INTELLECTUAL IMPAIRMENT IN CHILDREN EXPOSED TO POLYCHLORINATED BIPHENYLS IN UTERO

A BSTRACT Background In utero exposure to polychlorinated biphenyls, a ubiquitous environmental contaminant, has been linked to adverse effects on neurologic and intellectual function in infants and young children. We assessed whether these effects persist through school age and examined their importance in the acquisition of reading and arithmetic skills. Methods We tested 212 children, recruited as newborns to overrepresent infants born to women who had eaten Lake Michigan fish contaminated with polychlorinated biphenyls. A battery of IQ and achievement tests was administered when the children were 11 years of age. Concentrations of polychlorinated biphenyls in maternal serum and milk at delivery were slightly higher than in the general population. A composite measure of prenatal exposure was derived from concentrations in umbilicalcord serum and maternal serum and milk. Results Prenatal exposure to polychlorinated biphenyls was associated with lower full-scale and verbal IQ scores after control for potential confounding variables such as socioeconomic status (P 0.02). The strongest effects related to memory and attention. The most highly exposed children were three times as likely to have low average IQ scores (P 0.001) and twice as likely to be at least two years behind in reading comprehension (P 0.03). Although larger quantities of polychlorinated biphenyls are transferred by breast-feeding than in utero, there were deficits only in association with transplacental exposure, suggesting that the developing fetal brain is particularly sensitive to these compounds. Conclusions In utero exposure to polychlorinated biphenyls in concentrations slightly higher than those in the general population can have a long-term impact on intellectual function. (N Engl J Med 1996; 335:783-9.)