Title: Prenatal Lead Exposure Modifies the Impact of Maternal Self-Esteem on Children's Inattention Behavior.
Authors: Xu, Jian; Hu, Howard; Wright, Rosalind; Sánchez, Brisa N; Schnaas, Lourdes; Bellinger, David C; Park, Sung Kyun; Martínez, Sandra; Hernández-Avila, Mauricio; Téllez-Rojo, Martha Maria; Wright, Robert O
Published In J Pediatr, (2015 Aug)
Abstract: 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.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.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).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.
PubMed ID: 26047683
MeSH Terms: Age Factors; Attention Deficit Disorder with Hyperactivity/blood*; Attention Deficit Disorder with Hyperactivity/epidemiology*; Child; Child, Preschool; Cohort Studies; Female; Humans; Lead/adverse effects; Lead/blood*; Male; Mexico; Mothers/psychology*; Pregnancy; Prenatal Exposure Delayed Effects/blood; Prenatal Exposure Delayed Effects/psychology*; Risk Factors; Self Concept*