Interrelations of Lead Levels in Bone, Venous Blood, and Umbilical Cord Blood with Exogenous Lead Exposure through Maternal Plasma Lead in Peripartum Women

Chuang, Hung‐Yi; Schwartz, Joel; Gonzáles-Cossío, Teresa; Lugo, Marlene Cortez; Palazuelos, Eduardo; Aro, Antonio; Hu, Howard; Hernández-Ávila, Mauricio

doi:10.2307/3454713

Cited by 13 publications

(14 citation statements)

References 16 publications

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“…Studies have reported association of proximity of house to the road,/highways distance of house from road and residence in the city from Karachi and other places(Chuang et al 2001; Rahbar et al 2002; Shen et al 1997). In our study, these markers of automobile lead exposure were not significant.…”

Section: Discussionmentioning

confidence: 99%

Maternal nutritional status during pregnancy and surma use determine cord lead levels in Karachi, Pakistan

Janjua

Delzell

Larson

et al. 2008

Environmental Research

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Objectives-To estimate the umbilical cord blood lead levels (BLLs) of Pakistani neonates and to identify determinants for umbilical BLLs.Methods-We conducted a cross-sectional study of mothers and infants at one of the two obstetric units of two tertiary care hospitals in Karachi during January to August 2005. Information from 540 mothers selected randomly from those registered for delivery was obtained about their pregnancy, diet, and current and past lead exposures. We collected umbilical cord blood for lead levels analyzed using graphite furnace atomic absorption spectrophotometry. We computed geometric and arithmetic means. We performed multiple linear regression analysis to identify factors associated with log transformed umbilical cord BLLs. We also performed logistic regression analysis to identify determinants of high lead cord BLLs (≥10μg/dl).Results-The geometric mean cord BLLs of the neonates was 9.6μg/dl; arithmetic mean (SD) was 10.8 μg/dl (5.7) with a median of 9.7μg/dl and a range of 1.8 μg/dl-48.9μg/dl. Women who reported intake of less than 58.5 mg of elemental iron supplement per day during pregnancy had cord BLL of 10.0μg/dl; in comparison those women who had higher iron intake had lower cord BLL (8.4μg/ dl). Those who used surma (an eye cosmetic) daily had higher cord BLL (11.5 μg/dl) as compared to those who used it less frequently (9.4μg/dl). In multivariable linear regression model, higher iron intake, owning a car, and being in 2 nd quartile of mid arm circumference were associated with low lead levels while father's occupation in lead based industry were associated with significantly higher umbilical cord blood lead levels. There was interaction of daily surma use and ethnicity. Geometric mean BLLs were varied among surma users by ethnicity. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-Umbilical NIH Public Access

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Section: Discussionmentioning

confidence: 99%

Maternal nutritional status during pregnancy and surma use determine cord lead levels in Karachi, Pakistan

Janjua

Delzell

Larson

et al. 2008

Environmental Research

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“…We had measurements in whole blood; plasma blood lead may be more predictive of cord blood lead. 59 The d-aminolevulinic acid dehydratase (ALA-D) genotype may influence lead susceptibility, 60 and ALA-D activity is higher in cord than maternal blood. 61 Also, knowledge of both the total Hb and the percentage of fetal versus adult Hb in the cord blood would have been valuable, since fetal Hb has a higher affinity for lead than does adult Hb 62 and its proportion of the total varies across newborns.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing the difference between maternal and cord blood lead

et al. 2005

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Aims: To determine the factors that affect why some infants receive higher exposures relative to the mother's body burden than do others. Methods: A total of 159 mother-infant pairs from a cohort of women receiving prenatal care at MageeWomens Hospital in Pittsburgh, PA from 1992 to 1995 provided blood samples at delivery for lead determination. The difference between cord and maternal blood lead concentration (PbB) and a dichotomous variable indicator of higher cord than maternal PbB, were examined as indicators of relative transfer. Women were interviewed twice during the pregnancy about lifestyle, medical history, calcium nutrition, and physical activity. Results: Higher blood pressure was associated with relatively greater cord compared with maternal PbB, as was maternal alcohol use. Sickle cell trait and higher haemoglobin were associated with a lower cord relative to maternal blood lead PbB. No association was seen with smoking, physical exertion, or calcium consumption. Conclusion: While reduction in maternal exposure will reduce fetal exposure, it may also be possible to mitigate infant lead exposure by reducing transfer from the pregnant woman. Interventions aimed at reducing blood pressure and alcohol consumption during pregnancy may be useful in this regard. E xposure to lead causes developmental problems. Although postnatal and childhood exposure can have effects at low concentrations, 1 children who have been exposed to lead in utero may also suffer from deficits in development (such as intelligence, information processing, memory, and verbal skills), 2-7 growth, 8 9 and behaviour.10 11Because lead is incorporated into the bone matrix where it is retained for decades, 12 13 prenatal exposure to lead also contributes to an earlier and cumulatively greater body burden.14 15Maternal and infant blood lead levels (PbB) are highly correlated across a wide range of exposure levels, [16][17][18] so the most obvious sources of variation in fetal lead dose are those that affect the maternal PbB. Some sources of infant PbB reflect direct maternal exposure, such as occupational lead exposure, exposure to lead paint, or use of lead glazed ceramics.19 Since cigarette smoke contains lead, 20 21 smoking and passive smoking could fall into this category as well. 22Other factors associated with infant PbB may reflect a lifestyle associated with increased environmental exposure to lead. Maternal coffee consumption and alcohol use, 22 23 higher blood pressure, 24 25 and seasonal patterns 26-28 are such variables.For over 30 years, it has been recognised that lead freely crosses the placenta via diffusion.29 30 It has generally been assumed that there is no general enhancement or barrier to transfer. 31 However, factors besides the maternal lead exposure and PbB also appear to affect the concentration in fetal blood. Although maternal PbB is on average about 30% higher than the infant's, in most studies approximately one quarter of the infants have PbB higher than their mothers. [32][33][34][35][36] Rothenberg and co...

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“…However, these studies did not assess the dynamic nature of this association during pregnancy. Results obtained in those previous studies may not be applied to pregnant women due to the large physiological changes they undergo, such as increased bone resorption and intestinal mineral absorption, hemodilution, and transplacental transfer of Pb, with all of these being potential sources of variation in plasma Pb levels (Chuang et al, 2001;Tellez-Rojo et al, 2004).…”

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confidence: 97%

“…Another issue relating to the suitability of maternal blood lead levels during pregnancy to reflect fetal lead exposure (and maternal risks to the fetus) concerns evidence suggesting that whole-blood Pb levels, the conventionally used biomarker of Pb in blood, may not adequately represent Pb in plasma, the fraction of circulating Pb that is biologically available to cross cell membranes such as the placenta (Goyer, 1990;Hernandez-Avila et al, 1998, Chuang et al, 2001. This suggestion is substantiated by the findings of Bergdahl et al (1999) showing that plasma Pb concentration was a better predictor of toxicity on hematopoiesis than whole-blood Pb levels.…”

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confidence: 99%

Biological Markers of Fetal Lead Exposure at Each Stage of Pregnancy

Lamadrid‐Figueroa

Téllez‐Rojo

Hernández‐Cadena

et al. 2006

Journal of Toxicology and Environmental Health, Part A

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It has been suggested that plasma lead (Pb) represents the fraction of circulating Pb that crosses the placenta. Whole-blood Pb levels, the conventional method for measuring circulating Pb, may not adequately reflect plasma Pb levels. The objective of this study was to assess the relationship between whole-blood and plasma Pb in a cohort of pregnant women. A group of 237 pregnant women, recruited in Mexico City from 1997 to 1999, was studied. whole-blood and plasma lead concentrations were evaluated at 12, 24, and 34 wk of gestation by inductively coupled plasma-mass spectrometry. Data were analyzed using a mixed-effects regression model. An exponential relationship was found between plasma and whole-blood Pb levels and significant modification of the association by stage of pregnancy. The association was stronger in the second trimester relative to the first, and it further increased in the third trimester. The model predicts increased plasma Pb levels for a given whole-blood Pb value as pregnancy advances for whole-blood Pb levels greater than approximately 110 microg/L, but not for blood Pb levels less than 100 microg/L. These findings could be due to physiologic changes during pregnancy, such as decreasing hematocrit, saturation of red cell Pb binding capacity, and increased bone resorption or intestinal absorption. Collectively, these data suggest that at elevated maternal blood Pb levels the developing fetus may be at greater risk of Pb exposure from increased maternal plasma Pb than otherwise predicted from whole-blood Pb levels.

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Interrelations of Lead Levels in Bone, Venous Blood, and Umbilical Cord Blood with Exogenous Lead Exposure through Maternal Plasma Lead in Peripartum Women

Cited by 13 publications

References 16 publications

Maternal nutritional status during pregnancy and surma use determine cord lead levels in Karachi, Pakistan

Maternal nutritional status during pregnancy and surma use determine cord lead levels in Karachi, Pakistan

Factors influencing the difference between maternal and cord blood lead

Biological Markers of Fetal Lead Exposure at Each Stage of Pregnancy

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