Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2005 Apr;62(4):263–269. doi: 10.1136/oem.2003.012492

Factors influencing the difference between maternal and cord blood lead

E Harville 1, I Hertz-Picciotto 1, M Schramm 1, M Watt-Morse 1, K Chantala 1, J Osterloh 1, P Parsons 1, W Rogan 1
PMCID: PMC1740989  PMID: 15778260

Abstract

Aims: To determine the factors that affect why some infants receive higher exposures relative to the mother's body burden than do others.

Methods: A total of 159 mother-infant pairs from a cohort of women receiving prenatal care at Magee-Womens Hospital in Pittsburgh, PA from 1992 to 1995 provided blood samples at delivery for lead determination. The difference between cord and maternal blood lead concentration (PbB) and a dichotomous variable indicator of higher cord than maternal PbB, were examined as indicators of relative transfer. Women were interviewed twice during the pregnancy about lifestyle, medical history, calcium nutrition, and physical activity.

Results: Higher blood pressure was associated with relatively greater cord compared with maternal PbB, as was maternal alcohol use. Sickle cell trait and higher haemoglobin were associated with a lower cord relative to maternal blood lead PbB. No association was seen with smoking, physical exertion, or calcium consumption.

Conclusion: While reduction in maternal exposure will reduce fetal exposure, it may also be possible to mitigate infant lead exposure by reducing transfer from the pregnant woman. Interventions aimed at reducing blood pressure and alcohol consumption during pregnancy may be useful in this regard.

Full Text

The Full Text of this article is available as a PDF (99.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams J. G., 3rd, Newman M. V., Steinberg M. H., DeSimone J. Effect of lead and ethanol upon gamma-globin synthesis in sickle reticulocytes. Am J Med Sci. 1986 Nov;292(5):299–305. doi: 10.1097/00000441-198611000-00009. [DOI] [PubMed] [Google Scholar]
  2. Baghurst P. A., McMichael A. J., Wigg N. R., Vimpani G. V., Robertson E. F., Roberts R. J., Tong S. L. Environmental exposure to lead and children's intelligence at the age of seven years. The Port Pirie Cohort Study. N Engl J Med. 1992 Oct 29;327(18):1279–1284. doi: 10.1056/NEJM199210293271805. [DOI] [PubMed] [Google Scholar]
  3. Bellinger D. C., Needleman H. L., Leviton A., Waternaux C., Rabinowitz M. B., Nichols M. L. Early sensory-motor development and prenatal exposure to lead. Neurobehav Toxicol Teratol. 1984 Sep-Oct;6(5):387–402. [PubMed] [Google Scholar]
  4. Bellinger D., Leviton A., Sloman J. Antecedents and correlates of improved cognitive performance in children exposed in utero to low levels of lead. Environ Health Perspect. 1990 Nov;89:5–11. doi: 10.1289/ehp.90895. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bellinger D., Leviton A., Waternaux C., Needleman H., Rabinowitz M. Longitudinal analyses of prenatal and postnatal lead exposure and early cognitive development. N Engl J Med. 1987 Apr 23;316(17):1037–1043. doi: 10.1056/NEJM198704233161701. [DOI] [PubMed] [Google Scholar]
  6. Block G., Hartman A. M., Dresser C. M., Carroll M. D., Gannon J., Gardner L. A data-based approach to diet questionnaire design and testing. Am J Epidemiol. 1986 Sep;124(3):453–469. doi: 10.1093/oxfordjournals.aje.a114416. [DOI] [PubMed] [Google Scholar]
  7. Block G., Hartman A. M., Naughton D. A reduced dietary questionnaire: development and validation. Epidemiology. 1990 Jan;1(1):58–64. doi: 10.1097/00001648-199001000-00013. [DOI] [PubMed] [Google Scholar]
  8. Campagna D., Huel G., Girard F., Sahuquillo J., Blot P. Environmental lead exposure and activity of delta-aminolevulinic acid dehydratase (ALA-D) in maternal and cord blood. Toxicology. 1999 Jun 15;134(2-3):143–152. doi: 10.1016/s0300-483x(99)00031-1. [DOI] [PubMed] [Google Scholar]
  9. Carbone R., Laforgia N., Crollo E., Mautone A., Iolascon A. Maternal and neonatal lead exposure in southern Italy. Biol Neonate. 1998;73(6):362–366. doi: 10.1159/000013998. [DOI] [PubMed] [Google Scholar]
  10. Chuang H. Y., Schwartz J., Gonzales-Cossio T., Lugo M. C., Palazuelos E., Aro A., Hu H., Hernandez-Avila M. Interrelations of lead levels in bone, venous blood, and umbilical cord blood with exogenous lead exposure through maternal plasma lead in peripartum women. Environ Health Perspect. 2001 May;109(5):527–532. doi: 10.1289/ehp.01109527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Cummings S. R., Block G., McHenry K., Baron R. B. Evaluation of two food frequency methods of measuring dietary calcium intake. Am J Epidemiol. 1987 Nov;126(5):796–802. doi: 10.1093/oxfordjournals.aje.a114716. [DOI] [PubMed] [Google Scholar]
  12. Dietrich K. N., Succop P. A., Berger O. G., Hammond P. B., Bornschein R. L. Lead exposure and the cognitive development of urban preschool children: the Cincinnati Lead Study cohort at age 4 years. Neurotoxicol Teratol. 1991 Mar-Apr;13(2):203–211. doi: 10.1016/0892-0362(91)90012-l. [DOI] [PubMed] [Google Scholar]
  13. Drasch G. A., Kretschmer E., Lochner C. Lead and sudden infant death. Investigations on blood samples of SID babies. Eur J Pediatr. 1988 Jan;147(1):79–84. doi: 10.1007/BF00442618. [DOI] [PubMed] [Google Scholar]
  14. Ernhart C. B. A critical review of low-level prenatal lead exposure in the human: 1. Effects on the fetus and newborn. Reprod Toxicol. 1992;6(1):9–19. doi: 10.1016/0890-6238(92)90017-n. [DOI] [PubMed] [Google Scholar]
  15. Ernhart C. B. A critical review of low-level prenatal lead exposure in the human: 2. Effects on the developing child. Reprod Toxicol. 1992;6(1):21–40. doi: 10.1016/0890-6238(92)90018-o. [DOI] [PubMed] [Google Scholar]
  16. Ernhart C. B., Wolf A. W., Kennard M. J., Erhard P., Filipovich H. F., Sokol R. J. Intrauterine exposure to low levels of lead: the status of the neonate. Arch Environ Health. 1986 Sep-Oct;41(5):287–291. doi: 10.1080/00039896.1986.9936698. [DOI] [PubMed] [Google Scholar]
  17. Ernhart C. B., Wolf A. W., Sokol R. J., Brittenham G. M., Erhard P. Fetal lead exposure: antenatal factors. Environ Res. 1985 Oct;38(1):54–66. doi: 10.1016/0013-9351(85)90072-6. [DOI] [PubMed] [Google Scholar]
  18. Farias P., Borja-Aburto V. H., Rios C., Hertz-Picciotto I., Rojas-Lopez M., Chavez-Ayala R. Blood lead levels in pregnant women of high and low socioeconomic status in Mexico City. Environ Health Perspect. 1996 Oct;104(10):1070–1074. doi: 10.1289/ehp.961041070. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Gardella C. Lead exposure in pregnancy: a review of the literature and argument for routine prenatal screening. Obstet Gynecol Surv. 2001 Apr;56(4):231–238. doi: 10.1097/00006254-200104000-00024. [DOI] [PubMed] [Google Scholar]
  20. Gershanik J. J., Brooks G. G., Little J. A. Blood lead values in pregnant women and their offspring. Am J Obstet Gynecol. 1974 Jun 15;119(4):508–511. doi: 10.1016/0002-9378(74)90210-5. [DOI] [PubMed] [Google Scholar]
  21. González-Cossío T., Peterson K. E., Sanín L. H., Fishbein E., Palazuelos E., Aro A., Hernández-Avila M., Hu H. Decrease in birth weight in relation to maternal bone-lead burden. Pediatrics. 1997 Nov;100(5):856–862. doi: 10.1542/peds.100.5.856. [DOI] [PubMed] [Google Scholar]
  22. Goyer R. A. Transplacental transport of lead. Environ Health Perspect. 1990 Nov;89:101–105. doi: 10.1289/ehp.9089101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Graziano J. H., Popovac D., Factor-Litvak P., Shrout P., Kline J., Murphy M. J., Zhao Y. H., Mehmeti A., Ahmedi X., Rajovic B. Determinants of elevated blood lead during pregnancy in a population surrounding a lead smelter in Kosovo, Yugoslavia. Environ Health Perspect. 1990 Nov;89:95–100. doi: 10.1289/ehp.908995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Greenland S. Modeling and variable selection in epidemiologic analysis. Am J Public Health. 1989 Mar;79(3):340–349. doi: 10.2105/ajph.79.3.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Gulson B. L., Mahaffey K. R., Jameson C. W., Patison N., Law A. J., Mizon K. J., Korsch M. J., Pederson D. Impact of diet on lead in blood and urine in female adults and relevance to mobilization of lead from bone stores. Environ Health Perspect. 1999 Apr;107(4):257–263. doi: 10.1289/ehp.99107257. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Gupta V., Gill K. D. Influence of ethanol on lead distribution and biochemical changes in rats exposed to lead. Alcohol. 2000 Jan;20(1):9–17. doi: 10.1016/s0741-8329(99)00046-4. [DOI] [PubMed] [Google Scholar]
  27. Han S., Pfizenmaier D. H., Garcia E., Eguez M. L., Ling M., Kemp F. W., Bogden J. D. Effects of lead exposure before pregnancy and dietary calcium during pregnancy on fetal development and lead accumulation. Environ Health Perspect. 2000 Jun;108(6):527–531. doi: 10.1289/ehp.00108527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Han S., Qiao X., Kemp F. W., Bogden J. D. Lead exposure at an early age substantially increases lead retention in the rat. Environ Health Perspect. 1997 Apr;105(4):412–417. doi: 10.1289/ehp.97105412. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Harris P., Holley M. R. Lead levels in cord blood. Pediatrics. 1972 Apr;49(4):606–608. [PubMed] [Google Scholar]
  30. Hernández-Avila M., Smith D., Meneses F., Sanin L. H., Hu H. The influence of bone and blood lead on plasma lead levels in environmentally exposed adults. Environ Health Perspect. 1998 Aug;106(8):473–477. doi: 10.1289/ehp.106-1533211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Hertz-Picciotto I., Croft J. Review of the relation between blood lead and blood pressure. Epidemiol Rev. 1993;15(2):352–373. doi: 10.1093/oxfordjournals.epirev.a036125. [DOI] [PubMed] [Google Scholar]
  32. Hertz-Picciotto I., Schramm M., Watt-Morse M., Chantala K., Anderson J., Osterloh J. Patterns and determinants of blood lead during pregnancy. Am J Epidemiol. 2000 Nov 1;152(9):829–837. doi: 10.1093/aje/152.9.829. [DOI] [PubMed] [Google Scholar]
  33. Huel G., Tubert P., Frery N., Moreau T., Dreyfus J. Joint effect of gestational age and maternal lead exposure on psychomotor development of the child at six years. Neurotoxicology. 1992 Spring;13(1):249–254. [PubMed] [Google Scholar]
  34. Kalcher K., Kern W., Pietsch R. Cadmium and lead in the smoke of a filter cigarette. Sci Total Environ. 1993 Jan 15;128(1):21–35. doi: 10.1016/0048-9697(93)90177-8. [DOI] [PubMed] [Google Scholar]
  35. Kelman B. J., Walter B. K. Transplacental movements of inorganic lead from mother to fetus. Proc Soc Exp Biol Med. 1980 Feb;163(2):278–282. doi: 10.3181/00379727-163-40762. [DOI] [PubMed] [Google Scholar]
  36. Li K. M. Lead values in umbilical cord blood and maternal blood. J R Soc Health. 1988 Apr;108(2):59–59. doi: 10.1177/146642408810800210. [DOI] [PubMed] [Google Scholar]
  37. Milman N., Christensen J. M., Ibsen K. K. Blood lead and erythrocyte zinc protoporphyrin in mothers and newborn infants. Eur J Pediatr. 1988 Jan;147(1):71–73. doi: 10.1007/BF00442616. [DOI] [PubMed] [Google Scholar]
  38. Nashashibi N., Cardamakis E., Bolbos G., Tzingounis V. Investigation of kinetic of lead during pregnancy and lactation. Gynecol Obstet Invest. 1999;48(3):158–162. doi: 10.1159/000010164. [DOI] [PubMed] [Google Scholar]
  39. Ong C. N., Lee W. R. High affinity of lead for fetal haemoglobin. Br J Ind Med. 1980 Aug;37(3):292–298. doi: 10.1136/oem.37.3.292. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Qiao H., Parsons P. J., Slavin W. Transferability of blood lead determinations by furnace atomic absorption spectrophotometry and continuum background correction. Clin Chem. 1995 Oct;41(10):1451–1454. [PubMed] [Google Scholar]
  41. Rabinowitz M. B., Needleman H. L. Temporal trends in the lead concentrations of umbilical cord blood. Science. 1982 Jun 25;216(4553):1429–1431. doi: 10.1126/science.7089532. [DOI] [PubMed] [Google Scholar]
  42. Rabinowitz M., Bellinger D., Leviton A., Needleman H., Schoenbaum S. Pregnancy hypertension, blood pressure during labor, and blood lead levels. Hypertension. 1987 Oct;10(4):447–451. doi: 10.1161/01.hyp.10.4.447. [DOI] [PubMed] [Google Scholar]
  43. Richardson David B., Wing Steve, Lorey Fred, Hertz-Picciotto Irva. Adult hemoglobin levels at birth and risk of sudden infant death syndrome. Arch Pediatr Adolesc Med. 2004 Apr;158(4):366–371. doi: 10.1001/archpedi.158.4.366. [DOI] [PubMed] [Google Scholar]
  44. Rothenberg S. J., Karchmer S., Schnaas L., Perroni E., Zea F., Salinas V., Fernández Alba J. Maternal influences on cord blood lead levels. J Expo Anal Environ Epidemiol. 1996 Apr-Jun;6(2):211–227. [PubMed] [Google Scholar]
  45. Rothenberg S. J., Kondrashov V., Manalo M., Manton W. I., Khan F., Todd A. C., Johnson C. Seasonal variation in bone lead contribution to blood lead during pregnancy. Environ Res. 2001 Mar;85(3):191–194. doi: 10.1006/enrs.2000.4238. [DOI] [PubMed] [Google Scholar]
  46. Rothenberg S. J., Manalo M., Jiang J., Cuellar R., Reyes S., Sanchez M., Diaz M., Khan F., Aguilar A., Reynoso B. Blood lead level and blood pressure during pregnancy in South Central Los Angeles. Arch Environ Health. 1999 Nov-Dec;54(6):382–389. doi: 10.1080/00039899909603369. [DOI] [PubMed] [Google Scholar]
  47. Rothenberg S. J., Schnaas L., Cansino-Ortiz S., Perroni-Hernández E., de la Torre P., Neri-Méndez C., Ortega P., Hidalgo-Loperena H., Svendsgaard D. Neurobehavioral deficits after low level lead exposure in neonates: the Mexico City pilot study. Neurotoxicol Teratol. 1989 Mar-Apr;11(2):85–93. doi: 10.1016/0892-0362(89)90046-9. [DOI] [PubMed] [Google Scholar]
  48. Rothenberg S. J., Schnaas L., Perroni E., Hernández R. M., Martínez S., Hernández C. Pre- and postnatal lead effect on head circumference: a case for critical periods. Neurotoxicol Teratol. 1999 Jan-Feb;21(1):1–11. doi: 10.1016/s0892-0362(98)00034-8. [DOI] [PubMed] [Google Scholar]
  49. Rothenberg Stephen J., Kondrashov Vladislav, Manalo Mario, Jiang Jian, Cuellar Rosa, Garcia Mario, Reynoso Blanca, Reyes Sergio, Diaz Maria, Todd Andrew C. Increases in hypertension and blood pressure during pregnancy with increased bone lead levels. Am J Epidemiol. 2002 Dec 15;156(12):1079–1087. doi: 10.1093/aje/kwf163. [DOI] [PubMed] [Google Scholar]
  50. Shen X. M., Yan C. H., Guo D., Wu S. M., Li R. Q., Huang H., Ao L. M., Zhou J. D., Hong Z. Y., Xu J. D. Low-level prenatal lead exposure and neurobehavioral development of children in the first year of life: a prospective study in Shanghai. Environ Res. 1998 Oct;79(1):1–8. doi: 10.1006/enrs.1998.3851. [DOI] [PubMed] [Google Scholar]
  51. Sikorski R., Paszkowski T., Milart P., Radomanski T., Jr, Szkoda J. Intrapartum levels of trace metals in maternal blood in relation to umbilical cord blood values: lead, iron, copper, zinc. Int J Gynaecol Obstet. 1988 Apr;26(2):213–221. doi: 10.1016/0020-7292(88)90265-2. [DOI] [PubMed] [Google Scholar]
  52. Stallmach Thomas, Hebisch Gundula. Placental pathology: its impact on explaining prenatal and perinatal death. Virchows Arch. 2004 May 11;445(1):9–16. doi: 10.1007/s00428-004-1032-2. [DOI] [PubMed] [Google Scholar]
  53. Suarez C. R., Black L. E., 3rd, Hurley R. M. Elevated lead levels in a patient with sickle cell disease and inappropriate secretion of antidiuretic hormone. Pediatr Emerg Care. 1992 Apr;8(2):88–90. doi: 10.1097/00006565-199204000-00007. [DOI] [PubMed] [Google Scholar]
  54. Todd A. C., Wetmur J. G., Moline J. M., Godbold J. H., Levin S. M., Landrigan P. J. Unraveling the chronic toxicity of lead: an essential priority for environmental health. Environ Health Perspect. 1996 Mar;104 (Suppl 1):141–146. doi: 10.1289/ehp.96104s1141. [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Tsuchiya H., Mitani K., Kodama K., Nakata T. Placental transfer of heavy metals in normal pregnant Japanese women. Arch Environ Health. 1984 Jan-Feb;39(1):11–17. doi: 10.1080/00039896.1984.10545827. [DOI] [PubMed] [Google Scholar]
  56. Wasserman G. A., Liu X., Popovac D., Factor-Litvak P., Kline J., Waternaux C., LoIacono N., Graziano J. H. The Yugoslavia Prospective Lead Study: contributions of prenatal and postnatal lead exposure to early intelligence. Neurotoxicol Teratol. 2000 Nov-Dec;22(6):811–818. doi: 10.1016/s0892-0362(00)00106-9. [DOI] [PubMed] [Google Scholar]
  57. Watanabe T., Kasahara M., Nakatsuka H., Ikeda M. Cadmium and lead contents of cigarettes produced in various areas of the world. Sci Total Environ. 1987 Oct;66:29–37. doi: 10.1016/0048-9697(87)90074-x. [DOI] [PubMed] [Google Scholar]
  58. Zetterlund B., Winberg J., Lundgren G., Johansson G. Lead in umbilical cord blood correlated with the blood lead of the mother in areas with low, medium or high atmospheric pollution. Acta Paediatr Scand. 1977 Mar;66(2):169–175. doi: 10.1111/j.1651-2227.1977.tb07829.x. [DOI] [PubMed] [Google Scholar]
  59. al-Saleh I., Khalil M. A., Taylor A. Lead, erythrocyte protoporphyrin, and hematological parameters in normal maternal and umbilical cord blood from subjects of the Riyadh region, Saudi Arabia. Arch Environ Health. 1995 Jan-Feb;50(1):66–73. doi: 10.1080/00039896.1995.9955014. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES