Background: Endemic fluorosis (skeletal and dental) is a serious public health problem in many parts of the world, especially in India. Age, sex, dietary calcium (Ca), the hormonal status, the dose and duration of the fluoride intake, and renal efficiency in handling fluoride all influence fluoride metabolism.
Objectives: The aim of the study was to evaluate the effect of the fluoride present in drinking water on the serum alkaline phosphatase (ALP) and phosphate levels in pregnant women and newborn infants.
Material and methods: In the present cross-sectional study, the participants were categorized into 2 groups based on a fluoride concentration in their drinking water: the low/optimum-fluoride group (<1 ppm); and the high-fluoride group (≥1 ppm). Each group was comprised of 90 pregnant women who were recruited from the hospital at the time of admission for delivery. Fluoride was measured in their drinking water, urine, maternal serum, and cord blood. The ALP and phosphate levels were measured in serum using a fully automated analyzer.
Results: The drinking water consumed by the pregnant women contained fluoride, which was significantly positively correlated with the urine and blood serum fluoride levels. There were significant differences in the ALP levels between the 2 groups in both maternal serum and cord blood. The level of phosphate in maternal serum was significantly higher in the high-fluoride group. The results of both simple and multivariate regression analyses revealed that the fluoride content in drinking water was significantly associated with the ALP level in cord blood and the phosphate level in maternal serum.
Conclusions: The ALP levels were negatively associated with drinking water fluoride concentrations in both maternal serum and cord blood. The phosphate levels in maternal serum were positively associated with drinking water fluoride concentrations.
Keywords: alkaline phosphatase; cord blood; fluoride; pregnancy; serum phosphate.