Effect of Calcium Supplementation on Blood Lead Levels in Pregnancy: A Randomized Placebo-Controlled Trial

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Effect of Calcium Supplementation on Blood Lead Levels in Pregnancy: A Randomized Placebo-Controlled Trial

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dc.contributor.author Lamadrid-Figueroa, Héctor
dc.contributor.author Téllez-Rojo, Martha M.
dc.contributor.author Mercado-García, Adriana
dc.contributor.author Hu, Howard
dc.contributor.author Hernández-Avila, Mauricio
dc.contributor.author Ettinger, Adrienne S
dc.contributor.author Peterson, Karen E.
dc.contributor.author Schwartz, Joel David
dc.date.accessioned 2011-12-23T02:12:24Z
dc.date.issued 2008
dc.identifier.citation Ettinger, Adrienne S., Hector Lamadrid-Figueroa, Martha M. Tellez-Rojo, Adriana Mercado-Garcia, Karen E. Peterson, Joel Schwartz, Howard Hu, and Mauricio Hernandez-Avila. 2009. Effect of calcium supplementation on blood lead levels in pregnancy: A randomized placebo-controlled trial. Environmental Health Perspectives 117(1): 26-31. en_US
dc.identifier.issn 0091-6765 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:5978622
dc.description.abstract Background: Prenatal lead exposure is associated with deficits in fetal growth and neurodevelopment. Calcium supplementation may attenuate fetal exposure by inhibiting mobilization of maternal bone lead and/or intestinal absorption of ingested lead. Objective: Our goal was to evaluate the effect of 1,200 mg dietary calcium supplementation on maternal blood lead levels during pregnancy. Methods: In a double-blind, randomized, placebo-controlled trial conducted from 2001 through 2003 in Mexico City, we randomly assigned 670 women in their first trimester of pregnancy to ingest calcium (n = 334) or placebo (n = 336). We followed subjects through pregnancy and evaluated the effect of supplementation on maternal blood lead, using an intent-to-treat analysis by a mixed-effects regression model with random intercept, in 557 participants (83%) who completed follow-up. We then conducted as-treated analyses using similar models stratified by treatment compliance. Results: Adjusting for baseline lead level, age, trimester of pregnancy, and dietary energy and calcium intake, calcium was associated with an average 11% reduction (0.4 μg/dL) in blood lead level relative to placebo (p = 0.004). This reduction was more evident in the second trimester (−14%, p lesss than 0.001) than in the third (−8%, p = 0.107) and was strongest in women who were most compliant (those who consumed ≥ 75% calcium pills; −24%, p less than 0.001), had baseline blood lead greater than 5 μg/dL (−17%, p less than 0.01), or reported use of lead-glazed ceramics and high bone lead (−31%, p less than 0.01). Conclusion: Calcium supplementation was associated with modest reductions in blood lead when administered during pregnancy and may constitute an important secondary prevention effort to reduce circulating maternal lead and, consequently, fetal exposure. en_US
dc.language.iso en_US en_US
dc.publisher National Institute of Environmental Health Sciences en_US
dc.relation.isversionof doi:10.1289/ehp.11868 en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2627861/pdf/ en_US
dash.license LAA
dc.title Effect of Calcium Supplementation on Blood Lead Levels in Pregnancy: A Randomized Placebo-Controlled Trial en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal Environmental Health Perspectives en_US
dash.depositing.author Ettinger, Adrienne S
dc.date.available 2011-12-23T02:12:24Z
dash.affiliation.other HMS^Medicine-Brigham and Women's Hospital en_US
dash.affiliation.other SPH^Exposure Epidemiology and Risk Program en_US
dash.affiliation.other SPH^Nutrition en_US
dash.affiliation.other HMS^Medicine-Brigham and Women's Hospital en_US
dash.affiliation.other SPH^Exposure Epidemiology and Risk Program en_US

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