Effect of Blood Lead Levels on Hepcidin and other Iron Regulatory Markers in Iron Deficient Pregnant Women

Background and Objectives: Increasing prevalence of pregnancy iron deficiency poses significant health risk that links to the exposure to heavy metals like lead (Pb) which may further complicate this condition. To investigate such a relationship, hepcidin alongside other iron regulatory markers, also, oxidative stress marker Malondialdehyde (MDA) was estimated in relation to Pb in iron deficient (ID) pregnant women. Methods: The study included 84 pregnant women, blood parameters including hematological, iron markers and blood lead level in ID pregnant women compared with normal pregnant women at 2nd and 3rd trimesters. Lead was measured using ICP- technique, ELISA used for estimation of hepcidin and MDA. Results: The comparison of the main blood parameters regarding hematological and iron regulatory markers showed significant differences between patient and control groups. Also, blood Pb and MDA concentrations were significantly different. As a feature of lead toxicity, most of the studied blood films revealed that red cell morphology did not exhibit uniformity in size and shape (poikilocytes) which showed significant morphological abnormalities. Pearson correlation analysis revealed statistically significant correlations between Pb level and RBC, HCT, hepcidin, MDA. From the ROC curve analysis of Pb level the result indicated that Pb was a risk factor of ID in patient groups. Conclusion: The findings suggest an association with significant alterations in hematological parameters and iron metabolism. Concerning the statistical analysis of the ROC curve, as evidenced by the significant correlations observed Pb exposure plays risk factor for ID in pregnant women. Keywords: Iron deficiency, pregnancy, lead, MDA, hepcidin, ferritin