尚未完全明确。此外，关于孕期膳食钙摄入量对铅对胎儿及产后生长影响的保护作用的信息有限。我们研究了产前铅暴露与出生时及产后6个月、12个月和24个月生长之间的关系，并评估了钙摄入量对铅影响的作用。
对参与一项前瞻性出生队列研究（母婴环境健康研究）的1150名孕妇及其后代进行了评估。采用多变量回归分析来估计产前母亲血铅水平对每次随访时生长的影响。
参与研究的母亲在妊娠早期（妊娠20周前）和晚期（分娩时）的血铅水平<5.0μg/dL，平均水平为1.25μg/dL。产前铅暴露，尤其是在妊娠晚期，与24个月时婴儿生长发育迟缓显著相关。当孕妇膳食钙摄入量处于平均水平或较高水平时，这种关联不显著。相反，低于平均水平的钙摄入量会加剧产前铅暴露对儿童生长的不利影响。
产前铅暴露<5.0μg/dL会对产后生长产生不利影响，低钙摄入量会加重这种影响，这表明更严格地控制铅暴露和充足的钙摄入对于儿童健康是必要的。
