Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
Sci Total Environ. 2023 Sep 15;891:164322. doi: 10.1016/j.scitotenv.2023.164322. Epub 2023 May 25.
On May 19, 2011, Calgary, Canada stopped fluoridating its drinking water. This prospective ecological study examined if maternal exposure to fluoride during pregnancy from drinking water that was fluoridated at the recommended level of 0.7 mg/L was associated with children's intelligence and executive function at 3-5 years of age.
Participants were 616 maternal-child pairs enrolled in the Calgary cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study between 2009 and 2012. Maternal-child pairs were classified as fully exposed to fluoridated drinking water throughout pregnancy (n = 295); exposed to fluoridated drinking water for at least part of the pregnancy plus an additional 90 days (n = 220); or not exposed to fluoridated drinking water during pregnancy plus the 90 days prior to pregnancy (n = 101). Children's Full Scale IQs were assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition: Canadian (WPPSI-IV). Children's executive functions were also assessed: working memory (WPPSI-IV Working Memory Index), inhibitory control (Gift Delay, NEPSY-II Statue subtest), and cognitive flexibility (Boy-Girl Stroop, Dimensional Change Card Sort (DCCS)).
No associations were found between exposure group and Full Scale IQ. However, compared to no exposure, full exposure to fluoridated drinking water throughout pregnancy was associated with poorer performance on the Gift Delay (B = 0.53, 95 % CI = 0.31, 0.93). Sex-specific analyses revealed that girls in the fully exposed (AOR = 0.30, 95 % CI = 0.13, 0.74) and partially exposed groups (AOR = 0.42, 95 % CI = 0.17, 1.01) performed more poorly than girls in the not exposed group. Sex effects were also found on the DCCS; girls in the fully exposed (AOR = 0.34, 95 % CI = 0.14, 0.88) and partially exposed groups (AOR = 0.29, 95 % CI = 0.12, 0.73) performed more poorly.
Maternal exposure to drinking water throughout pregnancy fluoridated at the level of 0.7 mg/L was associated with poorer inhibitory control and cognitive flexibility, particularly in girls, suggesting a possible need to reduce maternal fluoride exposure during pregnancy.
2011 年 5 月 19 日，加拿大卡尔加里停止在饮用水中添加氟化物。这项前瞻性生态研究旨在探讨孕期母亲从推荐水平（0.7mg/L）的氟化饮用水中摄入氟化物是否与儿童 3-5 岁时的智力和执行功能有关。
2009 年至 2012 年间，616 对母婴参与了艾伯塔省妊娠结局和营养（APrON）研究的卡尔加里队列研究。母婴对分为在整个孕期都完全暴露于氟化饮用水（n=295）；在孕期至少部分时间暴露于氟化饮用水，并在怀孕前 90 天（n=220）额外暴露；或在孕期及怀孕前 90 天都未暴露于氟化饮用水（n=101）。采用韦氏学前和小学智力量表第四版（加拿大版）（WPPSI-IV）评估儿童的全量表智商。还评估了儿童的执行功能：工作记忆（WPPSI-IV 工作记忆指数）、抑制控制（礼物延迟，NPSY-II 雕像测验）和认知灵活性（男孩-女孩斯特鲁普，维度变化卡片分类（DCCS））。
未发现暴露组与全量表智商之间存在关联。然而，与无暴露相比，整个孕期完全暴露于氟化饮用水与礼物延迟（B=0.53，95%置信区间=0.31，0.93）表现更差有关。性别特异性分析显示，完全暴露组（AOR=0.30，95%置信区间=0.13，0.74）和部分暴露组（AOR=0.42，95%置信区间=0.17，1.01）的女孩比未暴露组的女孩表现更差。在 DCCS 上也发现了性别效应；完全暴露组（AOR=0.34，95%置信区间=0.14，0.88）和部分暴露组（AOR=0.29，95%置信区间=0.12，0.73）的女孩表现更差。
孕期母亲摄入推荐水平（0.7mg/L）的氟化饮用水与抑制控制和认知灵活性较差有关，特别是在女孩中，这表明可能需要减少孕期母体氟化物暴露。
