Patterns of exposure to multiple metals and associations with neurodevelopment of preschool children from Montevideo, Uruguay.

While it is known that toxic metals contribute individually to child cognitive and behavioral deficits, we still know little about the effects of exposure to multiple metals, particularly when exposures are low. We studied the association between children's blood lead and hair arsenic, cadmium, and manganese and their performance on the Bayley Scales of Infant Development III. Ninety-two preschool children (age 13-42 months) from Montevideo, Uruguay, provided a hair sample and 78 had a blood lead level (BLL) measurement. Using latent class analysis (LCA), we identified four groups of exposure based on metal concentrations: (1) low metals, (2) low-to-moderate metals, (3) high lead and cadmium, and (4) high metals. Using the four-group exposure variable as the main predictor, and fitting raw scores on the cognitive, receptive vocabulary, and expressive vocabulary scales as dependent variables, both complete-case and multiple imputation (MI) analyses were conducted. We found no association between multiple-metal exposures and neurodevelopment in covariate-adjusted models. This study demonstrates the use of LCA together with MI to determine patterns of exposure to multiple toxic metals and relate these to child neurodevelopment. However, because the overall study population was small, other studies with larger sample sizes are needed to investigate these associations.

The relationship among depression, parenting stress, and partner support in low-income women from Montevideo, Uruguay.

We investigated the prevalence and predictors of depression in low-income mothers (n = 99) of young children from Uruguay. We administered the Beck Depression Scale (BDI) and the Parenting Stress Index (PSI), and asked who is responsible for the main tasks of parenting and household care. We found a high prevalence of moderate-to-severe depression (BDI >19 points, 31.3%), with women with t scores > 90 on the PSI being seven times more likely to experience moderate-to-severe depressive symptoms than women with lower PSI scores (p <.01). This is the first investigation of the predictors of depression in urban Uruguayan mothers of low socioeconomic status.

Association of maternal and child blood lead and hemoglobin levels with maternal perceptions of parenting their young children.

Biological and psychosocial factors affect child development and behavior. Whereas biological underpinnings behind the neurotoxic effects of lead are studied extensively, the effects of psychosocial factors contributing to poor behavioral outcomes in lead-exposed children are not well understood. Parental attributes and practices may moderate or mediate the effects of lead on children's behavioral outcomes. We investigated the hypothesis that maternal and child lead and hemoglobin levels are associated with maternal perceptions of their parenting. Specifically, we hypothesized that children with higher blood lead (BLL) and lower hemoglobin concentrations would be associated with poorer maternal self-assessments of their parenting skills or the mother-child relationship. Children aged 13-55 months and their mothers (n=109) were recruited from among the participants of a previous lead and anemia screening study and from preschools in Montevideo, Uruguay. The mother-child pair attended two study visits: one to collect biological samples and answer demographic and child questionnaires, including statements regarding parenting; and a second to evaluate maternal IQ, depression and stress, and child development. Of the children, 51.6% had blood lead concentrations (BLLs) ≥ 5 µg/dL, 18.0% had anemia, and 8% had both conditions. Among mothers, 48.4% had BLLs ≥ 5 µg/dL, 16.0% had anemia, and 11% had both. BLLs ≥ 5 µg/dL in mother or child were associated with lower maternal perceptions of being skilled at discipline (p<0.05). Maternal anemia was associated with lower likelihood that mothers would let their children explore and play (p<0.05), whereas child anemia was associated with maternal perception of lower emotional support (p<0.01). In addition to shared environmental exposures, parenting and family interactions need to be considered as potentially contributing factors to poorer outcomes in lead-exposed children.