Jacques Adriana Duringer, Souza Filho Breno Augusto Bormann de, Andrade Carlos Augusto Ferreira de, Vaz Juliana Dos Santos, Basta Paulo Cesar
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Departamento de Saúde Coletiva, Universidade Federal do Rio Grande do Norte, Natal, Brasil.
Cad Saude Publica. 2025 Apr 11;41(3):e00228623. doi: 10.1590/0102-311XPT228623. eCollection 2025.
Neurodevelopment spans from conception to adulthood, encompassing the growth and maturation of the nervous system. Indigenous children living in the Amazon face several circumstances that can adversely impact their neurodevelopment, including prenatal care, birth conditions, malnutrition, infectious diseases, and socioeconomic challenges. Prenatal exposure to toxic substances configures another determinant influencing neurodevelopment. Exposure to methylmercury is associated with the maternal consumption of contaminated fish. After birth, children continue to undergo exposure by breastfeeding or feeding. This trial aimed to develop a theoretical model to find the determinants of neurodevelopment in the first 1,000 days of life considering prenatal exposure to methylmercury in Indigenous children. The seven steps of the Checklist for Theoretical Report in Epidemiological Studies were followed to elaborate this theoretical model. We offer theoretical-methodological reflections on the dimensions and explanatory variables that highlight how exposure to adverse conditions since intrauterine life worsens in the presence of methylmercury, which can damage human health. This theoretical model is unprecedented in considering the complex causal network involved and contributes to research and actions on maternal and child health.
神经发育从受孕持续到成年期,涵盖神经系统的生长和成熟过程。生活在亚马逊地区的原住民儿童面临多种可能对其神经发育产生不利影响的情况,包括产前护理、出生条件、营养不良、传染病以及社会经济挑战。产前接触有毒物质是影响神经发育的另一个决定因素。甲基汞暴露与母亲食用受污染的鱼类有关。出生后,儿童通过母乳喂养或喂食继续接触。本试验旨在建立一个理论模型,以找出考虑到原住民儿童产前接触甲基汞的情况下,生命最初1000天内神经发育的决定因素。按照流行病学研究理论报告清单的七个步骤来构建这个理论模型。我们对维度和解释变量进行理论方法反思,突出了自子宫内生活起暴露于不利条件在甲基汞存在时如何恶化,而甲基汞会损害人类健康。这个理论模型在考虑所涉及的复杂因果网络方面是前所未有的,有助于母婴健康方面的研究和行动。