Evidence map›Paper›PMID 37501132›Full record

ArticleInternational breastfeeding journal2023

Breastmilk cadmium levels and estimated infant exposure: a multicenter study of associated factors in a resource-limited country.

Ramzi Shawahna, Rana Saleh, Lina Owiwi, Aya Abdi, Diana Bani-Odeh, Iyad Maqboul, Hatim Hijaz, Mohammad Jaber

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International breastfeeding journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ramzi ShawahnaDepartment of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building: 19, Office: 1340, P.O. Box 7, Nablus, Palestine. ramzi_shawahna@hotmail.com.
Rana SalehDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Lina OwiwiDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Aya AbdiDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Diana Bani-OdehDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Iyad MaqboulDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Hatim HijazDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Mohammad JaberDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the undisputed benefits of breastfeeding, infants might become exposed to xenobiotics that could be excreted into breast milk following maternal exposure. This study was conducted to assess breastmilk cadmium levels among lactating women in Palestine, a resource-limited country. Estimated daily intake (EDI) of cadmium via breastmilk was also calculated and predictors of high breastmilk cadmium levels and high infant exposure via breastmilk were identified.

methodsThis multicenter study was conducted using a descriptive-analytical design. The lactating women were recruited from different maternity and public health clinics in all regions of Palestine. Demographic variables and exposure to sources of cadmium were collected in an interviewer-administered questionnaire. Foremilk samples (about 5 mL) were collected in polyethylene tubes using the hand-expression technique. The breast milk samples were collected in the period between December 2020 and March 2021. A pre-validated method using inductively coupled plasma mass spectrometry (ICP-MS) was used to quantify breastmilk cadmium levels. EDI values were calculated from the quantified breastmilk cadmium levels.

resultsBreastmilk samples were obtained from 256 lactating women. The mean breastmilk cadmium level was 0.34 (SD: 0.33) μg / L and the mean EDI of cadmium via breastmilk was 0.059 (SD: 0.058) µg / kg per body weight / day. Breastmilk cadmium levels were quantified in 92.6% of the breastmilk samples. Of the breastmilk samples, 13 (5.1%) had cadmium levels above those reported as "normal" by the World Health Organization (WHO). Multiple linear regression showed that higher breastmilk cadmium levels and higher EDI were predicted by being a smoker, living in a refugee camp, living close to an industrial area, living close to disposal of wastes, living close to paint shops, living in a house with peeling / chipping paint, frequent use of cosmetics, frequent use of hair dyes, and not using vitamins.

conclusionThe breastmilk cadmium levels and infant exposure were predicted by maternal exposure to sources of cadmium. The findings reported in this study are valuable to antenatal and postnatal healthcare service providers. More studies are needed to plan and implement measures to reduce breastmilk cadmium levels and infants' exposure to cadmium via breastmilk.

Indexed as

Breast FeedingMilk, HumanCadmiumColostrumFemaleHumansInfantLactationPregnancyCadmiumBreastmilkCadmiumInductively coupled plasma mass spectrometryLactationWomen

Identifiers

PMID37501132
PMCPMC10375743

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.