Babies in war: at risk for significant neurodevelopmental delays and/or defects
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War zones result in significant exposure to metals and compounds in weaponry. Environmental exposure to some anthropogenic compounds can be particularly harmful to growing fetuses and young children, as metals can compromise neurodevelopmental processes during critical periods of fetal and childhood development. This has detrimental effects on the structure and function of the nervous system.
The US is engaged in military activities around the world, and we should focus more on the detrimental impact that wartime exposure likely has on the development of crucial neural structures and pathologies for the populations who live in these places. We need to better elucidate what neurodevelopmental effects such implicated compounds actually have on innocent civilians in these areas, as well as our own personnel who may be pregnant at the time of conflict.
Some studies and what they have found
For instance, the Iraqi city of Fallujah, since the invasion of Iraq, has been marred by a significant increase in neural tube defects (Busby et al. 2010). There have been many compounds and elements potentially implicated in findings, one of which is depleted uranium (DU), widely used in military weaponry. However, DU neurotoxicity in humans is still somewhat unclear, and remains largely anecdotal. There are studies in laboratory animals demonstrating a link between DU exposure and neurotoxicity, possibly due to impairments of oxidative phosphorylation in brain mitochondria by DU, with resultant oxidative stress (Barber et al. 2007). However, the link regarding DU and other neurodevelopmental defects is still to be elucidated.
Another compound implicated in detrimental neurological effects is titanium, also used extensively in US weapons systems and machine guns. In another study of children in the Iraqi city of Hawija, samples of titanium were 1.3 times higher in children suffering from neurodevelopmental disorders such as epilepsy, continuous body seizures, and neurodevelopmental delay than that in children without neurodevelopmental disorders (Savabieasfahani et al., 2015 ). There is literature suggesting that in utero Titanium nanoparticle exposure is associated with brain cell necrosis, hippocampal cell apoptosis, and neurotoxic effects in exposed offspring (Mohammadipour et al., 2015). These are just two of many implicated compounds.
Another interesting study was done on 502 pregnant Palestinian women to assess the impact of metal load in subsequent infant emotional regulation and regulation. This study was conducted shortly following the 2014 war in Gaza. The authors analyzed five weapon-related heavy metals, namely uranium, strontium, chromium, mercury, and vanadium via mass spectroscopy from maternal hair samples at the time of childbirth. These mothers were also assessed for Post-Traumatic Stress Disorder (PTSD) and infants were assessed for emotional development at six to seven months of age via the Infant Behavior Questionnaire (IBQ). Exposure to chromium and uranium were significant predictors of emotional development in the infants, with increases in negative emotionality, decreased positive affectivity, and early impairments in early emotional regulation. Of note, the inevitable PTSD that ensued in some mothers from the war did not skew the impact of the exposures to these heavy metals on their infants’ emotional development (Vänskä et al., 2019).
Major takeaways, and where we go from here
What I have mentioned here barely scratches the surface of the many studies that have assessed exposure to contaminants in war and subsequent impacts on neurodevelopment. However, I must mention a major caveat here (and an area for further research): studies so far in war-torn regions have not sufficiently corroborated or refuted whether exposure to compounds has a significant correlation or causative relationship with neurological and neurodevelopmental defects in populations of these regions. For instance, it is also plausible that defects such as neural tube defects (NTDs) can be due to folic acid deficiency, and other developmental disabilities may also occur in the setting of insufficient access to nutrition or significant stressors on the mother during the pregnancy. It is still a gray area, and warrants much more focus from neurologists, other health care professionals, and neuroscientists in the United States and worldwide with an interest in global medicine.
To get a clear understanding of the current status of neurodevelopmental disorders in these children, and to determine the magnitude of this suspected global health issue, what we should do is cooperate with registries in hospitals in these regions, and work towards better elucidating the causes of these disorders in children both of innocent civilians of these areas as well as our own military personnel.