Publications (15)64.52 Total impact
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Article: Iodine Supplementation During Pregnancy and Infant Neuropsychological Development: INMA Mother and Child Cohort Study.
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ABSTRACT: Iodine supplementation during pregnancy is a common practice in developed countries. However, scant evidence is available regarding the safety and effectiveness of maternal iodine supplementation with regard to child neuropsychological development. We previously reported an inverse association between iodine supplementation and the psychomotor development of infants in a birth cohort from Valencia, Spain. In the present study, we assessed this association in a wider sample of mother and child pairs from 3 other regions in Spain. Neuropsychological development was assessed using the Bayley Scales of Infant Development in 1,519 infants (median age, 16 months) between 2006 and 2009. In multivariate analyses, maternal consumption of 150 μg/day or more of iodine from supplements was related to a 1.5-fold increase in the odds of a psychomotor score less than 85 (95% confidence interval: 0.8, 2.9) and to a 1.7-fold increase in the odds of a mental score less than 85 (95% confidence interval: 0.9, 3.0). Findings previously reported in the Valencia cohort were only partially verified. The results of the present study suggest that, at least in these regions, iodine supplementation does not improve infant neuropsychological development at 1 year of age. Further research is needed on the risks and benefits of supplementary iodine for both maternal thyroid function and child neurodevelopment.American journal of epidemiology 04/2013; · 5.59 Impact Factor -
Article: Early life exposures to home dampness, pet ownership and farm animal contact and neuropsychological development in 4 year old children: A prospective birth cohort study.
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ABSTRACT: Exposure to biocontaminants is associated with behavioural problems and poorer cognitive function. Our study assesses the associations between early life exposure to home dampness, pets and farm animal contact and cognitive function and social competences in 4-year old children, and the associations between these indoor factors and microbial compounds (bacterial endotoxin and fungal extracellular polysaccharides). A Spanish population-based birth-cohort enrolled 482 children, and 424 of them underwent psychometric testing at 4 years of age, including the McCarthy Scales of Child Abilities (MSCA) and the California Preschool Social Competence Scale (CPSCS). Information on pet ownership, farm animal contact and home dampness was periodically reported by the parents through questionnaires. Microbial compounds were measured in living room sofa dust collected at the age of 3 months. Persistent home dampness during early life significantly decreased the general score of MSCA by 4.9 points (95% CI: -8.9; -0.8), and it decreased the CPSCS by 6.5 points (95% CI: -12.2; -0.9) in the child's bedroom. Cat or dog ownership were not associated with the outcomes, but occasional farm animal contact increased the general cognitive score of MSCA by 5.6 points (95% CI: 1.8; 9.3). Cat and dog ownership were associated with higher levels of endotoxins in home dust. None of the measured microbial compounds were related with the psychometric tests scores. In conclusion, damp housing in early life may have adverse effects on neuropsychological development at 4 years old. More research is needed to explore the possible involvement of mycotoxins in the observed results.International journal of hygiene and environmental health 01/2013; · 2.64 Impact Factor -
Article: Thyroxine Levels During Pregnancy in Healthy Women and Early Child Neurodevelopment.
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ABSTRACT: BACKGROUND:: The fetus depends on maternal thyroid hormones during pregnancy for normal brain development. Little is known about the effects of subclinical hypothyroidism and mild hypothyroxinemia during pregnancy on neurodevelopment of the child. METHODS:: We evaluated a population-based birth cohort in Spain. A total of 1761 children and their mothers were included in the main analyses. Serum levels of free thyroxine and thyrotropin were measured in pregnant women. Mental and psychomotor development of their children was assessed using the Bayley Scales of Infant Development during the second year of life. RESULTS:: Low free thyroxine levels (<5th percentile) and self-reported prepregnancy thyroid disorder without medical treatment were associated with a decrease of mental scores (Beta = -3.4 [95% confidence interval= -6.7 to -0.2]) and -5.5 [-8.9 to -2.0], respectively). No association between thyrotropin levels and mental scores or psychomotor scores was observed. CONCLUSIONS:: Low free thyroxine levels in healthy pregnant women are related to a moderate delay in child neurodevelopment. The impairment is similar in magnitude to that observed in mothers with untreated prepregnancy thyroid disorder. The value of screening pregnant women for thyroid function requires further assessment, particularly in mildly iodine-deficient areas.Epidemiology (Cambridge, Mass.) 01/2013; 24(1):150-157. · 5.51 Impact Factor -
Article: Evaluating the neurotoxic effects of lactational exposure to persistent organic pollutants (POPs) in Spanish children.
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ABSTRACT: Although the brain continues developing in the postnatal period, epidemiological studies on the effects of postnatal exposure to neurotoxic POPs through breast-feeding remain mostly inconclusive. Failure to detect associations between postnatal exposure and health outcomes may stem from the limitations of commonly employed approaches to assess lactational exposure. The aim of the present study was to assess whether lactational exposure to polychlorinated biphenyl-153 (PCB-153), dichlorodiphenyldichloroethylene (DDE), or hexachlorobenzene (HCB) as estimated with a physiologically based pharmacokinetic (PBPK) model, is associated with decrements in mental and psychomotor development scores of the Bayley Scales of Infant Development (BSID) test in children aged around 14-months of a subsample (N=1175) of the Spanish INMA birth cohort, and to compare this with the effects of prenatal exposure. Although in the present study population PCB-153, DDE and HCB exposure increased within the first months of postnatal life, no associations were found between different periods of postnatal exposure to these compounds and mental or psychomotor scores. Increasing prenatal PCB-153 concentrations were associated with worse mental and psychomotor scores, although significance was only reached for psychomotor development (β [95%CI]=-1.36 [-2.61, -0.11]). Indeed, the association between exposure and effects observed during prenatal life weakened gradually across periods of postnatal life. Results of the present study suggest that, although breastfeeding increases children's blood persistent organic pollutants (POPs) levels during postnatal life, deleterious effects of PCB-153 on neuropsychological development are mainly attributable to prenatal exposure.NeuroToxicology 10/2012; · 3.10 Impact Factor -
Article: Polybrominated Diphenyl Ethers (PBDEs) in Breast Milk and Neuropsychological Development in Infants.
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ABSTRACT: Background: There is increasing interest in the potential effects of polybrominated diphenyl ethers (PBDEs) on children's neuropsychological development, but only a few small studies have evaluated such effects. Objectives: To examine the association between PBDE concentrations in colostrum and infant neuropsychological development and to assess the influence of other persistent organic pollutants (POPs) on such association. Methods: We measured concentrations of PBDEs and other POPs in colostrum samples of 290 women recruited in a Spanish birth cohort. We tested children for mental and psychomotor development with the Bayley Scales of Infant Development at age 12-18 months. We analyzed the sum of the seven most common PBDE congeners (BDE47, 99, 100, 153, 154, 183, 209) and each congener separately. Results: Increasing sumPBDEs concentrations showed an association of borderline statistical significance with decreasing mental development scores (β per log ng/g lipid =-2.25, 95%CI -4.75, 0.26). BDE209, the congener present in highest concentrations, appeared to be the main congener responsible for this association (β=-2.40, 95%CI -4.79, -0.01). There was little evidence for an association with psychomotor development. After adjustment for other POPs, the BDE209 association with mental development score became slightly weaker (β=-2.10, 95%CI -4.66, 0.46). Conclusions: Our findings suggest an association between increasing PBDE concentrations in colostrum and a worse infant mental development, particularly for BDE209, but require confirmation in larger studies. The association, if causal, may be due to unmeasured BDE209 metabolites, including OH-PBDEs, which are more toxic, more stable, and more likely to cross the placenta and to easily reach the brain than BDE209.Environmental Health Perspectives 09/2012; · 7.04 Impact Factor -
Article: Prenatal exposure to polychlorinated biphenyls and child neuropsychological development in 4-year-olds: an analysis per congener and specific cognitive domain.
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ABSTRACT: Polychlorinated biphenyls (PCB) are synthetic organochlorine compounds with potential neurotoxic effects. Although negative effects on neuropsychological development have been observed in previous studies on PCB exposure, there are inconsistencies in these effects at current exposure levels of these compounds which are much lower than for previous generations. This study aimed to disentangle the effects of prenatal and postnatal PCB exposure on neuropsychological development at 4 years of age. This study is based on a population-based birth cohort design established in Menorca (Spain) as part of the INMA [Environment and Childhood] Project. We assessed general neuropsychological development using the McCarthy Scales of Children's Abilities (MCSA). A total of 422 4-year old children were assessed with the MCSA. Levels of PCBs were measured in cord blood (n=405) and in blood samples taken at 4 years (n=285). We found no statistically significant effects of the sum of prenatal PCBs on MCSA scores. Nevertheless, individual congener analyses yielded significant detrimental effects of prenatal PCB153 on the majority of MCSA scores, while no effects were reported for other congeners. The levels of PCBs at 4 years of age were not associated with neuropsychological development. Thus, prenatal exposure to low-level concentrations of PCBs, particularly PCB153, was associated with an overall deleterious effect on neuropsychological development at 4 years of age, including negative effects on executive function, verbal functions and visuospatial abilities, but not on motor development.Science of The Total Environment 06/2012; 432:338-43. · 3.29 Impact Factor -
Article: Longitudinal association between early life socio-environmental factors and attention function at the age 11 years.
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ABSTRACT: Prenatal and early-life exposures can affect the course of children's neuropsychological development well into pre-adolescence, given the vulnerability of the developing brain. However, it is unknown which socio-environmental factors at early childhood can influence specific cognitive processes like attention at a later age. In this study, we aim to determine social and environmental exposures in early childhood that may be associated with attention function of 11-year-olds. We measured attention function using the continuous performance test-II (CPT-II) on 393 11-year old children from the Menorca's birth-cohort within the INMA-project (Spain), and pre-selected a list of socio-environmental observations taken when they were up to 4 years of age. We found that earlier socio-environmental characteristics, such as parental social class, educational level and maternal mental health are associated with later inattentive and impulsive symptomatology through a higher rate of omission and commission errors. In addition, omission errors were higher in children with atopy and lower in those whose mothers took dietary supplementation with folic acid and vitamins during pregnancy. Breastfeeding played a protective role against commission errors, while higher DDE and PCBs levels at age 4 were associated with slow speed response. Our findings suggest that a number of life socio-environmental factors during prenatal life and early childhood, such as socio-demographic characteristics, breastfeeding, maternal nutritional supplementation with folic acid and vitamins and exposure to some organochlorine compounds may influence inattentive and hyperactive/impulsive symptomatology during pre-adolescence.Environmental Research 05/2012; 117:54-9. · 3.40 Impact Factor -
Article: Prenatal exposure to organochlorine compounds and neuropsychological development up to two years of life.
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ABSTRACT: Polychlorinated biphenyls (PCB), hexachlorobenzene (HCB), and dichlorodiphenyl dichloroethylene (pp'DDE) are persistent, bioaccumulative, and toxic environmental pollutants with potential neurotoxic effects. Despite a growing body of studies investigating the health effects associated with these compounds, their specific effects on early neuropsychological development remain unclear. We investigated such neuropsychological effects in a population-based birth cohort based in three regions in Spain (Sabadell, Gipuzkoa, and Valencia) derived from the INMA [Environment and Childhood] Project. The main analyses in this report were based on 1391 mother-child pairs with complete information on maternal levels of organochlorine compounds and child neuropsychological assessment (Bayley Scales of Infant Development) at age 14 months. We found that prenatal PCB exposure, particularly to congeners 138 and 153, resulted in impairment of psychomotor development (coefficient=-1.24, 95% confidence interval=-2.41, -0.07), but found no evidence for effects on cognitive development. Prenatal exposure to pp'DDE or HCB was not associated with early neuropsychological development. The negative effects of exposure to PCBs on early psychomotor development suggest that the potential neurotoxic effects of these compounds may be evident even at low doses.Environment international 05/2012; 45:72-7. · 4.79 Impact Factor -
Article: Maternal intelligence-mental health and child neuropsychological development at age 14 months.
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ABSTRACT: To examine the relationship between maternal intelligence-mental health and neuropsychological development at age 14 months in a normal population, taking into account maternal occupational social class and education. We prospectively studied a population-based birth cohort, which forms part of the INMA (Environment and Childhood) Project. Cognitive and psychomotor development was assessed at 14 months using Bayley Scales of Infant Development. Maternal intelligence and mental health were assessed by the Cattell and Cattell test and the General Health Questionnaire-12 respectively. We observed a crude association between maternal intelligence and cognitive development in children at 14 months but this association disappeared when maternal education was included. The associations were stratified by maternal education and occupational social class. Within the manual maternal occupational social class, there was a significant difference in cognitive development between children whose mothers scored in the highest tertile of maternal IQ and those whose mothers scored in the lowest tertile. In contrast, no differences were observed among children whose mothers were in the non-manual occupational social class. The association between maternal intelligence and child cognitive development differed by occupational social class. While this association was not confounded by education or other variables in manual occupational social classes, maternal education explained this association among advantaged occupational social classes.Gaceta Sanitaria 01/2012; 26(5):397-404. · 1.33 Impact Factor -
Article: Child neurodevelopment in a Bolivian mining city.
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ABSTRACT: This study evaluates the neurodevelopment of children living near contaminated mining industries during their first year of life. Participants from the city of Oruro (Bolivia) were prospectively recruited during pregnancy. Follow-up occurred between May 2007 and November 2009. Information about the socioeconomic status and medical history of the pregnant women were collected using questionnaires. Neurodevelopment was evaluated for 246 children using the Bayley Scales of Infant Development (BSID) at 10.5-12.5 months of age. Exposure to trace elements (Pb, As, Cd, Sb, Cs, Zn, Fe, Cu, Se, Rb, and Sr) during prenatal life was evaluated by testing maternal blood concentrations before delivery. Almost all measured levels were lower than the control limits. The blood lead concentration of pregnant women was low, considering the contaminated environmental context. The geometric mean was 1.76 μg/dL (95% CI: 1.68-1.84), a level comparable with those observed in non-contaminated areas. The only element found to be relatively elevated was antimony, with a geometric mean of 1.03 μg/dL (95% CI: 0.96-1.11). Our results suggest that women from this mining area were not highly exposed. The Bayley Scales of Infant Development (BSID) did not reveal mental or psychomotor abnormalities. Surprisingly, at the observed low levels, lead was positively associated with the children's BSID performance.Environmental Research 12/2011; 112:147-54. · 3.40 Impact Factor -
Article: Breastfeeding, long-chain polyunsaturated fatty acids in colostrum, and infant mental development.
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ABSTRACT: Breastfeeding has been associated with improved neurodevelopment in children. However, it remains unknown to what extent nutritional advantages of breast milk may explain this relationship. We assessed the role of parental psychosocial factors and colostrum long-chain polyunsaturated fatty acid (LC-PUFA) levels in the relationship between breastfeeding and children's neurodevelopment. A population-based birth cohort was established in the city of Sabadell (Catalonia, Spain) as part of the INMA-INfancia y Medio Ambiente Project. A total of 657 women were recruited during the first trimester of pregnancy. Information about parental characteristics and breastfeeding was obtained by using a questionnaire, and trained psychologists assessed mental and psychomotor development by using the Bayley Scales of Infant Development in 504 children at 14 months of age. A high percentage of breastfeeds among all milk feeds accumulated during the first 14 months was positively related with child mental development (0.37 points per month of full breastfeeding [95% confidence interval: 0.06-0.67]). Maternal education, social class, and intelligence quotient only partly explained this association. Children with a longer duration of breastfeeding also exposed to higher ratios between n-3 and n-6 PUFAs in colostrum had significantly higher mental scores than children with low breastfeeding duration exposed to low levels. Greater levels of accumulated breastfeeding during the first year of life were related to higher mental development at 14 months, largely independently from a wide range of parental psychosocial factors. LC-PUFA levels seem to play a beneficial role in children's mental development when breastfeeding levels are high.PEDIATRICS 09/2011; 128(4):e880-9. · 4.47 Impact Factor -
Article: Effects of pre and postnatal exposure to low levels of polybromodiphenyl ethers on neurodevelopment and thyroid hormone levels at 4 years of age.
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ABSTRACT: There are at present very few studies of the effects of polybromodiphenyl ethers (PBDEs), used as flame retardants in consumer products, on neurodevelopment or thyroid hormone levels in humans. The present study aims to examine the association between pre and postnatal PBDE concentrations and neurodevelopment and thyroid hormone levels in children at age 4years and isolate the effects of PBDEs from those of PCBs, DDT, DDE and HCB. A prospective birth cohort in Menorca (Spain) enrolled 482 pregnant mothers between 1997 and 1998. At 4years, children were assessed for motor and cognitive function (McCarthy Scales of Children's Abilities), attention-deficit, hyperactivity and impulsivity (ADHD-DSM-IV) and social competence (California Preschool Social Competence Scale). PBDE concentrations were measured in cord blood (N=88) and in serum of 4years olds (N=244). Among all congeners analyzed only PBDE 47 was quantified in a reasonable number of samples (LOQ=0.002ng/ml). Exposure to PBDE 47 was analyzed as a dichotomous variable: concentrations above the LOQ (exposed) and concentrations below (referents). Scores for cognitive and motor functions were always lower in children pre and postnatally exposed to PBDE47 than in referents, but none of these associations was statistically significant (β coefficient (95%CI) of the total cognition score: -2.7 (-7.0, 1.6) for postnatal exposure, and -1.4 (-9.2, 6.5) for prenatal exposure). Postnatal exposure to PBDE 47 was statistically significantly related to an increased risk of symptoms on the attention deficit subscale of ADHD symptoms (RR (95%CI)=1.8 (1.0, 3.2)) but not to hyperactivity symptoms. A statistically significant higher risk of poor social competence symptoms was observed as a consequence of postnatal PBDE 47 exposure (RR (95%CI)=2.6 (1.2, 5.9)). Adjustment for other organochlorine compounds did not influence the results. Levels of thyroid hormones were not associated to PBDE exposure. This study highlights the importance of assessing the effects of PBDE exposure not just prenatally but also during the early years of life. In the light of current evidence a precautionary approach towards PBDE exposure of both mothers and children seems warranted.Environment international 04/2011; 37(3):605-11. · 4.79 Impact Factor -
Article: Genetic variants of the FADS gene cluster and ELOVL gene family, colostrums LC-PUFA levels, breastfeeding, and child cognition.
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ABSTRACT: Breastfeeding effects on cognition are attributed to long-chain polyunsaturated fatty acids (LC-PUFAs), but controversy persists. Genetic variation in fatty acid desaturase (FADS) and elongase (ELOVL) enzymes has been overlooked when studying the effects of LC-PUFAs supply on cognition. We aimed to: 1) to determine whether maternal genetic variants in the FADS cluster and ELOVL genes contribute to differences in LC-PUFA levels in colostrum; 2) to analyze whether these maternal variants are related to child cognition; and 3) to assess whether children's variants modify breastfeeding effects on cognition. Data come from two population-based birth cohorts (n = 400 mother-child pairs from INMA-Sabadell; and n = 340 children from INMA-Menorca). LC-PUFAs were measured in 270 colostrum samples from INMA-Sabadell. Tag SNPs were genotyped both in mothers and children (13 in the FADS cluster, 6 in ELOVL2, and 7 in ELOVL5). Child cognition was assessed at 14 mo and 4 y using the Bayley Scales of Infant Development and the McCarthy Scales of Children's Abilities, respectively. Children of mothers carrying genetic variants associated with lower FADS1 activity (regulating AA and EPA synthesis), higher FADS2 activity (regulating DHA synthesis), and with higher EPA/AA and DHA/AA ratios in colostrum showed a significant advantage in cognition at 14 mo (3.5 to 5.3 points). Not being breastfed conferred an 8- to 9-point disadvantage in cognition among children GG homozygote for rs174468 (low FADS1 activity) but not among those with the A allele. Moreover, not being breastfed resulted in a disadvantage in cognition (5 to 8 points) among children CC homozygote for rs2397142 (low ELOVL5 activity), but not among those carrying the G allele. Genetically determined maternal supplies of LC-PUFAs during pregnancy and lactation appear to be crucial for child cognition. Breastfeeding effects on cognition are modified by child genetic variation in fatty acid desaturase and elongase enzymes.PLoS ONE 01/2011; 6(2):e17181. · 4.09 Impact Factor -
Article: Prenatal exposure to cell phone use and neurodevelopment at 14 months.
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ABSTRACT: Recently, an association was reported between prenatal and postnatal exposure to cell phones and neurobehavioral problems in children at the age of 7 years. A birth cohort was established in Sabadell, Spain between 2004 and 2006. Mothers completed questions about cell phone use in week 32 of the pregnancy (n = 587). Neurodevelopment of their children was tested at age 14 months using the Bayley Scales of Infant Development (n = 530). We observed only small differences in neurodevelopment scores between the offspring of cell phone users and nonusers. Those of users had higher mental development scores and lower psychomotor development scores, which may be due to unmeasured confounding. There was no trend with amount of cell phone use within users. This study gives little evidence for an adverse effect of maternal cell phone use during pregnancy on the early neurodevelopment of offspring.Epidemiology (Cambridge, Mass.) 03/2010; 21(2):259-62. · 5.51 Impact Factor -
Article: Cognitive function and overweight in preschool children.
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ABSTRACT: The authors assessed the association between cognitive function and incidence and maintenance of overweight in preschool children. A population-based birth cohort was established in Menorca, Spain, between 1997 and 1999 (n = 482). Body mass index (weight (kg)/height (m)(2)) was measured at ages 4 years and 6 years (n = 421). At age 4 years, children were assessed for cognitive function (McCarthy Scales of Children's Abilities) (n = 395). After multivariable adjustment for a wide range of factors, including maternal education and body mass index, children with higher general cognition at age 4 years had a lower likelihood of being overweight (odds ratio = 0.47, 95% confidence interval (CI): 0.25, 0.88) at age 6 years. Children with higher general cognition at age 4 years had a lower likelihood of maintaining an unhealthy weight status (being at risk of overweight or overweight) between ages 4 years and 6 years, as well as worsening weight status over time, than children who maintained a healthy weight (odds ratios were 0.78 (95% CI: 0.54, 1.14) and 0.77 (95% CI: 0.51, 1.14), respectively). When specific dimensions of cognitive function were assessed, associations were mainly found for verbal and executive function areas. Children with higher cognitive function in early life might be at decreased risk of overweight later in childhood.American journal of epidemiology 07/2009; 170(4):438-46. · 5.59 Impact Factor
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2009–2013
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Centre for Research in Environmental Epidemiology (CREAL)
Barcelona, Catalonia, Spain
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