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Table 4 Characteristics of the 18 studies that conducted sex-stratified analyses

From: Biomarkers of environmental manganese exposure and associations with childhood neurodevelopment: a systematic review and meta-analysis

Author, Year Age (Years) Neurodevelopment Effect on Boys Effect on Girls p-value of Interaction Manganese Concentrations
Neurodevelopmental outcomes from cohort studies
Claus Henn 2018 [37] 6–16 Cognition NS NA Teeth: 12ab (n = 138)
Dion 2018 [20] 10.5–18 Cognition ↑ (W-Mn) ↓ (W-Mn) <  0.01 (W-Mn) Drinking water: 14.5 μg/Lc (n = 287), hair: 1.4 μg/gc (n = 274)
Gunier 2015 [31] 0.5, 1, 2 Cognition and motor NS 0.02 (Cognition), 0.03 (Motor) Teeth: prenatal: 0.51 ± 0.19bd (n = 197), postnatal: 0.20 ± 0.23bd (n = 193)
Mora 2015 [38] 7, 9, 10.5 Cognition and motor NS <  0.1 Teeth: prenatal: 0.50 ± 0.18bd (n = 248), postnatal: 0.19 ± 0.21bd (n = 244)
Mora 2018 [33] 1 Cognition NS 0.01 Maternal hair: 3.7 ± 5.4 μg/gd (n = 661), maternal blood: 24.4 ± 6.2 μg/Ld (n = 571)
Rahman 2017 [69] 10 Cognition NS <  0.081 Drinking water: 339 μg/La (n = 1265)
Takser 2003 [34] Newborns Motor NS 0.03 Cord blood: 38.5 μg/Lc (n = 222), maternal blood: 20.4 μg/Lc (n = 222), maternal hair: 0.36 μg/gc (n = 173), newborns hair: 0.75 μg/gc (n = 173), placenta: 0.1 μg/gc (n = 200)
Zhou 2019 [39] 6–8 Cognition NS NA Cord blood: 29.29 ± 1.48 μg/L (n = 296), urine: 0.66 ± 3.81 μg/L (n = 207)
Neurodevelopmental outcomes from cross-sectional studies
Bauer 2017 [42] 10–14 Cognition NS 0.05 Teeth: prenatal: 0.42cb (n = 142), postnatal: 0.12cb (n = 142)
Bouchard 2011 [16] 6–13 Cognition NS 0.55 (H-Mn), 0.14 (W-Mn) Hair: 0.7 μg/ga (n = 302), drinking water: 0.8 μg/La (n = 362)
Bouchard 2018 [8] 6–14 Cognition NS (Toe nail), ↑ (W-Mn) ↓ (Toe nail), NS (W-Mn) 0.028 (Toe nail), 0.015 (W-Mn) Toe nail: 2.0 μg/gc (n = 258), hair: 0.3 μg/gc (n = 258), saliva: 1.1 μg/Lc (n = 226), drinking water: 5.2/7.3 μg/Lc (boy: 127, girl: 132)
Carvalho 2018 [46] 7–12 Cognition NS 0.047 Hair: 11.5 μg/ga (n = 70)
Chiu 2017 [48] 11–14 Motor NS (Prenatal and postnatal), ↓ (Childhood) ↓ (Prenatal and postnatal), NS (Childhood) <  0.05 (Prenatal), <  0.01 (Postnatal), 0.01 (Childhood) Teeth: prenatal: 0.43ab (n = 189), postnatal: 0.13ab (n = 185)
Hernandez-Bonilla 2016 [54] 7–11 Cognition NS <  0.15 Hair: control: 0.55 μg/gc (n = 119), exposed: 5.25 μg/gc (n = 148)
Menezes-Filhoet 2014 [62] 7–12 Behavior NS NA Hair: boys: 12.1 μg/ga (n = 34), girls: 12.4 μg/g a (n = 36)
Rink 2014 [41] 1.1–3.7 Cognition NS <  0.05 Hair: 0.98 ± 0.74 μg/gd (n = 60)
Riojas-Rodríguez 2010 [6] 7–11 Cognition NS NA Control: hair: 0.57 μg/g, blood: 8.22 μg/Lc (n = 93), exposed: hair: 12.13 μg/g, blood: 9.71 μg/Lc (n = 79)
Torres-Agustinet 2013 [67] 7–11 Cognition NS NA Control: hair: 0.6 μg/g, blood: 8.0 μg/La (n = 95), exposed: hair: 12.6 μg/g, blood:9.5 μg/La (n = 79)
  1. ↓: Negative association; ↑: Positive association; NA Not available; NS No significant association. a: Median; b: 55Mn: 43Ca the area under the curve (AUC) × 104; c: Geometric mean; d: Mean ± standard deviation. H-Mn Manganese in hair; W-Mn Manganese in drinking water
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