Transplacental transfer of cobalt: Evidence from a study of mothers and their neonates in the African Copperbelt.

BACKGROUND: Transfer of the trace metal cobalt (Co) from mother to foetus has not been documented in populations with high environmental exposure to Co, as is the case in the African Copperbelt mining region. We analysed data obtained from 246 mother-infant pairs included (at delivery) in a previously published case-control study on birth defects, done in Lubumbashi (Democratic Republic of Congo) between March 1, 2013, and Feb 28, 2015. METHODS: Co was measured by Inductively Coupled Plasma Mass Spectrometry in maternal blood, maternal urine, umbilical cord blood and placental tissue, as available. RESULTS: The Co concentrations [geometric mean (GM) with interquartile range (IQR)] in maternal blood (GM 1.77 µg/L, IQR 1.07-2.93) and urine (GM 7.42 µg/g creatinine, IQR 4.41-11.0) were highly correlated (Spearman r = 0.71, n = 166; p < 0.001) and considerably higher than reference values determined for general populations elsewhere in the world. The concentrations of Co in umbilical cord blood (GM 2.41 µg/L) were higher (Wilcoxon test, p < 0.001) than in maternal blood (GM 1.37 µg/L), with a correlation between both values (Spearman r = 0.34; n = 127, p < 0.001). Co concentrations in placental tissue (geometric mean 0.02 µg/g wet weight) correlated with concentrations in maternal blood (Spearman r = 0.50, n = 86, p < 0.001) and in neonatal blood (Spearman r = 0.23, n = 83, p = 0.039). CONCLUSION: This first study of maternal and neonatal Co concentrations in the African Copperbelt provides strong evidence of a high transfer of Co from mother to foetus.

[Conservative treatment of giant omphaloceles with dissodic 2% aqueous eosin: a case serie]. / Traitement conservateur des omphalocèles géantes par l'éosine aqueuse disodique 2%: une série des cas.

Primary surgical closure for the treatment of giant omphalocele is punctuated by the onset of unpleasant complications. Conservative treatment is an option in low-income countries where neonatal resuscitation is associated with high mortality rates. We conducted a prospective study of patients admitted to the University Clinics of Lubumbashi between January and April 2020 and receiving conservative treatment based on dissodic 2% aqueous eosin according to a defined protocol. Three patients were included in our series. The mean age was 24 hours (1 - 48); they were all full term newborns (38 - 39 SA), born vaginally and with no prenatal diagnosis. Mean birth weight was 2,800 grams (2,400 - 3,000). Mean amniotic sac diameter was 13.7 cm (11 - 15 cm); it contained the liver in all cases. The median time to enteral feed was 4.3 days (4 - 5 days), to granulation was 31.7 days (30 - 33 days) and to epithelialization was 71.7 days (60 - 90 days). No death was reported. These preliminary results encourage the use of disodium aqueous eosin for the conservative treatment of unbroken giant omphaloceles.