and Cord Blood Levels of Cadmium, Lead, Manganese, Mercury,

Overview

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Key numbers

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of anemia in pregnancies, complicating as many as 40% of porter 1 (DMT1). DMT1 itself transports seven other differ-
study, Yadav et al. reported that 11% of women with IDA Infant and maternal data were retrospectively collected
had elevated BPb levels as compared to only 2.4% of women through a chart review. Infant data collected included birth
Selenium, a nonmetal, is an essential element that has as mothers with a hemoglobin < 9 g/dL, MCV level range
is commonly included due to its ability to modify mercury greater than 12 g/dL, an MCV level range of 80 to 95 fl, and
ery of ≥ 37 weeks. Respective charts of enrolled infants were tetramethyl ammonia hydroxide, 1% ethanol, 0.01% ammo-
then reviewed to evaluate for maternal exclusion criteria. nium pyrrolidine dithiocarbamate, 0.05% Triton™ X-100,
and a 5 μg/L iridium, rhodium, and tellurium internal stand- Table 1 Baseline demographic and clinical variables differences
Prenatal vitamin, % intake 64 65 0.94c
Prenatal iron, % intake 19 19 0.95c
Fetal sex, % (male, female) 57, 43 48, 52 0.7c
at 80%, alpha error at 5%, and to detect a mean lead level a
IDA group, and with 20% additional for inadequate samples, c
presented as median (interquartile range). An independent MCHC, g/dL 34.6 (34.3, 34.9) 31.4 (30.6, 31.9) < 0.001b
Mann–Whitney test was used when at least one of them was RDW% 14.1 (13.8, 15) 18.8 (17.8, 20.2) < 0.001b
Hispanic race was predominant in the controls, while the in the sIDA group (Table 4). Whites had one subject in each
Black race was predominant in the sIDA group (Table 1). group. In the control group, the levels were 0.22 µg/L, 132
By design, pregnancies with sIDA had significantly lower levels were 0.26 µg/L, 42 µg/L, 0.24 µg/L, and 167 µg/L for
hemoglobin, MCV, and MCHC indices (Table 2). There was BPb, BMn, BHg, and BSe, respectively. When comparing
between the groups (Table 2). difference between the two groups in any of the 4 metal
Blood mercury, µg/L 0.55 (0.27, 0.92) ↑ ↓ 0.19 (0.17, 0.52) 0.002b
Blood selenium, µg/L 160 ± 33 No difference ↑ 184 ± 31 0.007a
Element Control level N = 13 sIDA level N = 24 p-value Control level N = 12 sIDA levelN = 2 p-value
Blood mercury, µg/L 0.54 (± 0.29) 0.41 (0.17,0.53) 0.11b 0.77 (± 0.73) 0.17 (0.17,0.17) 0.03b
Blood selenium, µg/L 165 (± 30) 187 (± 32) 0.07a 147 (± 24) 156 (± 10) 0.65a
Agency (EPA) suggests a reference level of 5.8 µg/L for mer- groups as there could be different consumption habits due
at < 100 µg/L (29, 30),as compared to our levels of 160 and supplies in one group more than the other. Another impor-
184 µg/L in the control and sIDA groups, respectively. These tant limitation is the inclusion criteria to find pregnancies

Methods (brief)

study, Yadav et al. reported that 11% of women with IDA Infant and maternal data were retrospectively collected
had elevated BPb levels as compared to only 2.4% of women through a chart review. Infant data collected included birth
a history of high lead levels should be screened and evalu- and race. Maternal data collected included age, race, BMI,
with maternal IDA during pregnancy (10). Similarly, neurode- results collected included the predelivery cell blood count
were cadmium, manganese, mercury, and selenium. Sample Collection and Analysis
As a standard of practice, cord blood was routinely collected
This case–control study started with a prospective sample col- EDTA-containing tube. Samples were then sent and stored
lection that was followed by a retrospective chart review. First, in the blood bank at 4 °C. After 5–7 days, samples to be dis-
all leftover cord blood samples during the study period were carded and never utilized by the blood bank were saved for
these cord samples were reviewed for enrollment criteria. Lastly, sealed tubes back and forth. A volume of 0.5 mL was then
and once infants met inclusion criteria, the charts of their respec- poured into a certified metal-free tube. These samples were
per year. The Institutional Review Board approved the study website (16). In brief, whole blood samples were analyzed
Patients pole mass spectrometry (ICP-QQQ-MS) method. Prior to
analysis, blood samples were prepared by diluting 50 µL
ards. The matrix was introduced to an Agilent 8900 ICP- between the two groups
the dilution of the patient blood sample to the signal ratio
mium was rarely detected in any of the samples and the
Sample Size Calculation Gestational age, weeks 39 ± 1 39 ± 1 0.59a

Implications

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Verification notes

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Update history

The five most recent substantive edits to this page, classified major (evidence or structure moved), correction (a published value or statement was wrong and has been fixed), or minor (narrative rewritten without changing the underlying evidence). Each description is derived from what the edit did to this page; the linked commit is the authoritative record, routine regeneration passes are excluded, and the full version history lives in git. When DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.

Commit	Date	Change	Description
b01ec52c	2026-08-04	major	2 sections added
d49e450f	2026-08-03	major	5 sections added; narrative text revised