Can fluoride in water during pregnancy harm children's development? One study suggests there is a relationship

New research suggests that fluoride exposure during pregnancy could be linked to neurobehavioral problems in children. But even the study's authors — who were prompted to examine the issue after earlier concerns about prenatal fluoride — said it's too soon to stop adding this cavity-fighting mineral to drinking water.

The new study found that women who had higher fluoride levels during pregnancy They later revealed that their children were more likely to have episodes of tantrums, complain of headaches and stomachaches, and display other neurobehavioral symptoms by the age of 3.

The study, the first of its kind in the United States, comes as more cities choose to ban fluoride in public water systems.

“I don't think we're at the point of saying you shouldn't add fluoride to water. “Overall, (the addition of fluoride) is considered one of the biggest victories for public health, and certainly for the dental community,” said study author Tracy Bastain, associate professor of Clinical Population Sciences and Public Health. from the Keck School of Medicine, University of Southern California (USC).

“But our results make me think”Bastain commented. “Pregnant women should probably drink filtered water.”

The study, published this Monday in JAMA Network Open, analyzed urine samples taken from 229 women during their third trimester of pregnancy. Participants in the study were predominantly Hispanic women living in Los Angeles, and were part of ongoing research by the USC MADRES Center on Environmental Health Disparities. The center works to understand how a range of toxins and other environmental hazards affect low-income communities and other marginalized groups.

For the new study, researchers asked mothers to fill out a checklist to assess their children's emotional and behavioral health at age 3.

Children whose mothers had higher levels of fluoride in their urine were 83% more likely to show a range of neurobehavioral problems, including anxiety, emotional reactions and physical ailments, such as unexplained headaches and stomachaches, according to the forms. that the mothers had filled out.

The forms also included questions about symptoms that may be associated with autism disorders, such as the tendency not to make eye contact.

Although, according to the research, children whose mothers had higher levels of fluoride were more likely to show behavioral symptoms, Bastain strongly cautioned against interpreting the results as anything more than a possible association.

“Of course, It does not mean that the child has autism. We don't even have information about the autism diagnosis” of the children in the study, he stated.

The National Institutes of Health and the Environmental Protection Agency funded the USC study.

Bastain explained that the research team wanted to specifically look at the possible effects of fluoride on child development because of concerns raised by other scientists.

A 2019 study published in JAMA Pediatrics, for example, found that IQ levels were slightly lower in 3- and 4-year-old children whose mothers had higher measurements of urine fluoride when they were pregnant.

Dr. Mark Moss, director of the division of public health dentistry at East Carolina University School of Dental Medicine in Greenville, North Carolina, expected the findings to “cause a stir,” but urged the caution.

“It is something that deserves closer examination”said Moss, who was not involved in the new study. “But in terms of public health practice, no, this is not getting to the point where we have to hit the pause button” on the fluoride issue.

The neurobehavioral symptoms identified by the mothers in the study did not necessarily rise to the level of clinical diagnosis.

“(We can) say there was an increase in the odds of something bordering on subclinical, and it's hard to say that this now warrants a public health reconsideration,” said Dr. Nathaniel DeNicola, a private obstetrician-gynecologist. in Yorba Linda, California.

Still, DeNicola, who presents a podcast On the possible health effects of environmental toxins during pregnancy, she recommended her pregnant patients use water filters to remove other potentially harmful chemicals, such as pesticides. DeNicola was not involved in the new investigation.

One of the strengths of the study, according to DeNicola, is that the authors attempted to account for lead exposure, which is known to cause neurodevelopmental problems in children. But lead levels were only measured during the first trimester of pregnancy and did not coincide with the time the fluoride samples were taken.

The study had several limitations.

The researchers could not determine whether the women who participated in the study drank fluoridated water. The MADRES study may not be applicable to other populations or areas of the country. Additionally, the researchers did not look at fluoride levels in the children.

Experts unrelated to the new research noted that a single urine sample taken once during pregnancy is hardly a reliable indicator of true fluoride exposure. Bastain acknowledged that samples taken over a 24-hour period would have been “a little more ideal.”

“If researchers want to really study fluoride consumption and its health effects, a robust study should be conducted in areas of naturally fluoridated water, from low to higher concentrations,” said Dr. Johnny Johnson, pediatric dentist and president of the American Fluoridation Society. “Zones like this exist in the United States and can easily be done to investigate any health effects.”