title: Lead exposure in preterm infants receiving red blood cell transfusions.
abstract: BACKGROUND
  Preterm infants may inadvertently be exposed to lead from the packed red blood cell (pRBC) transfusions with almost no or very limited data available. The aim of the study was to quantify this exposure in preterm infants ≤30 wk gestational age (GA).
  
  
  METHODS
  Prospective cohort study, infants ≤30 wk GA were eligible, infants < 23 wk GA and known chromosomal diseases were excluded. Blood lead levels (BLLs) were obtained at birth, before and after each transfusion, and at discharge. BLLs were also obtained from the donor pRBC aliquot transfused. A linear mixed model analysis was done.
  
  
  RESULTS
  Of 75 infants, 34 received a total of 126 pRBC transfusions. Each infant had an average of 3.7 transfusions. 92% of lead levels in the transfused aliquot were ≤ 5 mcg/dl, 6.8% were between 6-8 mcg/dl and 1 had a level of 56 mcg/dl. Average total lead load was 1.3 mcg/dl. For each 1 mcg/dl increase in transfused pRBC lead level, infant's post-transfusion BLL increased by 0.20 mcg/dl (95% CI: 0.07 mcg/dl, 0.33 mcg/dl; P = 0.002), adjusting for GA and birth weight. There was no significant increase in discharge BLLs, which were similar for both transfused and nontransfused infants.
  
  
  CONCLUSIONS
  Post-transfusion infant BLLs correlate significantly with the transfused pRBCs lead level.
authors.affiliation: Department of Pediatrics, Baystate Children's Hospital, Springfield, Massachusetts.
authors.forename: Hijab
authors.initials: H
authors.lastname: Zubairi
authors.affiliation: 1] Department of Academic Affairs, Baystate Medical Center, Springfield, Massachusetts [2] Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Paul
authors.initials: P
authors.lastname: Visintainer
authors.affiliation: Department of Pediatrics, Baystate Children's Hospital, Springfield, Massachusetts.
authors.forename: Jennie
authors.initials: J
authors.lastname: Fleming
authors.affiliation: 1] Department of Pediatrics, Baystate Children's Hospital, Springfield, Massachusetts [2] Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Matthew
authors.initials: M
authors.lastname: Richardson
authors.affiliation: 1] Department of Pediatrics, Baystate Children's Hospital, Springfield, Massachusetts [2] Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Rachana
authors.initials: R
authors.lastname: Singh
mesh_terms: D001724:Birth Weight; D015331:Cohort Studies; D004781:Environmental Exposure; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007854:Lead / Q000097:blood*; D016014:Linear Models; D008297:Male; D011446:Prospective Studies; D065227:Transfusion Reaction
chemical_list: D007854:Lead