Maternal Bone Lead as an Independent Risk Factor for Fetal Neurotoxicity: A Prospective Study

作者：Ahmed E. Gomaa, Howard Hu, David Bellinger, Joel David Schwartz, Shirng‐Wern Tsaih, Teresa González‐Cossío, Lourdes Schnaas, Karen E. Peterson, Antonio Aro, Mauricio Hernández‐Ávila · 发表于：PEDIATRICS · 年份：2002 · DOI：10.1542/peds.110.1.110 · 被引用次数：150 · 研究领域：Heavy Metal Exposure and Toxicity、Pregnancy and Medication Impact、Trace Elements in Health

OBJECTIVE: A number of prospective studies have examined lead levels in umbilical cord blood at birth as predictors of infant mental development. Although several have found significant inverse associations, others have not. Measurement of lead levels in maternal bone, now recognized as the source of much fetal exposure, has the potential to serve as a better or complementary predictor of lead's effect on the fetus. Our objective was to compare lead levels in umbilical cord blood and maternal bone as independent predictors of infant mental development using a prospective design. METHODS: We recruited women who were giving birth at 3 maternity hospitals in Mexico City that serve a homogeneous middle-class community. Umbilical cord blood lead levels were measured by graphite furnace atomic absorption spectroscopy, and maternal lead levels in cortical (tibial) and trabecular (patellar) bone were measured within 4 weeks of giving birth using a 109-Cd K-x-ray fluorescence instrument. At 24 months of age, each infant was assessed using the Bayley Scales of Infant Development-II (Spanish Version). RESULTS: A total of 197 mother-infant pairs completed this portion of the study and had data on all variables of interest. After adjustment for other well-known determinants of infant neurodevelopment, including maternal age, IQ, and education; paternal education; marital status; breastfeeding duration; infant gender; and infant illness, lead levels in umbilical cord blood and trabecular b...