Objective:
To investigate the association of
prenatal mercury exposure and fish intake with
attention-deficit/hyperactivity disorder (ADHD)–related behavior.
Methods:
For a population-based prospective
birth cohort recruited in New Bedford, Massachusetts (1993-1998), we
analyzed data for children examined at age 8 years with peripartum
maternal hair mercury measures (n = 421) or maternal report
of fish consumption during pregnancy (n = 515). Inattentive
and impulsive/hyperactive behaviors were assessed using a teacher
rating scale and neuropsychological testing.
Results:
The median maternal hair mercury level
was 0.45 μg/g (range, 0.03-5.14 μg/g), and 52% of mothers consumed
more than 2 fish servings weekly. In multivariable regression models,
mercury exposure was associated with inattention and
impulsivity/hyperactivity; some outcomes had an apparent threshold
with associations at 1 μg/g or greater of mercury. For example, at 1
μg/g or greater, the adjusted risk ratios for mild/markedly atypical
inattentive and impulsive/hyperactive behaviors were 1.4 (95% CI,
1.0-1.8) and 1.7 (95% CI, 1.2-2.4), respectively, for an
interquartile range (0.5 μg/g) mercury increase; there was no
confounding by fish consumption. For neuropsychological assessments,
mercury and behavior associations were detected primarily for boys.
There was a protective association for fish consumption (>2
servings per week) with ADHD-related behaviors, particularly
impulsive/hyperactive behaviors (relative risk = 0.4; 95%
CI, 0.2-0.6).
Conclusions:
Low-level prenatal mercury exposure is
associated with a greater risk of ADHD-related behaviors, and fish
consumption during pregnancy is protective of these behaviors. These
findings underscore the difficulties of balancing the benefits of
fish intake with the detriments of low-level mercury exposure in
developing dietary recommendations in pregnancy.
Arch Pediatr Adolesc Med. 2012;():1-3. doi:10.1001/archpediatrics.2012.1900
Arch Pediatr Adolesc Med. 2012;():1-3. doi:10.1001/archpediatrics.2012.1900
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