Changes in Serial Blood Lead Levels during Pregnancy

Rothenberg, Stephen J.; Karchmer, S; Schnaas, Lourdes; Perroni, Estela; Zea, Francisco Antonio; Alba, Julio Fernandez

doi:10.2307/3432121

Cited by 37 publications

(44 citation statements)

References 12 publications

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“…The cross-sectional nature of our study limits our ability to draw inferences on the directionality of the relationship between patella and blood lead. Recently, a longitudinal study of blood lead levels during pregnancy among women living in Mexico City (22) reported an upward trend in maternal blood lead levels from 20 weeks to delivery. Although this increase could have been explained by increased absorption of lead, this upward trend could also indicate increased mobilization of lead from bone during the last half of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Dietary and environmental determinants of blood and bone lead levels in lactating postpartum women living in Mexico City.

Hernández-Ávila

González-Cossı́o

Palazuelos

et al. 1996

Environ Health Perspect

103

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Despite the recent declines in environmental lead exposure in the United States and Mexico, the potential for delayed toxicity from bone lead stores remains a significant public health concern. Some evidence indicates that mobilization of lead from bone may be markedly enhanced during the increased bone turnover of pregnancy and lactation, resulting in lead exposure to the fetus and the breast-fed infant. We conducted a cross-sectional investigation of the interrelationships between environmental, dietary, and lifestyle histories, blood lead levels, and bone lead levels among 98 recently postpartum women living in Mexico City. Lead levels in the patella (representing trabecular bone) and tibia (representing cortical bone) were measured by K X-ray fluorescence (KXRF). Multivariate linear regression models showed that significant predictors of higher blood lead included a history of preparing or storing food in lead-glazed ceramic ware, lower milk consumption, and higher levels of lead in patella bone. A 34 micrograms/g increase in patella lead (from the medians of the lowest to the highest quartiles) was associated with an increase in blood lead of 2.4 micrograms/dl. Given the measurement error associated with KXRF and the extrapolation of lead burden from a single bone site, this contribution probably represents an underestimate of the influence of trabecular bone on blood lead. Significant predictors of bone lead in multivariate models included years living in Mexico City, lower consumption of high calcium content foods, and nonuse of calcium supplements for the patella and years living in Mexico City, older age, and lower calcium intake for tibia bone. Low consumption of milk and cheese, as compared to the highest consumption category (every day), was associated with an increase in tibia bone lead of 9.7 micrograms Pb/g bone mineral. The findings of this cross-sectional study suggest that patella bone is a significant contributor to blood lead during lactation and that consumption of high calcium content foods may protect against the accumulation of lead in bone. Images Figure 1. Figure 1. Figure 2. Figure 2.

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Section: Discussionmentioning

confidence: 99%

Dietary and environmental determinants of blood and bone lead levels in lactating postpartum women living in Mexico City.

Hernández-Ávila

González-Cossı́o

Palazuelos

et al. 1996

Environ Health Perspect

103

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“…In Mexico City, water has an alkaline pH that prevents Pb removal from the pipes (6,8), and although Romieu et al (9) found that canned food is still a Pb source, its role has been dedining (8,10).…”

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confidence: 99%

Blood lead levels in pregnant women of high and low socioeconomic status in Mexico City.

Farías

Borja-Aburto

Rı́os

et al. 1996

Environ Health Perspect

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This study examined the determinants of blood lead (BPb) in 513 pregnant women in Mexico City: 311 from public hospital prenatal clinics, representing primarily women of low socioeconomic status (SES), and 202 from private hospitals, primarily women of high SES. Overall, BPb levels ranged from 1.38 to 29 micrograms/dl, with geometric means of 6.7 and 11.12 micrograms/dl for women from private and public hospitals, respectively. The crude geometric means difference obtained by t-test was 4.42 (p < 0.001). BPb was measured from January 1994 to August 1995 and showed higher levels during fall and winter and lower levels during spring and summer. The main BPb determinants were the use of lead-glazed ceramics in women from public hospitals and season of the year in women from private hospitals. Consumption of tortillas (corn bread rich in calcium) decreased BPb levels in the lower SES group, but the relationship was not statistically significant (p > 0.05). Consumption of milk products significantly (p < 0.05) reduced BPb levels in the higher SES group. In 112 women whose diets were deficient in calcium, taking calcium supplements lowered their blood lead levels about 7 micrograms/dl. A predictive model fitted to these data, using the strongest predictors plus gestational age, showed a difference of 14 micrograms/dl between the best and worst scenarios in women from public hospitals. Avoiding use of lead-glazed ceramics, consuming diets rich in calcium, and, if needed, taking calcium supplements, would be expected to result in substantial lowering of BPb, especially in pregnant women of low socioeconomic status. Images Figure 1. Figure 2.

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“…20 It can be hypothesized that "immigrant status" is a risk factor for lead poisoning among pregnant women in at least three ways: First, immigrant pregnant women from countries where lead exposure is endemic may carry high cumulative body lead burdens. Among the cases described here (as in the United States as a whole), 26 the country with the single largest number of immigrants was Mexico, where high endemic levels of lead exposure in the general population and among pregnant women have been reported, 27 especially in comparison with their American counterparts. 28,29 Several women reported a history of lead exposure in their country of origin and were without current exposures.…”

Section: Discussionmentioning

confidence: 99%

Lead Poisoning Among Pregnant Women in New York City: Risk Factors and Screening Practices

Klitzman

Sharma

Nicaj³

et al. 2002

Journal of Urban Health: Bulletin of the New York Academy of Medicine

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Changes in Serial Blood Lead Levels during Pregnancy

Abstract: and the medical residents and nursing staffs of the Obstetrical and Pediatric Services. We especially acknowledge the service of the obstetrical patients who donated their time and interest. We thank

Cited by 37 publications

References 12 publications

Dietary and environmental determinants of blood and bone lead levels in lactating postpartum women living in Mexico City.

Dietary and environmental determinants of blood and bone lead levels in lactating postpartum women living in Mexico City.

Blood lead levels in pregnant women of high and low socioeconomic status in Mexico City.

Lead Poisoning Among Pregnant Women in New York City: Risk Factors and Screening Practices

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