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Assessment of bone lead during pregnancy: a pilot study
1Pediatric Environmental Sciences Clinics, The Children's Hospital at Montefiore, 111 E. 210th Street, Bronx, New York 10467, USA.
Insights
Elevated bone lead (Pb) levels were uncommon in urban women, but pregnant individuals with bone Pb risk fetal exposure. This study assessed bone Pb in childbearing-age women.
Area of Science:
- Environmental Health
- Toxicology
- Public Health
Background:
- Childhood lead poisoning is a significant public health concern, with historical high blood lead (Pb) levels in children.
- Lead (Pb) exposure leads to accumulation in bone, which can be released back into the bloodstream, especially during periods of high bone turnover like pregnancy.
- Urban environments may pose risks for chronic lead exposure due to factors like leaded paint.
Purpose of the Study:
- To determine the prevalence of measurable bone lead (Pb) levels in childbearing-age urban women.
- To assess changes in bone lead (Pb) levels during pregnancy and postpartum.
- To evaluate the risk of in-utero lead (Pb) exposure from maternal bone stores.
Main Methods:
- Noninvasive L-line X-ray fluorescence (LXRF) was used to measure superficial cortical bone lead (Pb) content in tibial bone.
- Bone lead (Pb) levels were assessed sequentially three times over four months in pregnant and non-pregnant women.
- Blood lead (Pb) levels and home lead (Pb) assessments were also conducted.
Main Results:
- Of 53 women evaluated, 34 were pregnant. Only two pregnant women had blood lead (Pb) levels meeting the definition of lead poisoning (> /=10 microg/dL).
- Two women had bone lead (Pb) levels above the detection limit at enrollment.
- A case report indicated a declining bone lead (Pb) level concurrent with an increased blood lead (Pb) concentration.
Conclusions:
- The prevalence of elevated bone lead (Pb) levels appears low in this urban population, despite potential long-term exposure.
- Pregnant women with elevated bone lead (Pb) levels pose a risk of excessive in-utero lead (Pb) exposure to their fetuses.
- Further research is needed to fully understand the implications of bone lead (Pb) mobilization during pregnancy.
Abstract:
More than 85% of American children raised in the 1970s had blood lead (BPb) levels >/=10 microg/dL, the level that currently defines childhood Pb poisoning. With exposure and absorption Pb accumulates in bone. Bone Pb release back to blood also occurs, particularly when kinetic rates of bone turnover are elevated. We examined a group of childbearing age, urban African American and Hispanic women to determine whether they had measurable bone Pb and whether bone Pb levels changed during pregnancy. Tibial bone Pb content was assessed sequentially 3 times over 4 months by L-line X-ray fluorescence (LXRF); for pregnant enrollees this occurred during the second and third trimesters and 1-2 months postpartum. LXRF is a noninvasive, low-dose radiation technique that measures superficial cortical bone Pb. Other measures included age, years living in New York City, BPb and a home Pb assessment employing KXRF methodology. Of 53 women evaluated 34 were pregnant. Of these 34, 2 had blood Pb levels >/=10 microg/dL; 2 had bone Pb levels above the minimum detection limit of the instrumentation at the time of enrollment. A case report is presented in which a declining bone Pb level was accompanied by an increase in BPb concentration. We surmise that the prevalence of elevated bone Pb levels will be low in Bronx women despite long-term exposure to leaded paint. However, fetuses of those with elevated bone Pb are at risk of excessive in-utero Pb exposure.