New research suggests that fluoride exposure during pregnancy could be linked to neurobehavioral issues in children. However, the study’s authors caution against halting the addition of fluoride to drinking water, a practice known for its dental health benefits.
The study found that women with higher fluoride levels during pregnancy reported that their children, by age 3, were more likely to exhibit temper tantrums, headaches, stomachaches, and other neurobehavioral symptoms. This research, the first of its kind in the U.S., coincides with a trend of cities banning fluoride in public water systems.
“We’re not saying water should not be fluoridated,” said Tracy Bastain, a study author and associate professor at the University of Southern California’s Keck School of Medicine. “It’s generally considered one of the biggest public health wins, particularly for dental health. But our results do give me pause. Pregnant individuals should probably drink filtered water.”
Published in JAMA Network Open, the study analyzed urine samples from 229 women during their third trimester. Participants, primarily Hispanic women in Los Angeles, were part of ongoing research by USC’s MADRES Center for Environmental Health Disparities. Researchers assessed children’s emotional and behavioral health at age 3 through parental checklists.
Children of mothers with higher fluoride levels in their urine were 83% more likely to show neurobehavioral issues, such as anxiety and physical complaints like unexplained headaches and stomachaches. The forms included questions about symptoms related to autism spectrum disorder, though the study does not establish a direct link to autism.
Bastain stressed that the findings should be seen as a possible association, not a definitive cause. “It doesn’t mean that the child has autism. We don’t even have autism diagnosis information for the children in the study,” she said.
The National Institutes of Health and the Environmental Protection Agency funded the research, which was prompted by previous concerns about prenatal fluoride. A 2019 study in JAMA Pediatrics found slightly lower IQ levels in children whose mothers had higher fluoride measures during pregnancy.
Dr. Mark Moss, from the East Carolina University School of Dental Medicine, anticipated the findings would “cause a stir” but urged caution. “This deserves further look, but it doesn’t mean we should pause fluoridation,” he said.
The neurobehavioral symptoms reported did not necessarily meet clinical diagnosis levels. Dr. Nathaniel DeNicola, an OB-GYN, noted, “It’s hard to say this warrants reconsideration of public health policy.”
DeNicola recommends that his pregnant patients use water filters to remove potentially harmful chemicals, despite not being involved in the research. He acknowledged the study’s strength in attempting to account for lead exposure but noted limitations in the study’s design.
Critics pointed out flaws, such as the inability to confirm whether the women drank fluoridated water, the study’s limited demographic applicability, and the lack of fluoride level testing in children. Dr. Johnny Johnson, president of the American Fluoridation Society, emphasized the need for a robust study in areas with naturally varying fluoride levels to investigate health effects comprehensively.
