Blood lead levels in antenatal women and its association with iron deficiency anemia and adverse pregnancy outcomes

Abstract

Objectives: Lead is one of the most toxic heavy metal prevalent in the environment, which affects almost all major organs including heart, brain, intestines, kidneys as well as reproductive organs. It has been known that serum iron deficiency is associated with increased serum lead levels as lead is a particularly pernicious element to iron metabolism. Lead is also known to freely cross the placenta too; hence, this study was planned to determine any association between antenatal iron deficiency anemia (IDA), raised blood lead levels (BPb), and adverse pregnancy outcomes. Materials and Methods: This was an observational study done on 99 antenatal women with IDA and 41 nonanemic antenatal women. Lead levels were assessed in these 140 antenatal women and they were followed for adverse pregnancy outcomes. Chi-square test was used to find a difference in quantitative variables and Pearson's correlation test was used to assess association between BPb and hemoglobin levels. Results: We found that in 11 out of 99 (11.11%) women with IDA, BPb levels were high as compared to high BPb levels in only 1 out of 41 (2.4%) women without IDA and the high BPb levels ranged from 4 μg/dl–16.9 μg/dl with a mean BPb of 8.1 μg/dl. The difference in BPb among anemic and nonanemic antenatal women was significant ( P < 0.05) and there was a negative dose effect relationship between BPb levels and hemoglobin levels. This difference in antenatal outcomes among women with and without high BPb levels was also significant with increased incidence of pre-eclampsia, FGR, and preterm deliveries in women with raised BPb levels. The incidence of NICU admission was also higher in the neonates of mothers with high BPb levels. Conclusions: We propose screening of high-risk women based on their social, occupational, environmental, and personal factors, with serum lead levels in the preconception period itself. All public and personal measures must be taken to reduce lead consumption and exposure in the preconception and antenatal period.

Renal hypoxia–HIF–PHD–EPO signaling in transition metal nephrotoxicity: friend or foe?

“…In recent years, mounting evidence from individual reports has revealed that TM exposure increases the risk of anemia (e.g. Ashley-Martin et al 2021 ; Bayhan et al 2017 ; Choi et al 2017 ; Lopez-Rodriguez et al 2017 ; Shen et al 2019 ; Yadav et al 2020 ).…”

High burden of anemia among pregnant women in Tanzania: a call to address its determinants

“…Severity of the adverse outcomes of anemia in pregnancy depends largely on severity of anemia itself [6]. Some of the outcomes include premature labor and rupture of membranes [7], pregnancy induced hypertensive diseases including eclampsia and pre-eclampsia [8,9], risk of caesarean sections, and poor child outcomes including low birth weight, small for gestation age, still birth, and neonatal deaths [7]. Anemia in pregnancy may also predispose a child to early developmental challenges [10] and subsequent early burden of undernutrition [11].…”

The Differences in Blood Lead Levels in Women with Gestational Hypertension or Pre-Eclampsia and Women with Normal Pregnancy (A Study in the North Coast of Java, Brebes District)

“…Several studies on the impact of exposure to lead on the blood system, both in adults and children, have been carried out. Research in India proved that BLL in pregnant women with anemia is greater than in non-anemic pregnant women (59). Anemia in pregnant women needs to be prevented because it causes impaired fetal growth, low birth weight or small for gestational age (60), and increased risk of maternal and perinatal mortality (61).…”