TY - JOUR
T1 - Prenatal Lead Exposure Modifies the Impact of Maternal Self-Esteem on Children's Inattention Behavior
AU - Xu, Jian
AU - Hu, Howard
AU - Wright, Rosalind
AU - Sánchez, Brisa N.
AU - Schnaas, Lourdes
AU - Bellinger, David C.
AU - Park, Sung Kyun
AU - Martínez, Sandra
AU - Hernández-Avila, Mauricio
AU - Téllez-Rojo, Martha Maria
AU - Wright, Robert O.
N1 - Funding Information:
Supported by the US National Institute of Environmental Health Sciences (NIEHS; R01ES021446 , P42-ES05947 , P01ES012874 , RO1-ES013744 , RO1 ES014930 , P30-ES 00002 , K23 ES000381 , RO1 ES007821 ), Consejo Nacional de Ciencia y Tecnología (CONACyT; 4150M9405 ), Department of Federal District , México, National Institute of Public Health /Ministry of Health of Mexico, National Natural Science Foundation of China (NCFS; 81373016 ), and Science and Technology Commission of Shanghai Municipality (STCSM; 124119a1400 ). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIEHS, NIH, EPA, CONACyT, NCFS or STCSM. The authors declare no conflicts of interest.
Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Objective To prospectively evaluate the association of maternal self-esteem measured when their offspring were toddlers with the subsequent development of attention deficit hyperactivity disorder (ADHD)-like behavior in their school-age offspring and the potential modifying effects of prenatal lead exposure. Study design We evaluated a subsample of 192 mother-child pairs from a long-running birth-cohort project that enrolled mothers in Mexico from 1994-2011. Prenatal lead exposure was assessed using cord blood lead and maternal bone lead around delivery (tibia and patella lead, measured by K-x-ray-fluorescence). When children were 2 years old, maternal self-esteem was measured using the Coopersmith Self-Esteem Inventory. When children were 7-15 years old, children's blood lead levels and ADHD symptoms were assessed, and Conners' Parent Rating Scale-Revised and Behavior Rating Inventory of Executive Function-Parent Form were used as measures of ADHD-like behavior. Results Adjusting for family economic status, marital status, maternal education and age, child's age and sex, and children's current blood lead levels, increased maternal self-esteem was associated with reduced child inattention behavior. Compared with those among high prenatal lead exposure (P25-P100), this association was stronger among low prenatal lead exposure groups (P1-P25, P values for the interaction effects between prenatal lead exposure and maternal self-esteem levels of <.10). Each 1-point increase in maternal self-esteem scores was associated with 0.6- to 1.3-point decrease in Conners' Parent Rating Scale-Revised and Behavior Rating Inventory of Executive Function-Parent Form T-scores among groups with low cord blood lead and patella lead (P1-P25). Conclusions Children experiencing high maternal self-esteem during toddlerhood were less likely to develop inattention behavior at school age. Prenatal lead exposure may play a role in attenuating this protective effect.
AB - Objective To prospectively evaluate the association of maternal self-esteem measured when their offspring were toddlers with the subsequent development of attention deficit hyperactivity disorder (ADHD)-like behavior in their school-age offspring and the potential modifying effects of prenatal lead exposure. Study design We evaluated a subsample of 192 mother-child pairs from a long-running birth-cohort project that enrolled mothers in Mexico from 1994-2011. Prenatal lead exposure was assessed using cord blood lead and maternal bone lead around delivery (tibia and patella lead, measured by K-x-ray-fluorescence). When children were 2 years old, maternal self-esteem was measured using the Coopersmith Self-Esteem Inventory. When children were 7-15 years old, children's blood lead levels and ADHD symptoms were assessed, and Conners' Parent Rating Scale-Revised and Behavior Rating Inventory of Executive Function-Parent Form were used as measures of ADHD-like behavior. Results Adjusting for family economic status, marital status, maternal education and age, child's age and sex, and children's current blood lead levels, increased maternal self-esteem was associated with reduced child inattention behavior. Compared with those among high prenatal lead exposure (P25-P100), this association was stronger among low prenatal lead exposure groups (P1-P25, P values for the interaction effects between prenatal lead exposure and maternal self-esteem levels of <.10). Each 1-point increase in maternal self-esteem scores was associated with 0.6- to 1.3-point decrease in Conners' Parent Rating Scale-Revised and Behavior Rating Inventory of Executive Function-Parent Form T-scores among groups with low cord blood lead and patella lead (P1-P25). Conclusions Children experiencing high maternal self-esteem during toddlerhood were less likely to develop inattention behavior at school age. Prenatal lead exposure may play a role in attenuating this protective effect.
UR - http://www.scopus.com/inward/record.url?scp=84937727880&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2015.04.057
DO - 10.1016/j.jpeds.2015.04.057
M3 - Article
C2 - 26047683
AN - SCOPUS:84937727880
SN - 0022-3476
VL - 167
SP - 435
EP - 441
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 2
ER -