A simulation study to improve calcium intake through wheat flour fortification.

OBJECTIVE: to simulate the impact on calcium intake- effectiveness and safety- of fortifying wheat flour with 200, 400 and 500 mg of calcium per 100 g of flour. DESIGN: secondary analysis of cross-sectional data collected through repeated 24-hour dietary recalls using IOWA the Intake Modelling, Assessment and Planning Program. SETTING: urban cities in the National Health and Nutrition Survey of Argentina (ENNyS 2018 - 2019). PARTICIPANTS: 21358 participants, including children, adolescents, and adults. RESULTS: Most individuals in all age groups reported consuming wheat flour. The prevalence of low calcium intake was above 80% in individuals older than 9 years. Simulating the fortification of 500 mg of calcium per 100 g of wheat flour showed that the prevalence of low calcium intake could be reduced by more than 40 percentage points in girls and women aged 19 to less than 51 and boys and men aged 4 to less than 71, while it remained above 65% in older ages. The percentages above the upper intake level remained below 1.5% in all age groups. CONCLUSIONS: Calcium flour fortification could be further explored to improve calcium intake. Subnational simulations could be performed to identify groups that might not be reached by this strategy that could be explored in Argentina. This analysis could be used to advocate for a strategy to fortify wheat flour.

Blood Lead Levels and Their Association with Iron Deficiency and Anemia in Children.

Lead is a ubiquitous and neurotoxic heavy metal particularly harmful to children, who are more susceptible than adults to its toxic effects. The prevalence of lead poisoning and iron deficiency (ID) is high in socioeconomically vulnerable child populations, negatively affecting neurocognitive development in children. Although numerous studies have shown the association between blood lead levels (BLL) and ID, the issue remains controversial. Here, we aimed to identify the association between BLL and iron nutritional status in children. We conducted an analytical cross-sectional study of healthy children aged 1-6 y attending periodic health checks in primary healthcare units from La Plata and its surroundings, Buenos Aires, Argentina, between 2012 and 2017. We performed anthropometric evaluations and determined BLL, hemoglobin (Hb) and serum ferritin levels. Blood lead levels ≥ 5 µg/dL were defined as elevated BLL; ferritin levels < 12 ng/ml were considered ID; Hb levels < 11 g/dL (< 11.5 g/dL for children ≥ 5 y) were defined as anemia. Data were analysed using Mann Whitney test, Student´s t-test, chi-square test and logistic regression. The R package (v. 4.2.2.) was used for the statistical analysis of data. The sample included 392 children (mean age, 2.4 ± 1.4 y; 44.6% females). The prevalence of elevated BLL, ID and anemia was 8.7%, 26.3% and 31.8%, respectively. We found a significant association between elevated BLL and ID (odds ratio [OR], 95% confidence interval [CI]: 3.16 (1.50, 6.63)). The prevalence of elevated BLL was 16.2% and 5.8% in children with and without ID, respectively (p = 0.003). We also found association between elevated BLL and anemia (OR 95% CI: 3.03 (1.49, 6.29)). In conclusion, blood lead levels ≥ 5 µg/dL were significantly associated with ID and anemia in children aged 1-6 years.

Calcium concentration of drinking water to improve calcium intake: A simulation study.

The risk of inadequate calcium intake is a worldwide problem. We performed a simulation exercise on the impact, effectiveness, and safety of increasing calcium levels in drinking water using the 2019 Health and Nutrition National Survey of Argentina, which provides water intake and water sources data at the individual level. We simulated the distribution of calcium intake assuming a calcium concentration of 100 mg of calcium per liter of tap water and 400 mg of calcium per liter of bottled water. After the simulation, all population groups had a slightly improved calcium intake. Higher impacts were observed in adults, as reported water intake was higher in adults 19-51 years old. In young adult women, the estimated calcium intake inadequacy decreased from 91.0% to 79.7% when calcium was increased in tap water and to 72.2% when calcium was increased in tap and bottled water. The impact was lower in adolescents and older adults who have higher calcium recommendations and reported lower water intake. Increased calcium concentration of water could improve calcium intake in Argentina, especially in adults as their reported water intake is higher. Combining more than one strategy to improve calcium intake might be required for countries like Argentina with low calcium intake.

Calculation of the contribution of water to calcium intake in low- and middle-income countries.

Dietary calcium intake is low in many countries, particularly in low- and middle-income countries (LMICs). Water is often overlooked as a source of dietary calcium despite it being universally consumed and providing good calcium bioavailability. Our objective was to assess water distribution systems in LMICs and to develop a formula to simulate the contribution of different water sources to calcium availability. We calculated the contribution of drinking water considering different calcium concentration levels to estimate total calcium availability. We consider a country's households' access to drinking water sources and the distribution of the country's population by age and gender. Calcium availability could be increased by an average of 49 mg of calcium per person per day in the 62 countries assessed if calcium in drinking water was considered. In 22 (31%) of the countries studied, 80% of households are supplied by water sources that could increase calcium availability. Improving calcium concentration in water could be considered as a strategy in LMICs to slightly improve calcium availability.

Testing for sensory threshold in drinking water with added calcium: a first step towards developing a calcium fortified water.

Background: Food fortification is an effective strategy that has been recommended for improving population calcium inadequate intakes. Increasing calcium concentration of water has been proposed as a possible strategy to improve calcium intake. The objective of this study was to determine the sensory threshold of different calcium salts added to drinking water using survival analysis. Methods: We performed the triangle test methodology for samples of water with added calcium using three different calcium salts: calcium chloride, calcium gluconate and calcium lactate. For each salt, a panel of 54 consumers tested seven batches of three water samples. Data were adjusted for chance and sensory threshold was estimated using the survival methodology and a discrimination of 50%. Results: The threshold value estimation for calcium gluconate was 587 ± 131 mg/L of water, corresponding to 25% discrimination, for calcium lactate was 676 ± 186 mg/L, corresponding to 50% discrimination, and for calcium chloride was 291 ± 73 mg/L, corresponding to 50% discrimination. Conclusions: These results show that water with calcium added in different salts and up to a concentration of 500 mg of calcium/L of water is feasible. The calcium salt allowing the highest calcium concentration with the lowest perceived changes in taste was calcium gluconate. Future studies need to explore stability and acceptability over longer periods of time.

Contribution of calcium in drinking water from a South American country to dietary calcium intake.

OBJECTIVE: To describe the calcium concentration of tap and bottled waters from Argentina and to estimate the contribution of drinking water to calcium recommendations. RESULTS: Calcium concentrations provided by water authorities ranged from 6 to 105 mg/L. The mean calcium level of samples analysed at the Laboratorio de Ingeniería Sanitaria, National University of La Plata was 15.8 (SD ± 13.2) mg/L and at the Bone Biology Laboratory of the National University of Rosario was 13.1 (± 10.0) mg/L. Calcium values of samples from supply systems and private wells was similar. Most bottled waters had calcium levels well below 50 mg/L. The intake of one litre of drinking water from Argentina could represent in average between 1.2 and 8.0% of the calcium daily values for an adult.

Mechanisms Involved in the Relationship between Low Calcium Intake and High Blood Pressure.

There is increasing epidemiologic and animal evidence that a low calcium diet increases blood pressure. The aim of this review is to compile the information on the link between low calcium intake and blood pressure. Calcium intake may regulate blood pressure by modifying intracellular calcium in vascular smooth muscle cells and by varying vascular volume through the renin-angiotensin-aldosterone system. Low calcium intake produces a rise of parathyroid gland activity. The parathyroid hormone increases intracellular calcium in vascular smooth muscles resulting in vasoconstriction. Parathyroidectomized animals did not show an increase in blood pressure when fed a low calcium diet as did sham-operated animals. Low calcium intake also increases the synthesis of calcitriol in a direct manner or mediated by parathyroid hormone (PTH). Calcitriol increases intracellular calcium in vascular smooth muscle cells. Both low calcium intake and PTH may stimulate renin release and consequently angiotensin II and aldosterone synthesis. We are willing with this review to promote discussions and contributions to achieve a better understanding of these mechanisms, and if required, the design of future studies.

Deficiencia de vitamina A y factores asociados en niños preescolares de la periferia de la ciudad de La Plata, Buenos Aires / Vitamin A deficiency and associated factors in preschoolers from the outskirts of La Plata, Buenos Aires

Introducción. La deficiencia de vitamina A (DVA) ha sido reconocida como un importante problema de salud pública en países en vías de desarrollo. Los niños en edad preescolar son grupos de riesgo en poblaciones vulnerables. El objetivo fue determinar la prevalencia de DVA y los factores asociados en una muestra de niños de edad preescolar. Material y métodos. Estudio de corte transversal que incluyó a niños de 1 a 6 años beneficiarios de planes sociales, atendidos en centros de atención primaria de la periferia de la ciudad de la Plata, Buenos Aires. Se determinó el contenido de vitamina A midiendo retinol sérico, por cromatografía líquida, y se registraron parámetros antropométricos e ingesta alimentaria. Se utilizó un modelo de regresión logística multinomial para evaluar la asociación entre las variables. Resultados. Se analizaron datos de 624 niños. La media geométrica de retinol fue 23,8 pg/dl (IC 95 %: 23,3-24,3). Las prevalencias de DVA y riesgo de DVA fueron 24,3 % y 57,4 %, respectivamente. Los niveles de retinol fueron significativamente menores en niños varones, con bajo peso y aquellos con bajo consumo (menor del primer tercilo de distribución). El análisis multivariable mostró asociación significativa entre DVA y el sexo masculino (OR: 1,93; IC 95 %: 1,15-3,24) y con el bajo consumo (OR: 1,48; IC 95 %: 1,15-2,62). Conclusión. La prevalencia de DVA hallada (24,3 %) constituye un importante problema de salud pública en esta población. Los factores asociados a dicha deficiencia fueron el sexo masculino y el bajo consumo.

Introduction. Vitamin A deficiency (VAD) has been recognized as an important public health problem in developing countries. Preschoolers account for risk groups within vulnerable populations. The objective of this study was to determine the prevalence of VAD and associated factors in a sample of preschoolers. Material and methods. Cross-sectional study with children aged 1-6 years receiving social assistance and seen at primary health care centers in the outskirts of the city of La Plata, Buenos Aires. Vitamin A levels were determined by measuring serum retinol with a liquid chromatography; anthropometric parameters and dietary intake were recorded. A multinomial logistic regression model was used to assess the association among outcome measures. Results. Data from 624 children were analyzed. The geometric mean of retinol was 23.8 pg/dL (95 % CI: 23.3-24.3). The prevalence of VAD and the risk for VAD were 24.3 % and 57.4 %, respectively. Retinol levels were significantly lower among boys, low-weight children, and those with low intake (below the first tertile of distribution). The multivariate analysis showed a significant association between VAD and male sex (odds ratio: 1.93; 95 % CI: 1.15-3.24) and between VAD and low intake (odds ratio: 1.48; 95 % CI: 1.15-2.62). Conclusion. The prevalence of VAD (24.3 %) is a major public health problem in this population. VAD-associated factors were male sex and low vitamin A intake.

Vitamin A deficiency and associated factors in preschoolers from the outskirts of La Plata, Buenos Aires. / Deficiencia de vitamina A y factores asociados en niños preescolares de la periferia de la ciudad de La Plata, Buenos Aires.

INTRODUCTION: Vitamin A deficiency (VAD) has been recognized as an important public health problem in developing countries. Preschoolers account for risk groups within vulnerable populations. The objective of this study was to determine the prevalence of VAD and associated factors in a sample of preschoolers. MATERIALS AND METHODS: Cross-sectional study with children aged 1-6 years receiving social assistance and seen at primary health care centers in the outskirts of the city of La Plata, Buenos Aires. Vitamin A levels were determined by measuring serum retinol with a liquid chromatography; anthropometric parameters and dietary intake were recorded. A multinomial logistic regression model was used to assess the association among outcome measures. RESULTS: Data from 624 children were analyzed. The geometric mean of retinol was 23.8 pg/dL (95 % CI: 23.3-24.3). The prevalence of VAD and the risk for VAD were 24.3 % and 57.4 %, respectively. Retinol levels were significantly lower among boys, low-weight children, and those with low intake (below the first tertile of distribution). The multivariate analysis showed a significant association between VAD and male sex (odds ratio: 1.93; 95 % CI: 1.15-3.24) and between VAD and low intake (odds ratio: 1.48; 95 % CI: 1.15-2.62). CONCLUSION: The prevalence of VAD (24.3 %) is a major public health problem in this population. VAD-associated factors were male sex and low vitamin A intake.

Introducción. La deficiencia de vitamina A (DVA) ha sido reconocida como un importante problema de salud pública en países en vías de desarrollo. Los niños en edad preescolar son grupos de riesgo en poblaciones vulnerables. El objetivo fue determinar la prevalencia de DVA y los factores asociados en una muestra de niños de edad preescolar. Material y métodos. Estudio de corte transversal que incluyó a niños de 1 a 6 años beneficiarios de planes sociales, atendidos en centros de atención primaria de la periferia de la ciudad de la Plata, Buenos Aires. Se determinó el contenido de vitamina A midiendo retinol sérico, por cromatografía líquida, y se registraron parámetros antropométricos e ingesta alimentaria. Se utilizó un modelo de regresión logística multinomial para evaluar la asociación entre las variables. Resultados. Se analizaron datos de 624 niños. La media geométrica de retinol fue 23,8 pg/dl (IC 95 %: 23,3-24,3). Las prevalencias de DVA y riesgo de DVA fueron 24,3 % y 57,4 %, respectivamente. Los niveles de retinol fueron significativamente menores en niños varones, con bajo peso y aquellos con bajo consumo (menor del primer tercilo de distribución). El análisis multivariable mostró asociación significativa entre DVA y el sexo masculino (OR: 1,93; IC 95 %: 1,15-3,24) y con el bajo consumo (OR: 1,48; IC 95 %: 1,15-2,62). Conclusión. La prevalencia de DVA hallada (24,3 %) constituye un importante problema de salud pública en esta población. Los factores asociados a dicha deficiencia fueron el sexo masculino y el bajo consumo.

Contenido de vitamina A en la leche materna madura y su adecuación a las recomendaciones nutricionales en el lactante / Vitamin A content in mature breast milk and its adequacy to the nutritional recommendations for infants

Objetivo. Determinar el contenido de vitamina A en la leche materna y evaluar si cubre las recomendaciones para lactantes. Material y métodos. Estudio observacional, prospectivo, de corte transversal. Se analizaron muestras de leche de madres asistidas en el hospital público, obtenidas entre los 30 y los 90 días posparto. Se determinó la concentración de vitamina A por cromatografía y su adecuación a la ingesta dietética recomendada. Se utilizó el coeficiente de Spearman para estudiar la correlación entre variables. Resultados. Participaron 79 madres. La concentración de vitamina A en las leches fue 1,80 µmol/L (1,36-2,30); el tiempo medio de lactancia, de 57 días. No se encontró correlación significativa entre días de lactancia y contenido de vitamina A. El contenido en 50% de las muestras no cubrió las recomendaciones de vitamina A para los lactantes. Conclusión. El contenido de vitamina A fue insuficiente para cubrir las recomendaciones en la mitad de los casos.

Objective. To determine vitamin A content in breast milk and evaluate whether it satisfies the recommendations for infants. Material and methods. Observational, prospective, cross sectional study. Milk samples were obtained between 30 and 90 days postpartum from mothers seen in public hospitals, and analyzed. Vitamin A concentration was determined by chromatography and its adequacy to the recommended dietary intake. The correlation between outcome measures was analyzed using Spearman's correlation coefficient. Results. A total of 79 mothers participated. Vitamin A concentration in milk samples was 1.80 umol/L (1.36-2.30) and the mean breastfeeding time was 57 days. No significant correlation between breastfeeding days and vitamin A content was observed. In 50% of the samples, vitamin A content did not satisfy the recommendations for infants. Conclusion. Vitamin A content was not enough to satisfy the recommendations in half of the cases.

Vitamin A content in mature breast milk and its adequacy to the nutritional recommendations for infants. / Contenido de vitamina A en la leche materna madura y su adecuación a las recomendaciones nutricionales en el lactante.

OBJECTIVE: To determine vitamin A content in breast milk and evaluate whether it satisfies the recommendations for infants. MATERIAL AND METHODS: Observational, prospective, cross sectional study. Milk samples were obtained between 30 and 90 days postpartum from mothers seen in public hospitals, and analyzed. Vitamin A concentration was determined by chromatography and its adequacy to the recommended dietary intake. The correlation between outcome measures was analyzed using Spearman's correlation coefficient. RESULTS: A total of 79 mothers participated. Vitamin A concentration in milk samples was 1.80 umol/L (1.36-2.30) and the mean breastfeeding time was 57 days. No significant correlation between breastfeeding days and vitamin A content was observed. In 50% of the samples, vitamin A content did not satisfy the recommendations for infants. CONCLUSION: Vitamin A content was not enough to satisfy the recommendations in half of the cases.

OBJETIVO: Determinar el contenido de vitamina A en la leche materna y evaluar si cubre las recomendaciones para lactantes. MATERIAL Y MÉTODOS: Estudio observacional, prospectivo, de corte transversal. Se analizaron muestras de leche de madres asistidas en el hospital público, obtenidas entre los 30 y los 90 días posparto. Se determinó la concentración de vitamina A por cromatografía y su adecuación a la ingesta dietética recomendada. Se utilizó el coeficiente de Spearman para estudiar la correlación entre variables. RESULTADOS: Participaron 79 madres. La concentración de vitamina A en las leches fue 1,80 µmol/L (1,36-2,30); el tiempo medio de lactancia, de 57 días. No se encontró correlación significativa entre días de lactancia y contenido de vitamina A. El contenido en 50% de las muestras no cubrió las recomendaciones de vitamina A para los lactantes. CONCLUSIÓN: El contenido de vitamina A fue insuficiente para cubrir las recomendaciones en la mitad de los casos.

Lactancia materna exclusiva y su relación con el estado nutricional de vitamina A del binomio madre-hijo / Exclusive breastfeeding and its relationship with the vitamin A nutritional status of the mother-child binomial

INTRODUCCIÓN Las madres en período de lactancia y los lactantes son considerados grupos vulnerables a la deficiencia de vitamina A (DVA). OBJETIVO Conocer la relación entre el estado nutricional de vitamina A en la madre y el lactante alimentado con lactancia materna exclusiva y calcular la adecuación de las leches a las recomendaciones. MÉTODO Estudio observacional, analítico, de corte transversal, en lactantes de 6 meses de edad con lactancia materna exclusiva y sus madres. Se determinó la cantidad de vitamina A en suero y leche por cromatografía líquida. Se calculó la concentración media de retinol y las prevalencias de deficiencias de vitamina A en la madre y el lactante y se establecieron correlaciones entre ellas. Se analizó la adecuación de las leches a las recomendaciones nutricionales de referencia. RESULTADOS Se estudiaron 63 binomios madre-hijo. La concentración media de retinol en suero materno fue 1,84 ± 0,48 µmol /L. Ninguna madre presentó DVA en suero y sólo el 2% riesgo de DVA. La concentración media de retinol en leche fue 1,41 ± 0,80µmol /L y 15,57 µg/g grasa (11,37; 23,98), el 38% de las mujeres presentaron deficiencia de vitamina en leche, y al ajustar por la grasa el 12%. El 67% de las leches no cubren las recomendaciones. En lactantes, la concentración media de retinol en suero fue 1,09 ± 0,25 µmol /L, la prevalencia de DVA 5% y el riesgo de DVA 47,5%. Se encontraron diferencias estadísticamente significativas entre las concentraciones medias de retinol en suero de la madre y del lactante (p=0,0490) y entre los niveles medios de retinol en suero de los lactantes alimentados con leches deficientes y los alimentados con leches no deficientes (p=0,0420). DISCUSIÓN No hubo madres con DVA en suero y sólo el 5 % de los lactantes estaban deficientes. Se encontró asociación entre el estado nutricional en vitamina A en suero y leche de la madre y el del suero del lactante. El 67% de las leches no se adecuaron a las recomendaciones

Contenido de vitamina A en leche materna madura después de lapasteurización: requerimientos nutricionales del lactante / Vitamin A Content in Mature Breast Milk after Pasteurization: Nutritional Requirements of the

INTRODUCCION: La leche materna proveniente de los bancos de leche humana (BLH) es el mejor sustituto cuando la lactancia no es posible. Sin embargo, la pasteurización puededisminuir el contenido de vitamina A. OBJETIVO: Comparar el contenido de vitamina A en leche madura de BLH antes y después de la pasteurización, y analizar si la leche pasteurizada se adecua a los requerimientos nutricionales del lactante. METODOS:Las muestras de leche fueron recogidas por las madres donantes. Se analizó la vitamina A por cromatografía líquida, y se calculó la media de concentración antes y después de la pasteurización. Secompararon los resultados según el test de Student. Se analizó la adecuación de la vitamina a los requerimientos nutricionales del lactante. RESULTADOS: Se analizaron 53 muestras de leche de madres donantes cuya edad promedio era de 31,3±4,4 años. La media del tiempo de lactancia fue de 91±59 días. La concentraciónmedia de vitamina A en leche antes y después de la pasteurización fue de 36,6±13,5 μg/dl y 30,5±12,8 μg/dl, respectivamente (p<0,001). Se observó una disminución media de concentraciónde 6,1 μg/dl (16,7%) de vitamina A luego de la pasteurización. El porcentaje de adecuación de la vitamina A en la leche pasteurizada fue del 59,6%. CONCLUSIONES: La disminución de vitamina A en leche madura de BLH luego de la pasteurización fue del 16,7%. La concentración de vitamina A hallada en la leche pasteurizada fue insuficiente para cubrir los requerimientos del lactante.

INTRODUCTION: Breast milk from human milk banks (HMB) is the best substitute when breastfeeding is not possible, although pasteurization maydecrease vitamin A content. OBJECTIVE: To compare vitamin A content in mature milk from HMB before and after pasteurization, and to analyze whether pasteurized milk meets the infant nutritional requirements. METHODS:Milk samples were collected by donor mothers. Vitamin A was assessed by liquid chromatography, and mean concentration before and after pasteurization was calculated. Results were compared with StudentÆs t-test.Vitamin A adequacy to the infantÆs nutritional requirements was analyzed. RESULTS: A total of 53 human milksamples from donor mothers were analyzed (average age: 31.3±4.4 years; mean breastfeeding duration:91±59 days). Mean vitamin A concentration in milk before and after pasteurization was 36.6±13.5 μg/dland 30.5±12.8 μg/dl, respectively (p<0.001). The mean decrease of vitamin A concentration after pasteurization was 6.1 μg/dl (16.7%). Vitamin A adequacy percentagein milk after pasteurization was 59.6%. CONCLUSIONS: Vitamin A decrease in mature milk from HMB after pasteurization was 16.7%. Vitamin A concentration in milk after pasteurization was not sufficient to meet the infantÆs needs.

Niveles de plomo en sangre de cordón umbilical: relación con factores de exposición al plomo en una maternidad pública de La Plata, Argentina / Cord blood lead levels: relationship with maternal lead exposure factors in a public hospital in La Plata, Argentina

INTRODUCCION: La exposición de las mujeres embarazadas al plomo es un riesgo para la salud perinatal que se puede traducir en alteraciones en el desarrollo cognitivo de los niños y en otros efectos deletéreos para la salud infantil.OBJETIVOS: Determinar los niveles de plomo en sangre de cordón umbilical en recién nacidos de una maternidad pública de La Plata. Estudiar si existe relación entre los niveles de plomo en sangre de cordón umbilical y factores de exposición al plomo de la madre.METODOS: Se realizó un estudio analítico de corte transversal, que incluyó a 167 recién nacidos de una maternidad pública. Se determinó plomo en sangre de cordón umbilical, y se realizó una encuesta sociodemográfica, ambiental y de hábitos nutricionales para buscar la relación entre la presencia de plomo y factores de riesgo de exposición en la madre.RESULTADOS: El 97% de los recién nacidos mostró plombemia en sangre de cordón con niveles menores a 5 Ag/dl, el 3% restante presentó valores de entre 5 y 10 Ag/dl. Los factores de riesgo más frecuentes asociados con la exposición de las madres fueron los siguientes: ser fumadoras pasivas, tener necesidades básicas insatisfechas y vivir cerca de fuentes de exposición, como paradas de colectivo, calles de tierra, talleres mecánicos, vías transitadas o viviendas en reparación o en construcción.CONCLUSIONES: La proporción de valores elevados de plombemia fue muy baja para encontrar correlaciones con los factores de riesgo de exposición en la madre. Aunque los resultados sugieren un bajo riesgo de exposición prenatal al plomo, es necesario continuar con políticas de prevención de la exposición ambiental, ya que se desconoce el valor umbral a partir del cual el plomo produce efectos adversos sobre la salud infantil.

INTRODUCTION: Exposure to lead during pregnancy is a risk for perinatal health that can lead to cognitive development alterations and other deleterious effects con children’s health.OBJECTIVE: To determine cord blood lead levels in newborns of a public hospital in La Plata. To investigate if there is a relationship between cord blood lead levels and exposure risk factors in the mothers.METHODS: This analytical cross-sectional study included 167 newborns of a public maternity. Cord blood samples were analyzed for lead concentration, and pregnant women answered a questionnaire on social, demographic and environmental aspects and nutritional habits, seeking a relationship between cord blood lead level and maternal risk factors for lead exposure. RESULTS: 97% of the newborns had cord blood lead levels lower than 5 Ag/dl, 3% had levels between 5 and 10 Ag/dl. The lead exposure risk factors which appeared most frequently were: being second hand smokers, having basic needs unsatisfied, living near exposure sources like bus stops, dirt roads, mechanical garages, high-traffic roads and houses under construction or repair.CONCLUSIONS: The proportion of high cord blood lead levels was too low to find any correlations with maternal lead exposure rise factors. The results indicated a low risk of prenatal lead exposure. However, it is necessary to continue with preventive environmental policy, because the minimum blood lead level which could produce adverse effects on children health is yet unknown.

Niveles de plomo en sangre de cordón umbilical: relación con factores de exposición al plomo en una maternidad pública de La Plata, Argentina / Cord blood lead levels: relationship with maternal lead exposure factors in a public hospital in La Plata, Argentina

INTRODUCCION: La exposición de las mujeres embarazadas al plomo es un riesgo para la salud perinatal que se puede traducir en alteraciones en el desarrollo cognitivo de los niños y en otros efectos deletéreos para la salud infantil.OBJETIVOS: Determinar los niveles de plomo en sangre de cordón umbilical en recién nacidos de una maternidad pública de La Plata. Estudiar si existe relación entre los niveles de plomo en sangre de cordón umbilical y factores de exposición al plomo de la madre.METODOS: Se realizó un estudio analítico de corte transversal, que incluyó a 167 recién nacidos de una maternidad pública. Se determinó plomo en sangre de cordón umbilical, y se realizó una encuesta sociodemográfica, ambiental y de hábitos nutricionales para buscar la relación entre la presencia de plomo y factores de riesgo de exposición en la madre.RESULTADOS: El 97% de los recién nacidos mostró plombemia en sangre de cordón con niveles menores a 5 Ag/dl, el 3% restante presentó valores de entre 5 y 10 Ag/dl. Los factores de riesgo más frecuentes asociados con la exposición de las madres fueron los siguientes: ser fumadoras pasivas, tener necesidades básicas insatisfechas y vivir cerca de fuentes de exposición, como paradas de colectivo, calles de tierra, talleres mecánicos, vías transitadas o viviendas en reparación o en construcción.CONCLUSIONES: La proporción de valores elevados de plombemia fue muy baja para encontrar correlaciones con los factores de riesgo de exposición en la madre. Aunque los resultados sugieren un bajo riesgo de exposición prenatal al plomo, es necesario continuar con políticas de prevención de la exposición ambiental, ya que se desconoce el valor umbral a partir del cual el plomo produce efectos adversos sobre la salud infantil.

INTRODUCTION: Exposure to lead during pregnancy is a risk for perinatal health that can lead to cognitive development alterations and other deleterious effects con childrens health.OBJECTIVE: To determine cord blood lead levels in newborns of a public hospital in La Plata. To investigate if there is a relationship between cord blood lead levels and exposure risk factors in the mothers.METHODS: This analytical cross-sectional study included 167 newborns of a public maternity. Cord blood samples were analyzed for lead concentration, and pregnant women answered a questionnaire on social, demographic and environmental aspects and nutritional habits, seeking a relationship between cord blood lead level and maternal risk factors for lead exposure. RESULTS: 97% of the newborns had cord blood lead levels lower than 5 Ag/dl, 3% had levels between 5 and 10 Ag/dl. The lead exposure risk factors which appeared most frequently were: being second hand smokers, having basic needs unsatisfied, living near exposure sources like bus stops, dirt roads, mechanical garages, high-traffic roads and houses under construction or repair.CONCLUSIONS: The proportion of high cord blood lead levels was too low to find any correlations with maternal lead exposure rise factors. The results indicated a low risk of prenatal lead exposure. However, it is necessary to continue with preventive environmental policy, because the minimum blood lead level which could produce adverse effects on children health is yet unknown.