Exposure to environmental factors, such as neurotoxic metals and micronutrients, during critical periods of development can contribute to long-term consequences in offspring's health, including neurodevelopmental outcomes. The aim of this study was to evaluate the association between simultaneous prenatal exposure to metals [lead (Pb), cadmium (Cd), mercury (Hg)] and micronutrients [selenium (Se), zinc (Zn), copper (Cu)] and neurodevelopmental outcomes in school-age children from the Polish Mother and Child Cohort (REPRO_PL).

Metals and micronutrients concentrations were measured in cord blood (Pb, Cd, Se, Zn, Cu) and in maternal hair (Hg) collected during the 3rd trimester of pregnancy. Behavioral and emotional problems, as well as children's cognitive and psychomotor development, were assessed in 436 school-age children using the Strengths and Difficulties Questionnaire (SDQ, filled in by the mothers) and the Polish adaptation of the Intelligence and Development Scales (IDS, administered by trained psychologists). Multivariate regression models were applied after imputation of missing values, using two approaches: (i) a joint analysis taking into account all metals and micronutrients simultaneously, and (ii) an ExWAS study (single-exposure model).

In the SDQ, Hyperactivity/Inattention problems and Total difficulties were associated with higher Hg concentrations in maternal hair (0.18, 95% CI: 0.05; 0.3; and 0.14, 95% CI: 0.01; 0.3, respectively), whereas Emotional symptoms were inversely associated with Se and Zn levels in cord blood (−0.13, 95% CI: −0.3; 0.004; and −0.10, 95% CI: −0.2; 0.02, respectively). In the IDS, cord blood Pb levels were found to be negatively associated with Fluid and Crystallized IQ (−0.12, 95% CI: −0.3; 0.02; and −0.14, 95% CI: −0.3; 0.007, respectively) as well as Mathematical skills (−0.15, 95% CI: −0.3; 0.01).

The current research has been able to simultaneously assess the exposure to various interacting chemicals during the prenatal period. We demonstrate that prenatal co-exposures to Pb, Hg, Zn and Se have long-term influences on the neuropsychological outcome of school-age children.

在发育的关键时期接触环境因素，如神经毒性金属和微量营养素，可能会对后代的健康产生长期影响，包括神经发育结果。本研究的目的是评估产前同时暴露于金属 [铅 (Pb)、镉 (Cd)、汞 (Hg)] 和微量营养素 [硒 (Se)、锌 (Zn)、铜 (Cu)] 之间的关系来自波兰母婴队列 (REPRO_PL) 的学龄儿童的神经发育结果。

在妊娠第三个三个月期间采集的脐带血（Pb、Cd、Se、Zn、Cu）和母体毛发（Hg）中测量金属和微量营养素浓度。使用优势和困难问卷（SDQ，由母亲填写）和波兰改编的智力和发展量表（IDS，由训练有素的心理学家管理）。在估算缺失值后应用多元回归模型，使用两种方法：(i) 同时考虑所有金属和微量营养素的联合分析，以及 (ii) ExWAS 研究（单次暴露模型）。

在 SDQ 中，多动/注意力不集中问题和总困难与母体头发中较高的 Hg 浓度相关（分别为 0.18, 95% CI：0.05；0.3；和 0.14, 95% CI：0.01；0.3），而情绪症状则成反比与脐带血中的硒和锌水平相关（分别为-0.13，95% CI：-0.3；0.004；和-0.10，95% CI：-0.2；0.02）。在 IDS 中，发现脐带血 Pb 水平与体液和结晶 IQ 呈负相关（分别为 -0.12，95% CI：-0.3；0.02；和 -0.14，95% CI：-0.3；0.007）以及数学技能（-0.15，95% CI：-0.3；0.01）。

目前的研究已经能够同时评估在产前期间暴露于各种相互作用的化学物质。我们证明，产前共同暴露于 Pb、Hg、Zn 和 Se 对学龄儿童的神经心理结果具有长期影响。