The effects of prenatal exposure to heavy metals on childhood cognitive skills and health status are reported from the Robert Wood Johnson Medical School, New Brunswick, NJ. Cadmium, chromium, cobalt, lead, mercury, nickel and silver were determined in amniotic fluid taken from 92 pregnant women at 16 - 18 weeks gestation. A prenatal toxic risk score was based on the presence of a detectable level for the various metals. A correlation analysis indicated a negative relation between the toxic risk score and cognitive performance and a significant positive correlation between the toxic risk score and both the total number of atopic illnesses and infections assessed at 3 years of age. These findings indicate that health status as well as cognitive ability may show deficits as a consequence of prenatal heavy metal exposure. 
COMMENT. Lead intoxication in infants is common and is of different origin from that in toddlers . Formula preparation with lead contaminated water accounted for 9 of 50 infantile cases whereas paint chip ingestion was the most common cause among 47 children (86%) aged 18 through 30 months. These data support recent recommendations to initiate lead screening in children at 6 months of age. A maintained average blood level of 25 ug/dL or more during the second and third year of life was found to be detrimental to the child’s attained stature at 33 months of age in a study from the University of Cincinnati.