Journal Article

Impact of Bone Lead and Bone Resorption on Plasma and Whole Blood Lead Levels during Pregnancy

Martha María Téllez-Rojo, Mauricio Hernández-Avila, Héctor Lamadrid-Figueroa, Donald Smith, Leticia Hernández-Cadena, Adriana Mercado, Antonio Aro, Joel Schwartz and Howard Hu

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 160, issue 7, pages 668-678
Published in print October 2004 | ISSN: 0002-9262
Published online October 2004 | e-ISSN: 1476-6256 | DOI:
Impact of Bone Lead and Bone Resorption on Plasma and Whole Blood Lead Levels during Pregnancy

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The authors tested the hypotheses that maternal bone lead burden is associated with increasing maternal whole blood and plasma lead levels over the course of pregnancy and that this association is modified by rates of maternal bone resorption. A total of 193 Mexican women were evaluated (1997–1999) in the first, second, and third trimesters of pregnancy. Whole blood lead and plasma lead levels were measured in each trimester. Urine was analyzed for cross-linked N-telopeptides (NTx) of type I collagen, a biomarker of bone resorption. Patella and tibia lead levels were measured at 4 weeks postpartum. The relation between whole blood, plasma, and bone lead and NTx was assessed using mixed models. Plasma lead concentrations followed a U-shape, while NTx levels increased significantly during pregnancy. In a multivariate model, the authors observed a significant and positive interaction between NTx and bone lead when plasma lead was used as the outcome variable. Dietary calcium intake was inversely associated with plasma lead. Results for whole blood lead were similar but less pronounced. These results confirm previous evidence that bone resorption increases during pregnancy, with a consequential significant release of lead from bone, constituting an endogenous source of prenatal exposure. They also provide a rationale for testing strategies (e.g., nutritional supplementation with calcium) aimed at decreasing prenatal lead exposure.

Keywords: bone resorption; lead; longitudinal studies; pregnancy; Abbreviations: BCE, bone collagen equivalents; NTx, cross-linked N-telopeptides.

Journal Article.  6735 words.  Illustrated.

Subjects: Public Health and Epidemiology

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