Lead exposure and association with angiogenic factors and hypertensive disorders of pregnancy

Johnson, Katherine M.; Specht, Aaron J.; Hart, Jessica M.; Salahuddin, Saira; Erlinger, Adrienne L.; Hacker, Michele R.; Woolf, Alan D.; Hauptman, Marissa; Karumanchi, S. Ananth; Wylie, Blair J.; O’Brien, Karen

doi:10.1016/j.preghy.2020.07.014

Cited by 7 publications

(3 citation statements)

References 34 publications

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“…Pregnancy is a unique model, given the overall health of younger women simultaneously exposed to the hemodynamic stress of pregnancy, which might uncover subtle renal findings. Previous studies have linked lead exposure to maternal hypertension [34,35], although not preeclampsia [36], but have not examined renal function. Studies of perinatal exposure are similarly less vulnerable to reverse confounding, and maternal lead exposure has been associated with higher blood pressure in their offspring over long-term follow-up [37][38][39][40], potentially via subtle tubulointerstitial damage that manifest later in life or epigenetic mechanisms during critical periods of development.…”

Section: Key Pointsmentioning

confidence: 99%

Synergistic susceptibility to environmental lead toxicity in chronic kidney disease

Danziger

2024

Current Opinion in Nephrology &Amp; Hypertension

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Purpose of review While high levels of lead exposure, as occurs accidentally or occupationally, can cause toxicity across multiple organ systems, the hazard of commonly encountered levels of lead in the environment remains unresolved. Challenges to researching the health effects of lead include its complex interplay with renal function, rendering analyses at risk of unaccounted confounding, and the likely small effect size of environmental levels of exposure. While children are known to be disproportionately susceptible to lead toxicity, resulting in appropriately more stringent regulatory surveillance for those under 5 years old, emerging evidence suggests that those with chronic kidney disease (CKD) similarly are at a greater risk. This review summarizes the role of environmental lead toxicity as a potential cause and consequence of CKD. Recent findings Whether environmental lead exposure causes CKD remains debatable, with little recent research advancing the conflicting, mostly cross-sectional, analyses from years ago. However, an emerging body of evidence suggests that CKD increases the susceptibility to lead toxicity. Higher circulating lead levels and lower urinary excretion result in greater lead accumulation in CKD, with simultaneous greater risk of clinically meaningful disease. Recent studies suggest that levels of lead found commonly in the United States drinking water supply, and currently permissible by the Environmental Protection Agency, associate with hematologic toxicity in those with advanced CKD. Whether environmental lead contamination may have additional negative health impact among this at-risk population, including cardiovascular and neurocognitive disease, warrants further study. Summary The underlying pathophysiology of kidney disease synergizes the susceptibility to environmental lead toxicity for those with CKD. Low levels of exposure, as found commonly in the United States water supply, may have adverse health impact in CKD. Further research will be needed to determine if more stringent environmental regulations are warranted to protect the health of all.

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Section: Key Pointsmentioning

confidence: 99%

Synergistic susceptibility to environmental lead toxicity in chronic kidney disease

Danziger

2024

Current Opinion in Nephrology &Amp; Hypertension

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“…Moreover, the diagnostic criteria were significantly changed over the eight decades (24, 25). Three studies were excluded for not reporting blood samples of lead (6,26,27). Three articles were excluded as they overlapped the study population with the finalist articles (28)(29)(30).…”

Section: Study Selectionmentioning

confidence: 99%

“…This may lead to iatrogenic preterm deliveries, causing heavy economic burden for the family and the society. Moreover, as the etiology of PE remains poorly understood, some researchers proposed that heavy metals may play a role (4)(5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

A global perspective of correlation between maternal blood lead levels and risks of preeclampsia: An updated systematic review and meta-analysis

Zhong

Yang

Chu

et al. 2022

Front. Public Health

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BackgroundPreeclampsia (PE) is a specific hypertensive disorder in pregnancy. Lead (Pb) is a heavy metal that affects women's reproductive health. However, it is unclear whether lead exposure during can predispose maternal risk of developing preeclampsia. This systematic review and meta-analysis study aimed to explore the association.MethodsWe searched studies from three databases (PubMed, Web of Science, Embase). Only case-control, cross-sectional, and cohort studies reporting maternal blood lead levels (BLL) and PE were included from database inception to 31st July 2022. Pregnant women with blood lead levels measured were eligible. Those healthy pregnant women who did not develop preeclampsia were assessed as comparators. Letters, comments, case reports, and reviews were excluded. Newcastle-Ottawa Scale (NOS) and its adaptive form were applied for assessment. The random-effects method (REM) was applied to calculate the standardized mean difference (SMD) with a 95% confidence interval (CI). Stata 16.0 and RevMan 5.3 were the software used for data extraction and analysis.Results25 studies out of 1,808 articles made the finalist for systematic reviews, of which 21 underwent further quantity analysis. A total of 1,533 preeclamptic women and 10,998 healthy pregnant controls were included in the meta-analysis. The overall result revealed that maternal lead exposure was significantly higher in women with preeclampsia (SMD: 1.06, 95% CI 0.69, 1.43); (I2 = 96.40%; P = 0.000).ConclusionThis study demonstrates that maternal lead exposure is associated with preeclampsia during pregnancy. The association is present even in low blood lead levels. The conclusion should be taken seriously and women should avoid unexpected exposure to a lead-containing environment as much as possible.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=347220, identifier: CRD42022347220.

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Risk-Factor Based Lead Screening and Correlation with Blood Lead Levels in Pregnancy

Johnson

Specht

Hart

et al. 2022

Matern Child Health J

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Lead exposure and association with angiogenic factors and hypertensive disorders of pregnancy

Cited by 7 publications

References 34 publications

Synergistic susceptibility to environmental lead toxicity in chronic kidney disease

Synergistic susceptibility to environmental lead toxicity in chronic kidney disease

A global perspective of correlation between maternal blood lead levels and risks of preeclampsia: An updated systematic review and meta-analysis

Risk-Factor Based Lead Screening and Correlation with Blood Lead Levels in Pregnancy

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