The association of lead exposure during pregnancy and childhood anthropometry in the Mexican PROGRESS cohort

Abstract

Lead exposure during pregnancy remains a public health problem with potential lifelong impacts on children’s growth and development. Mexico is unique in that stunting and obesity are both major public health concerns in children. This situation might be exacerbated by lead exposure which remains more common in Mexico than in the United States due in part to the use of lead glazed pottery in food preparation and storage. Our objective is to determine how lead exposure during pregnancy is associated with children’s growth parameters, including height, weight, body mass index and percentage body fat measured between ages 4–6 years old in a Mexico City pregnancy cohort. Blood lead was collected in the 2nd and 3rd trimester of pregnancy as well as at delivery. Bone lead was assessed in mothers as a long term exposure biomarker. We performed multivariable linear regression analyses to assess the association between each of these lead exposure biomarkers and child anthropometry. We found a significant negative association between maternal 3rd trimester blood lead concentration and offspring height for age (β −0.10; 95% CI −0.19, −0.01), and a negative association between maternal 3rd trimester blood lead concentration and weight for age (β −0.11; 95% CI −0.22, −0.003). Our results in this Mexican population add to previous findings of an association of lead and decreased stature and weight in early childhood. Ongoing follow-up and longitudinal analyses may help elucidate how this impacts growth trajectory and other children’s health outcomes.

Peripubertal blood lead levels and growth among Russian boys

“…In our Russian cohort, we evaluated the association of peripubertal (ages 8–9 years) BLL with subsequent height; in contrast, most prior prospective epidemiologic studies have examined prenatal lead exposures (Afeiche et al 2011; Dallaire et al 2014; Hong et al 2014; Jedrychowski et al 2015; Renzetti et al 2017; Shukla et al 1991) or exposures during early childhood (e.g., up to age 2 years) (Afeiche et al 2012; Cassidy-Bushrow et al 2016; Shukla et al 1991). Moreover, with few exceptions (Dallaire et al 2014; Jedrychowski et al 2015; Renzetti et al 2017), children were not followed beyond age 5 years.…”

“…Moreover, with few exceptions (Dallaire et al 2014; Jedrychowski et al 2015; Renzetti et al 2017), children were not followed beyond age 5 years. Among prospective studies with measures of perinatal lead exposure, the timing of exposure and nutritional deficiencies impacted associations of lead with height.…”

“…Among prospective studies with measures of perinatal lead exposure, the timing of exposure and nutritional deficiencies impacted associations of lead with height. In Mexican (Renzetti et al 2017) and Korean (Hong et al 2014) cohorts, reduced childhood growth was associated with higher BLLs measured during the third trimester of pregnancy but not during the first or second trimesters, or with cord blood levels. An earlier U.S. study found prenatal BLLs associated with lower growth only in the presence of continued lead exposure during early childhood (Shukla et al 1991).…”

“…Maternal third-trimester BLL was associated with lower age-adjusted weight at age 2 years in a Korean cohort (Hong et al 2014), and U.S. children with measurable BLL at age 2 years had significantly lower BMI (Cassidy-Bushrow et al 2016). In one Mexican cohort, maternal bone lead measurements were significantly associated with lower weight among girls at age 5 years (Afeiche et al 2011), while another Mexican cohort found higher maternal third-trimester BLLs associated with lower age-adjusted weight at ages 4–6 years (Renzetti et al 2017). However, cord BLL in an Inuit cohort followed to age 14 years reported no association with BMI (Dallaire et al 2014).…”

Influence of complex childhood diseases on variation in growth and skeletal development

“…A wide range of environmental factors have been associated with child growth outcomes, ranging from the psychosocial environment to public sanitation to environmental pollutants to the physical environment (Isasi et al, 2016;Mishra & Retherford, 2007;Peck & Lundberg, 1995;Rah et al, 2015;Renzetti et al, 2016). By far, infectious diseases (Adair & Guilkey, 1997;Black, Perez-Escamilla, & Rao, 2015;Schlaudecker, Steinhoff, & Moore, 2011) and the nutritional milieu (both abundance and scarcity of nutritional resources) can have a direct negative impact on childhood growth outcomes (Black, Perez-Escamilla, & Rao, 2015), such that population differences in growth of children under 5 years of age are largely attributable to these contextual factors, rather than hereditary differences (Habicht, Martorell, Yarbrough, Malina, & Klein, 1974).…”