Prenatal exposure to a mixture of elements and neurobehavioral outcomes in mid-childhood: Results from Project Viva

Highlights: • Joint effects of essential/non-essential elements on neurobehavior are understudied. • We estimated maternal erythrocyte Pb, Mn, Se, and Hg concentrations prenatally. • We found trends of worse neurobehavioral scores with increasing element mixtures. • Associations were small in magnitude given exposure levels within the population. • Pb and Se were most consistently associated with worse neurobehavioral scores. Lead (Pb), manganese (Mn), selenium (Se) and methylmercury (MeHg) can be neurotoxic individually, despite Mn and Se also being essential elements. Little is known about the joint effects of essential and non-essential elements on neurobehavior, particularly for prenatal exposures.