Fetal exposure to mercury and lead from intrauterine blood transfusions

Abstract

BACKGROUND: Mercury (Hg) and lead (Pb) exposure during childhood is associated with irreversible neurodevelopmental effects. Fetal exposure to Hg and Pb from intrauterine blood transfusion (IUBT) has not been reported. METHODS: Fetal exposure was estimated based on transfusion volume and metal concentration in donor packed red blood cell (PRBCs). As biomarkers to quantify prenatal exposure are unknown, Hg and Pb in donor PRBCs were compared to estimated intravenous (IV) RfDs based on gastrointestinal absorption. RESULTS: Three pregnant women received 8 single-donor IUBTs with volumes ranging from 19 to 120 mL/kg. Hg and Pb were present in all donor PRBC units. In all, 1/8 IUBT resulted in Hg dose five times higher than the estimated IV RfD. Median Pb dose in one fetus who received 5 single-donor IUBTs between 20-32 weeks gestation was 3.4 μg/kg (range 0.5-7.9 μg/kg). One donor unit contained 12.9 μg/dL of Pb, resulting in a fetal dose of 7.9 μg/kg, 40 times higher than the estimated IV RfD at 20 weeks gestation. CONCLUSION: This is the first study documenting inadvertent exposure to Hg and Pb from IUBT and quantifying the magnitude of exposure. Screening of donor blood is warranted to prevent toxic effects from Hg and Pb to the developing fetus.

Association of Pentachlorophenol with Fetal Risk of Prolonged Bradycardia: A Systematic Review and Meta-Analysis

“…Changes in the PLAP conformation can not only alter its function but also cause the structure and function of the placental cell membrane change, which must have adverse effects on the normal fetal development. In addition, PCP is a lipid-soluble substance that can enter the fetus through the placenta and have a direct toxic effect on the fetus [ 30 ]. In Heidelberg Hospital, Germany, during a physical examination of 65 women with a long history of PCP exposure, it was found that its serum PCP content was asked above 20 bucket g/L; thus, the exposure history of PCP in pregnant women will also have adverse effects on the fetus.…”

“…Similarly, in humans, with the deterioration of environmental quality, many environmental pollutants can pass through the way such as respiratory tract, the digestive tract, the skin into pregnant woman's body, and then through the limited tire barrier into fetal body because the fetus is sensitive to the chemical poison effect than adults; in the process of growth and development, if some poisonous substances contact within the womb, it may produce some effects, and adult contact with the substance is not the same as severe damage or even cancer [ 29 , 30 ].…”

On‐going consequences of in utero exposure of Pb: An epigenetic perspective

“…It was evident that more than 25 μg/dl in newborn blood can cause developmental disorders (Wani et al, 2015); however, growing evidence demonstrates that a blood Pb level less than 25 μg/dl might also increase that risk (Bellinger & Needleman, 2003; Wani et al, 2015). Due to the less active gastrointestinal excretory system, the neonatal Pb level remains slightly higher than that of the mother (Falck et al, 2019), as shown by blood Pb levels of 51 and 49 μg/dl in neonate and mother's blood, respectively (Shannon, 2003). Hence, the relatively higher level of Pb in fetal circulation elevates the risk of abnormalities by various mechanisms.…”

“…The movement of Pb from the mother's body to the fetal circulation follows both passive diffusion and active transport via divalent metal transporters (Falck et al, 2019). According to some published papers, Pb can be transferred by simple diffusion without any involvement of transporters (Goyer, 1990;Shannon, 2003).…”

“…Prenatal and perinatal developmental stages are the most susceptible targets of Pb, as a higher fraction of Pb is absorbed in different organs of the growing individual (Flora et al, 2012; Sanders et al, 2009). No beneficial physiological or metabolic role of Pb exposure has been reported in human (Falck et al, 2019; Flora et al, 2012). Prenatal and perinatal developmental stages are larger windows for this heavy metal to enter, modify the gene expression profile and ultimately impair the early development of tissues.…”