Early Cord Clamping Boosts Lead in At-Risk Infants

    

    Tue Dec 11, 2007 6:52 pm (PST)

    http://www.medscape .com/viewarticle /566984

 

    Early Cord Clamping Boosts Lead in At-Risk Infants

 

    By David Douglas

 

    NEW YORK (Reuters Health) Dec 05 - In settings where lead exposure is
high,

    the practice of immediate umbilical cord clamping after delivery can
give

    rise to elevated blood lead levels in infancy, in part by decreasing
iron

    status, according to US and Mexican researchers.

 

    "Clamping the umbilical cord in the first 10 to 15 seconds after birth,"

    lead investigator Dr. Camila M. Chaparro told Reuters Health, "is
frequently

    practiced in many delivery settings -- both in the developed and
developing

    world -- and is a practice that was instituted with little scientific

    evidence justifying it."

 

    In the November issue of the Journal of Pediatrics, Dr. Chaparro of the
Pan

    American Health Organization, Washington, DC and colleagues note that in

    Mexico City, lead exposure is high and iron deficiency is also common.

 

    To investigate whether infant iron status, modified by umbilical cord

    clamping time and infant feeding mode, affected infant blood lead

    concentration, the researchers randomized 266 prospective mothers in
Mexico

    City to 10-second or 2-minute umbilical cord clamping at the time of

    delivery.

 

    Examination of data on maternal lead exposure at baseline and on infant

    feeding showed that maternal blood lead concentration, infant ferritin,
and

    breast-feeding practices predicted infant blood lead concentration at 6

    months.

 

    In infants with higher placental blood lead concentration and breast-fed

    infants not receiving any iron-fortified formula or milk at 6 months,
say

    the researchers, "early clamping increased infant blood lead
concentration. "

 

    The researchers suggest that the most plausible underlying mechanism is

    upregulation of divalent metal transporter 1 in response to lowered iron

    status, resulting in greater uptake of lead. Nevertheless, they point
out

    that for a variety of reasons, only 23% of the total effect on infant
lead

    status could be attributed to changes in iron status.

 

    "Clamping the cord immediately not only decreases infant iron levels,"

    concluded Dr. Chaparro, "but may increase infant blood lead levels. Both

    iron deficiency and elevated blood lead levels are independently and

    negatively associated with infant mental development, and waiting a few

    minutes to clamp the cord at birth is one way to prevent the development
of

    these conditions."

 

    J Pediatr 2007;151:506- 512.

 


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