RESUMO
BACKGROUND: In developing countries, deficiencies in essential micronutrients are common, particularly in pregnant women. Although, biochemical indicators of diet and nutrition are useful to assess nutritional status, few studies have examined such indicators throughout pregnancy in women in developing countries. METHODS: The primary objective of this study was to assess the nutritional status of 78 Peruvian women throughout pregnancy for 16 different nutritional indicators including fat-soluble vitamins and carotenoids, iron-status indicators, and selenium. Venous blood samples from which serum was prepared were collected during trimesters one (n = 78), two (n = 65), three (n = 62), and at term via the umbilical cord (n = 52). Questionnaires were completed to determine the demographic characteristics of subjects. Linear mixed effects models were used to study the associations between each maternal indicator and the demographic characteristics. RESULTS: None of the women were vitamin A and E deficient at any stage of pregnancy and only 1/62 women (1.6%) was selenium deficient during the third trimester. However, 6.4%, 44% and 64% of women had ferritin levels indicative of iron deficiency during the first, second and third trimester, respectively. Statistically significant changes (p ≤ 0.05) throughout pregnancy were noted for 15/16 nutritional indicators for this Peruvian cohort, with little-to-no association with demographic characteristics. Three carotenoids (beta-carotene, beta-cryptoxanthin and trans-lycopene) were significantly associated with education status, while trans-lycopene was associated with age and beta-cryptoxanthin with SES (p < 0.05). Concentrations of retinol, tocopherol, beta-cryptoxanthin, lutein + zeaxanthin and selenium were lower in cord serum compared with maternal serum (p < 0.05). Conversely, levels of iron status indicators (ferritin, transferrin saturation and iron) were higher in cord serum (p < 0.05). CONCLUSION: The increasing prevalence of iron deficiency throughout pregnancy in these Peruvian women was expected. It was surprising though not to find deficiencies in other nutrients. The results highlight the importance of continual monitoring of women throughout pregnancy for iron deficiency which could be caused by increasing fetal needs and/or inadequate iron intake as pregnancy progresses.
Assuntos
Dieta , Estado Nutricional , Trimestres da Gravidez/fisiologia , Adulto , Carotenoides/sangue , Criptoxantinas , Países em Desenvolvimento , Feminino , Sangue Fetal/química , Humanos , Ferro da Dieta/sangue , Modelos Lineares , Luteína/sangue , Licopeno , Micronutrientes/sangue , Micronutrientes/deficiência , Inquéritos Nutricionais , Peru , Gravidez , Selênio/sangue , Fatores Socioeconômicos , Inquéritos e Questionários , Vitamina A/sangue , Xantofilas/sangue , Adulto Jovem , Zeaxantinas , beta Caroteno/sangueRESUMO
Although the production and use of some persistent organic pollutants (POPs) have been banned or highly restricted, human exposure remains a subject of investigation due to their environmental persistence. Physiological changes during pregnancy may affect the disposition of POPs in the mother's body, and thus fetal exposure. Changes in serum concentrations of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) across pregnancy trimesters, and trans-placental transfer to the fetus were investigated. Seventy-nine pregnant women in Trujillo, Peru were recruited in the first trimester of pregnancy, and provided blood samples for the analysis of 35 PCB congeners, 9 OCPs, and 11 polybrominated biphenyl diethers (PBDEs). Subsequently, maternal blood samples were collected in the second (n=64) and third trimesters (n=59), and cord blood samples (n=50) were collected at delivery. There were statistically significant changes across trimesters (p<0.05) for both fresh weight (increase) and lipid adjusted concentrations (decrease) of hexachlorobenzene (HCB), 2,2-Bis(4-chlorophenyl)-1,1-dichloroethene (p,p'-DDE), PCB-74, 118, 138-158, 153, 170, 180 and 194. Fresh weight concentrations of these POPs increased from first to third trimester by 10-28%. On the other hand lipid adjusted concentrations decreased from first to third trimester by 16-28%. Serum lipids increased from first to third trimester by 53% indicating the dilution of the POPs in the lipids. Concentrations of 2,2-Bis(4-chlorophenyl)-1,1,1-trichloroethane (p,p'-DDT), its metabolite p,p'-DDE, PCB-118, 138-158, 153, 170 and 180 above their limits of detection were measured in >60% of cord serum samples. Intra-individual correlations in maternal serum concentrations were high for most of the POPs (ρ=0.62-0.99; p<0.05) while correlations between maternal and cord serum concentrations were also high (ρ=0.68-0.99; p<0.05). Results indicate that the disposition in the body and blood concentrations of POPs may change during pregnancy, and show trans-placental transfer of DDT, DDE and PCBs.
Assuntos
Poluentes Ambientais/sangue , Sangue Fetal/química , Éteres Difenil Halogenados/sangue , Exposição Materna , Bifenilos Policlorados/sangue , Adolescente , Adulto , Poluentes Ambientais/farmacocinética , Feminino , Éteres Difenil Halogenados/farmacocinética , Humanos , Troca Materno-Fetal , Pessoa de Meia-Idade , Peru , Bifenilos Policlorados/farmacocinética , Gravidez , Trimestres da Gravidez , Inquéritos e Questionários , Distribuição Tecidual , Adulto JovemRESUMO
Women and children in developing countries are often exposed to high levels of air pollution including polycyclic aromatic hydrocarbons (PAHs), which may negatively impact their health, due to household combustion of biomass fuel for cooking and heating. We compared creatinine adjusted hydroxy-PAH (OH-PAH) concentrations in pregnant women in Trujillo, Peru who cook with wood to levels measured in those who cook with kerosene, liquefied petroleum gas or a combination of fuels. Seventy-nine women were recruited for the study between May and July 2004 in the first trimester of their pregnancy. Urine samples were collected from the subjects in the first, second and third trimesters for OH-PAH analyses. The concentrations of the OH-PAHs were compared across the type of fuel used for cooking and pregnancy trimesters. The relationships between OH-PAHs levels in the first trimester and concurrently measured personal exposures to PM2.5, carbon monoxide and nitrogen dioxide together with their indoor and outdoor air concentrations were also investigated. Women cooking with wood or kerosene had the highest creatinine adjusted OH-PAH concentrations compared with those using gas, coal briquette or a combination of fuels. Concentrations of creatinine adjusted 2-hydroxy-fluorene, 3-hydroxy-fluorene, 1-hydroxy-fluorene, 2-hydroxy-phenanthrene and 4-hydroxy-phenanthrene were significantly higher (p<0.05) in women who used wood or kerosene alone compared with women who used liquefied petroleum gas (LPG), coal briquette or a combination of fuels. An increase in the concentrations of creatinine adjusted 9-hydroxy-fluorene, 1-hydroxy-phenanthrene, 2-hydroxy-phenanthrene, 4-hydroxy-phenanthrene and 1-hydroxy-pyrene in the third trimesters was also observed. Weak positive correlation (Spearman correlation coefficient, ρ<0.4; p<0.05) was observed between all first trimester creatinine adjusted OH-PAHs and indoor (kitchen and living room), and personal 48-h TWA PM2.5. Women who cooked exclusively with wood or kerosene had higher creatinine adjusted OH-PAH levels in their urine samples compared to women who cooked with LPG or coal briquette.
Assuntos
Poluentes Atmosféricos/urina , Poluição do Ar em Ambientes Fechados/análise , Culinária/métodos , Monitoramento Ambiental/métodos , Exposição Materna/estatística & dados numéricos , Hidrocarbonetos Policíclicos Aromáticos/urina , Adulto , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/estatística & dados numéricos , Monóxido de Carbono/análise , Carvão Mineral , Países em Desenvolvimento , Feminino , Humanos , Querosene , Peru , Fenantrenos/análise , Fenantrenos/urina , Hidrocarbonetos Policíclicos Aromáticos/análise , Gravidez , Pirenos/análise , Pirenos/urina , Madeira/química , Adulto JovemRESUMO
Public transport vehicle drivers, especially in highly polluted or trafficked areas, are exposed to high levels of air pollutants. In this study, we assessed the influence of traffic on levels of hydroxy polycyclic aromatic hydrocarbons (OH-PAHs) in commercial bus drivers in Trujillo, Peru, by measuring the within-shift changes in the urinary whole weight and creatinine-corrected concentrations of the PAH metabolites. We measured personal PM(2.5) as a proxy of exposure to traffic emission. Urine samples were collected daily from two bus drivers and three minivan drivers in Trujillo, pre-, mid-, post-work shift and on days when the drivers were off work (total n = 144). Ten OH-PAH metabolites were measured in the urine samples. Drivers were also monitored for exposure to PM(2.5) (n = 41). Daily work shift (mean = 13.1 ± 1.3 hr) integrated PM(2.5) was measured in the breathing zones of the drivers for an average of 10.5 days per driver. The differences across shift in OH-PAH concentrations were not statistically significant except for urinary 2-hydroxyfluorene (2-FLU) (p = 0.04) and 4-hydroxyphenanthrene (4-PHE) (p = 0.01) and creatinine-corrected 4-hydroxyphenanthrene (p = 0.01). Correlation between pairs of hydroxy-PAHs (ρ = 0.50 to 0.93) were highest for mid-shift samples. Concentrations of PM(2.5) (geometric mean = 64 µg/m(3); 95% confidence limits = 52 µg/m(3), 78 µg/m(3)) is similar to those measured in many other studies of traffic exposure. There was significant change across work shift for concentrations of only two of the OH-PAHs (2-FLU and 4-PHE). Results indicate that the drivers may have had limited time for clearance of PAH exposure from the body between work shifts. Comparisons of the concentrations of creatinine-corrected hydroxy-PAH to those reported in other studies indicate that exposure of public transport drivers to PAH could be similar. By following the subjects over multiple days, this study gives an indication of appropriate exposure situations for the use of hydroxy-PAHs and will be beneficial in designing future occupational studies of PAH exposure.
Assuntos
Poluentes Atmosféricos/análise , Exposição por Inalação/análise , Exposição Ocupacional/análise , Material Particulado/análise , Hidrocarbonetos Policíclicos Aromáticos/urina , Adulto , Biomarcadores/urina , Fluorenos/urina , Humanos , Pessoa de Meia-Idade , Veículos Automotores , Peru , Fenantrenos/urina , Fatores de Tempo , Emissões de VeículosRESUMO
Street-level and rooftop (three-story building) concentrations of particulate matter < or = 2.5 microm in diameter (PM2.5) were measured in downtown Trujillo, Peru, in July and August 2003 to determine the PM2.5 concentration reduction on days with normal traffic conditions (32 days) versus a day when motor vehicles were temporarily banned from the downtown district (8:00 a.m. to 6:00 p.m., July 15) known as El Dia Sin Autos ("The Day Without Cars"). The mean 8:00 a.m. to 6:00 p.m. street-level PM2.5 concentration during the motor vehicle ban (21.4 microg/m3; one day) was 49% lower than when vehicles were not impeded (42.2 +/- 7.8 microg/m3--mean +/- 1 standard deviation; 20 days). The rooftop monitoring station indicated a 20% decrease in PM2.5 concentrations (24.8 +/- 2.6 microg/m3 vs. 19.9 +/- 6.0 microg/m3) when motor vehicles were not present within historic downtown Trujillo. Temperature, relative humidity, and wind speed during the motor vehicle ban and during normal traffic were not significantly different (p > .05).