Background

Normal prenatal neurodevelopment follows stages that are potentially influenced by both chemical and psychosocial environments. Exposure to elevated manganese during this critically vulnerable period has been found to be neurotoxic. Independently, maternal prenatal depression has been associated with subsequent neurodevelopmental decrements in children. The association between child neurodevelopment and prenatal co-exposure to manganese and maternal depression has not been sufficiently studied.

Methods

During pregnancy and at birth, we measured maternal blood and cord blood manganese levels respectively. Maternal depression was assessed in the 3rd trimester of pregnancy using the Edinburgh Depression Scale. Neurodevelopment was evaluated at 24 months of age with the Bayley Scales of Infant Development. A multivariate multiple regression model was used to analyze cognitive, language and motor scores simultaneously for 473 children from the PROGRESS birth cohort in Mexico City.

Results

Over 25% of our study participants reported having depressive symptoms. 3rd trimester blood manganese as well as depressive symptoms were independently negatively associated with all neurodevelopment scores in adjusted models. In stratified analyses, the negative association between manganese (maternal as well as cord blood) and 24-month language scores was stronger among women with depressive symptoms. Receptive language was mostly affected. Inverted U-shaped curves were seen for the association between with cord blood manganese and neurodevelopment scores.

Conclusions

Our findings are in line with previous studies of manganese and depression neurotoxicity. The prenatal period may be particularly sensitive to manganese and depression co-exposures and should be of interest for public health interventions to promote healthy emotional and nutritional pregnancies.

中文翻译：

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产前同时接触锰和抑郁症以及24个月的神经发育

背景

正常的产前神经发育遵循可能受化学和社会心理环境影响的阶段。在这个极为脆弱的时期内，接触高锰会导致神经毒性。独立地，母亲的产前抑郁症已与儿童随后的神经发育减退相关。儿童神经发育与产前锰和母体抑郁的共同暴露之间的关联尚未得到充分研究。

方法

在怀孕期间和出生时，我们分别测量了孕妇血液和脐带血锰水平。使用爱丁堡抑郁量表在妊娠的第三个三个月对母亲的抑郁进行评估。在24个月大时使用Bayley婴儿发育量表评估了神经发育。多元多元回归模型用于同时分析来自墨西哥城PROGRESS出生队列的473名儿童的认知，语言和运动成绩。

结果

在我们的研究参与者中，有超过25％的人报告有抑郁症状。在调整后的模型中，妊娠晚期的锰和抑郁症状与所有神经发育评分均呈负相关。在分层分析中，患有抑郁症状的女性中锰（母亲和脐带血）与24个月语言评分之间的负相关性更强。接受语言受到的影响最大。脐血锰与神经发育评分之间的相关性呈倒U形曲线。

结论

我们的发现与先前关于锰和抑郁症神经毒性的研究一致。产前时期可能对锰和抑郁症的共同暴露特别敏感，应该引起公众健康干预，以促进健康的情绪和营养妊娠。