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Environ Health Perspect. 2017 Jun 28;125(6):067020. doi: 10.1289/EHP925.

Maternal and Cord Blood Manganese Concentrations and Early Childhood Neurodevelopment among Residents near a Mining-Impacted Superfund Site.

Author information

Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
Department of Neurology, Harvard Medical School and Boston Children’s Hospital, Boston, Massachusetts, USA
Department of Psychiatry, Harvard Medical School and Boston Children’s Hospital, Boston, Massachusetts, USA
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
Local Environmental Action Demanded (L.E.A.D.) Agency, Inc., Vinita, Oklahoma, USA
Division of Environmental Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA



Environmental manganese exposure has been associated with adverse neurodevelopmental outcomes among school-aged children; yet, few studies have evaluated prenatal exposure.


Our study examines associations between prenatal manganese concentrations and placental transfer of manganese with neurodevelopment in 224 2-y-old children residing near the Tar Creek Superfund Site.


We collected maternal and cord blood at delivery, measured manganese using inductively coupled plasma mass spectrometry, and assessed neurodevelopment using the Bayley Scales of Infant Development-II. Associations between manganese and mental (MDI) and psychomotor (PDI) development indices were estimated in multivariable models. Placental transfer, approximated by cord/maternal manganese ratio, cord/total manganese ratio (total=maternal+cord), and by joint classification according to high or low (above or below median) maternal and cord manganese, was evaluated as a predictor of neurodevelopment.


Median levels [interquartile ranges (IQR)] of manganese in maternal and cord blood, respectively, were 24.0 (19.5-29.7) and 43.1 (33.5-52.1) μg/L. Adjusting for lead, arsenic, and other potential confounders, an IQR increase in maternal manganese was associated with -3.0 (95% CI: -5.3, -0.7) points on MDI and -2.3 (95% CI: -4.1, -0.4) points on PDI. Cord manganese concentrations were not associated with neurodevelopment scores. Cord/maternal and cord/total manganese ratios were positively associated with MDI [cord/maternal: β=2.6 (95% Cl: −0.04, 5.3); cord/total: β=22.0 (95% Cl: 3.2, 40.7)] and PDI (cord/maternal: β=1.7 (95% Cl: −0.5, 3.9); cord/total: β=15.6 (95% Cl: 0.3, 20.9)). Compared to mother-child pairs with low maternal and cord manganese, associations with neurodevelopment scores were negative for pairs with either high maternal, high cord, or high maternal and cord manganese.


Maternal blood manganese concentrations were negatively associated with early childhood neurodevelopment scores in our study. Findings highlight the importance of understanding maternal exposures during pregnancy and factors influencing placental transfer.

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