Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastián, Spain; Faculty of Psychology of the University of the Basque Country (UPV-EHU), 20018, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain.
Faculty of Psychology of the University of the Basque Country (UPV-EHU), 20018, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, BD9 6RJ, Bradford, United Kingdom.
Environ Res. 2023 Oct 15;235:116705. doi: 10.1016/j.envres.2023.116705. Epub 2023 Jul 19.
Health concerns about the potential impact of exposure to fluoride via drinking water (DW) on neuropsychological development include behavioral outcomes such as ADHD.
We aimed to examine the association between prenatal maternal urinary fluoride and symptoms associated with attention-deficit/hyperactivity disorder (ADHD) at the age of 8 and 11 years.
Data from 255 to 236 mother-child pairs from the "Infancia y Medio Ambiente" (INMA) birth cohort (Gipuzkoa; Spain) with maternal urinary F adjusted for creatinine (MUFcr) during pregnancy (first and third trimester) and child assessments of ADHD-like symptoms reported by Conners' Rating Scales-Revised at age of 8 and 11 years was available. Clinical approach was also used: cut off criteria (T > 66). Multiple linear regression models were fitted when outcomes were analyzed as continuous, and logistic regression models when the outcomes were analyzed with a categorical clinical approach. Covariates related to maternal characteristics, birth outcomes, childhood, quality of family context and biomarkers of neuro-toxicants were used.
No association was found between MUFcr levels during pregnancy and cognitive problems-inattention, hyperactivity or ADHD index score of symptoms at 8 or 11 years. When results were analyzed from the perspective of a clinical approach, at the age of 11 years, there were significant inverse association between MUFcr and being categorized as a cognitive problems-inattention case. ORs were also indicative of a lower risk, although not significant, for ADHD index at age 11. Sensitivity analyses, taking into consideration quality of family context or the levels of other toxicants during pregnancy showed similar results.
Higher levels of MUFcr in pregnant women were associated with a lower risk of cognitive problems-inattention at 11 years. These findings are inconsistent with those from previous studies and indicate the need for other population-based studies to confirm or overturn these results.
人们对通过饮用水（DW）暴露于氟化物对神经心理发育的潜在影响表示担忧，这包括 ADHD 等行为结果。
我们旨在研究孕妇尿液氟化物与 8 岁和 11 岁时与注意力缺陷/多动障碍（ADHD）相关的症状之间的关联。
本研究数据来自“Infancia y Medio Ambiente”（INMA）出生队列（西班牙吉普斯夸省）的 255 至 236 对母婴，其中包括母亲在怀孕期间（第一和第三孕期）尿液氟化物与肌酐比值（MUFcr）以及 8 岁和 11 岁时由 Conners' 修订后的评级量表报告的 ADHD 样症状的儿童评估数据。还采用了临床方法：截断标准（T>66）。当结果作为连续变量进行分析时，使用多元线性回归模型；当结果采用分类临床方法进行分析时，使用逻辑回归模型。使用与母亲特征、出生结局、儿童期、家庭环境质量和神经毒物生物标志物相关的协变量。
怀孕期间 MUFcr 水平与 8 或 11 岁时的认知问题-注意力不集中、多动或 ADHD 症状指数评分之间无关联。当从临床方法的角度分析结果时，在 11 岁时，MUFcr 与被归类为认知问题-注意力不集中病例之间存在显著的负相关。OR 也表明 ADHD 指数在 11 岁时的风险较低，尽管没有统计学意义。考虑到家庭环境质量或怀孕期间其他毒物水平的敏感性分析结果相似。
孕妇中较高的 MUFcr 水平与 11 岁时认知问题-注意力不集中的风险较低相关。这些发现与之前的研究结果不一致，表明需要进行其他基于人群的研究来证实或推翻这些结果。
