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2824742 
Journal Article 
Lead, mercury and cadmium in umbilical cord blood and its association with parental epidemiological variables and birth factors 
García-Esquinas, E; Pérez-Gómez, B; Fernández-Navarro, P; Fernández, MA; de Paz, C; Pérez-Meixeira, AM; Gil, E; Iriso, A; Sanz, JC; Astray, J; Cisneros, M; de Santos, A; Asensio, Á; García-Sagredo, JM; García, JF; Vioque, J; López-Abente, G; Pollán, M; González, MJ; Martínez, M; Aragonés, N 
2013 
Yes 
BMC Public Health
ISSN: 1471-2458 
13 
841 
English 
Background
In Spain, few studies have evaluated prenatal exposure to heavy metals. The objective of this study was to describe lead, mercury and cadmium concentrations in blood from a sample of newborn–mother-father trios, as well as to investigate the association between metals in cord blood and parental variables. We also explored the relationship between cord blood metal concentrations and child characteristics at birth.

Methods
Metal correlations among family members were assessed using Spearman Rank Correlation Coefficient. Linear regression was used to explore the association between parental variables and log-transformed cord blood lead and cord blood mercury concentrations. In the case of cadmium, tobit regression was used due to the existence of samples below the detection limit. The association between cord blood metal concentrations and child characteristics at birth was evaluated using linear regression.

Results
Geometric means for lead, mercury and cadmium were 14.09 μg/L, 6.72 μg/L and 0.27 μg/L in newborns; 19.80 μg/L, 3.90 μg/L and 0.53 μg/L in pregnant women; and 33.00 μg/L, 5.38 μg/L and 0.49 μg/L in men. Positive correlations were found between metal concentrations among members of the trio. Lead and cadmium concentrations were 15% and 22% higher in newborns from mothers who smoked during pregnancy, while mercury concentrations were 25% higher in newborns from mothers with greater fish intake. Cord-blood lead levels showed seasonal periodicity, with lower concentrations observed in winter. Cord blood cadmium concentrations over 0.29 μg/L were associated with lower 1-minute and 5-minute Apgar scores.

Conclusions
These results reinforce the need to establish biomonitoring programs in Spain, and provide support for tobacco smoke and fish consumption as important preventable sources of heavy metal exposure in newborns. Additionally, our findings support the hypothesis that cadmium exposure might be deleterious to fetal development.