Prenatal Water Fluoride Exposure and Children’s Behavioral Problems

作者：Alexis Hernandez, Anne E. Nigra, Katrina R. Simon, Tessa R. Bloomquist, Tushara Rajeev, Amy Margolis, Amii Kress, Mohamad Burjak, Lauren C. Shuffrey, Anahid Akbaryan, Xiaoye Xu, Chang Liu, Stephanie Marie Eick, Zhu Wang, Judy L. Aschner, Hyeong‐Moo Shin, Margaret Karagas, Rebecca C. Fry, Tiffany Sanchez, Theresa Bastain, Santiago Morales, P Brian Smith, L Kristin Newby, Linda Adair, Lisa P. Jacobson, Diane Catellier, Monica McGrath, Christian Douglas, Priya Duggal, Emily Knapp, Amii Kress, Courtney K. Blackwell, Maxwell A. Mansolf, Jin-Shei Lai, Emily Ho, David Cella, Richard Gershon, Michelle Macy, Suman R. Das, Jane E. Freedman, Simon A. Mallal, John A. McLean, Ravi V. Shah, Meghan H. Shilts, Akram N. Alshawabkeh, José F. Cordero, John Meeker, Leonardo Trasande, Carlos A. Camargo, Kohei Hasegawa, Zhaozhong Zhu, Ashley F. Sullivan, D Dabelea, Wei Perng, Traci A. Bekelman, Greta Wilkening, Sheryl Magzamen, Brianna F. Moore, Anne P. Starling, Deborah J. Rinehart, Daphne Koinis Mitchell, Viren D'Sa, Sean Deoni, Hans-Georg Mueller, Cristiane S. Duarte, Catherine Monk, Glorisa Canino, Jonathan Posner, Tenneill Murray, Claudia Lugo-Candelas, Anne L. Dunlop, Patricia A. Brennan, Christine Hockett, Amy Elliott, Assiamira M. Ferrara, Lisa Croen, Monique M. Hedderson, John Ainsworth, Leonard B. Bacharier, Casper G. Bendixsen, James E. Gern, Diane R. Gold, Tina V. Hartert, Daniel J. Jackson, Christine C. Johnson, Christine L.M. Joseph, Meyer Kattan, Gurjit K. Khurana Hershey, Robert F. Lemanske, Susan V. Lynch, Rachel Miller, George T. O’Connor, Carole Ober, Dennis Ownby, Katherine Rivera‐Spoljaric, Patrick H. Ryan, Christine M. Seroogy, Anne Marie Singh, Robert A. Wood, Edward M. Zoratti, Rima Habre, Shohreh Farzan, Frank D. Gilliland, Irva Hertz‐Picciotto, Deborah H. Bennett, Julie B. Schweitzer, Rebecca J. Schmidt, Janine M. LaSalle, Alison E. Hipwell, Catherine J. Karr, Nicole R. Bush, Kaja Z. LeWinn, Sheela Sathyanarayana, Qi Zhao, Frances Tylavsky, Kecia N. Carroll, Christine T. Loftus, Leslie D. Leve, Jody M. Ganiban, Jenae M. Neiderhiser, Scott T. Weiss, Augusto A. Litonjua, Cindy T. McEvoy, Eliot R. Spindel, Robert S. Tepper, Craig J. Newschaffer, Kristen Lyall, Heather E. Volk, Rebecca Landa, Sally J. Ozonoff, Joseph Piven, Heather Hazlett, Juhi Pandey, Robert Schultz, Steven Dager, Kelly Botteron, Daniel Messinger, Wendy Stone, J. C. Ames, T. O'Connor, Richard K. Miller, Emily Oken, Michele R. Hacker, Tamarra James-Todd, T. Michael O'Shea, Rebecca C. Fry, Jean A. Frazier, Rachana Singh, Caitlin Rollins, Angela Montgomery, Ruben Vaidya, Robert M. Joseph, Lisa K. Washburn, Semsa Gogcu, Kelly Bear, Julie V. Rollins, Stephen R. Hooper, Geneviève Taylor, Wesley Jackson, Amanda Thompson, Julie Daniels, Michelle Hernandez, Kun Lu, Michael Msall, Madeleine Lenski, Rawad Obeid, Steven L. Pastyrnak, Elizabeth Jensen, Christina Sakai, Hudson Santos, Jean M. Kerver, Nigel Paneth, Charles Barone, Michael R. Elliott, Douglas M. Ruden, Chris Fussman, Julie Beth Herbstman, Amy Margolis, Susan L. Schantz, Sarah Dee Geiger, Andrea Aguiar, Karen Tabb, Rita Strakovsky, Tracey Woodruff, Rachel A. Morello-Frosch, Amy Padula, Joseph B. Stanford, Christina A. Porucznik, Angelo P. Giardino, Rosalind J. Wright, Robert O. Wright, Brent Collett, Nicole L. Baumann-Blackmore, Ronald Gangnon, Chris G. McKennan, Jo Wilson, Matt Altman, Judy L. Aschner, Annemarie Stroustrup, Stephanie L. Merhar, Paul E. Moore, Gloria Pryhuber, Mark Hudak, Ann Marie Reynolds Lyndaker, Andrea L. Lampland, Burton Rochelson, Sophia Jan, Matthew J. Blitz, Michelle W. Katzow, Zenobia Brown, Codruta Chiuzan, Timothy Rafael, Dawnette Lewis, Natalie Meirowitz, Brenda Poindexter, Tebeb Gebretsadik, Sarah Osmundson, Jennifer K. Straughen, Amy Eapen, Andrea Cassidy-Bushrow, Ganesa Wegienka, Alex Sitarik, Kim Woodcroft, Audrey Urquhart, Albert Levin, Tisa M. Johnson-Hooper, Brent Davidson, Tengfei Ma, Emily S. Barrett, Martin J. Blaser, Maria Gloria Dominguez-Bello, Daniel B. Horton, Manuel Jimenez, Todd Rosen, Kristy Palomares, Lyndsay A. Avalos, Yeyi Zhu, Kelly J . Hunt, Roger B. Newman, Michael S. Bloom, Mallory H. Alkis, James R. Roberts, Sunni L. Mumford, Heather H. Burris, Sara B. DeMauro, Lynn M. Yee, Aaron Hamvas, Antonia F. Olidipo, Andrew S. Haddad, Lisa R. Eiland, Nicole T. Spillane, Kirin N. Suri, Stephanie A. Fisher, Jeffrey A. Goldstein, Leena B. Mithal, Raye-Ann O. DeRegnier, Nathalie L. Maitre, Ruby H.N. Nguyen, Meghan M. JaKa, Abbey C. Sidebottom, Michael J. Paidas, JoNell Efantis Potter, Natale Ruby, Lunthita Duthely, Arumugam Jayakumar, Karen Young, Isabel Maldonado, Meghan Miller, Jonathan L. Slaughter, Sarah A. Keim, Courtney D. Lynch, Kartik K. Venkatesh, Kristina Walker Whitworth, Elaine Symanski, Thomas F. Northrup, Hector Mendez Figueroa, Ricardo A. Mosquera, Margaret R Karagas, Juliette C. Madan, Debra M. MacKenzie, Johnnye L. Lewis, Brandon J. Rennie, BENNETT L. LEVENTHAL, Young Shin Kim, Somer Bishop, Sara S. Nozadi, Li Luo, Barry M. Lester, Carmen J. Marsit, Todd Everson, Cynthia M. Loncar, Elisabeth C. McGowan, Stephen J. Sheinkopf, Brian S. Carter, Jennifer Check, Jennifer Helderman, Charles R. Neal, Lynne M. Smith · 发表于：JAMA Network Open · 年份：2026 · DOI：10.1001/jamanetworkopen.2026.29389 · 被引用次数：1 · 研究领域：Fluoride Effects and Removal、Per- and polyfluoroalkyl substances research、Arsenic contamination and mitigation

Importance: Although fluoride exposure at high levels during the perinatal period has been associated with socioemotional problems among children, there is limited evidence regarding potential associations at lower levels of fluoride exposure, particularly in the US. Objective: To examine the association between prenatal exposure to public drinking water fluoride levels and children's socioemotional problems in a pooled US pediatric consortium. Design, Setting, and Participants: This cohort study used observational pregnancy cohort data from January 1, 2005, to December 31, 2019, on children aged 1.5 to 17 years from the Environmental Influences on Child Health Outcomes (ECHO) Cohort, which took place at 20 prenatal pediatric cohort sites across 34 US states. Statistical analysis was conducted from December 2024 to December 2025. Exposure: Area-level, time-weighted, mean fluoride concentrations in public water were estimated based on residential addresses during pregnancy. Main Outcomes and Measures: Children's socioemotional problems were assessed using caregiver reports of internalizing and externalizing problems via the Child Behavior Checklist. Generalized estimating equation models evaluated the adjusted mean difference in T scores (1) across the range of exposure values in cubic spline models, (2) per 500.0-µg/L higher fluoride level in linear models, (3) across quartiles of exposure, and (4) at the US Public Health Services recommended cutoff (≤700.0 µg/L; 3998 less th...