Elements in placenta and pregnancy outcome in arctic and subarctic areas
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OBJECTIVES: This paper describes a comprehensive assessment of the association of concentrations of essential and toxic elements in maternal and neonatal body fluids and the placenta as predictors of birth weight and newborn body mass index (BMIC) for deliveries in northern Norway and Russia. STUDY DESIGN: A prospective cross-sectional study of delivering women and their outcomes from different locations in Russian and Norwegian arctic and sub-arctic areas. METHODS: Life-style information, blood, urine and placenta specimens were collected for 50 consecutive mother-infant pairs from hospital delivery departments in a total of six communities located in Finnmark, Norway, or the western arctic/subarctic regions of Russia. Questionnaire information was collected by individual interviews performed by trained health personnel. Pregnancy outcomes were verified by consulting medical records. Cadmium, copper, iron (as ferritin), nickel, lead, selenium and zinc were measured in maternal blood, serum or maternal urine: and in cord blood, or neonatal urine and placental tissue. Univariate and multivariate linear regression analysis and ANOVA were employed to explore associations between these clinical chemistry outcomes and birth weight and BMIC. RESULTS: A number of significant relationships were evident between: placental and maternal blood cadmium (p < 0.005); cord and maternal blood lead (p < 0.001); placental and maternal blood lead (p < 0.001); placental and cord-blood lead (p < 0.001); placental and maternal serum, or blood, selenium (p < 0.001); and placental and maternal serum copper (p < 0.001). Maternal body mass index (BMI), maternal age, placental lead, or maternal blood lead, and smoking were retained as predictors of birth weight and BMIC in the multivariate modelling. Birth weights in both countries were normally distributed. CONCLUSIONS: Maternal age and BMI as positive predictors of birth weight, and cigarette smoking and lead exposure as negative determinants, are discussed in terms of established evidence and recognized confounders, including maternal genetic factors, socio-economic status, socio-political change, life-style issues, prenatal care and nutrition. It is recommended that future work in societies undergoing socio-economic transition might best focus on preventive measures to improve neonatal health and development.
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