The relationship of blood lead levels to obstetric outcome

Angell, Norman F.; Lavery, J. Patrick

doi:10.1016/s0002-9378(16)32282-7

Cited by 45 publications

(12 citation statements)

References 15 publications

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“…Our findings that maternal lead levels during pregnancy are strongly related to neonatal lead level are consonant with previously published studies (Amitai et al 1999;Angell and Lavery 1982;Campagna et al 1999;Carbone et al 1998;Chuang et al 2001;Dietrich et al 1987;Graziano et al 1990;Lauwerys et al 1978;McMichael et al 1988;Nashashibi et al 1999;NavarreteEspinosa et al 2000). The correlation in the APILS sample between maternal and neonatal lead levels at parturition is well within the published range from 0.36 (Amitai et al 1999) to 0.92 (Graziano et al 1990).…”

Section: Discussionsupporting

confidence: 94%

Maternal blood lead concentration, diet during pregnancy, and anthropometry predict neonatal blood lead in a socioeconomically disadvantaged population.

Schell

Denham

Stark

et al. 2003

Environ Health Perspect

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To determine the influences of maternal diet and nutrition during pregnancy on the blood lead level of neonates, we conducted a study of mother-infant pairs from lower socioeconomic circumstances living in Albany County, New York. Maternal blood lead (MBPb), anthropometry, and diet were assessed in each trimester. Neonates' blood lead (NBPb) levels were low (geometric mean = 1.58 micro g/dL), and none had elevated blood lead. More than 50% of the mothers had intakes below the recommended dietary allowances for zinc, calcium, iron, vitamin D, and kilocalories. As expected, MBPb was strongly and positively related to NBPb. Among the anthropometric measures of maternal nutritional status, variables measuring gain in weight and arm circumference were negatively related to NBPb. In multivariable models reflecting different analytic strageties and including MBPb, anthropometry, and sociodemographic characteristics, dietary intakes of iron and vitamin D were negatively related to NBPb. The effect of zinc varied substantially depending on model covariates. Effects of dietary constituents are difficult to distinguish, given the intercorrelated nature of nutrients in the diet. Nevertheless, the influences of maternal anthropometric variables, iron, and vitamin D on neonatal lead levels are clear in our analyses.

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Section: Discussionsupporting

confidence: 94%

Maternal blood lead concentration, diet during pregnancy, and anthropometry predict neonatal blood lead in a socioeconomically disadvantaged population.

Schell

Denham

Stark

et al. 2003

Environ Health Perspect

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“…Our study confirms the relationship between maternal and cord blood levels, related to lead passive diffusion through the placenta [3,[6][7][8][9][10][11][13][14][15][16][17][18], so that it is possible to calcu-late the neonatal blood lead level from the maternal level ( fig. 1).…”

Section: Discussionsupporting

confidence: 84%

Maternal and Neonatal Lead Exposure in Southern Italy

Carbone

Laforgia²,

Crollo³

et al. 1998

Neonatology

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We evaluated the blood lead levels in 159 pregnant women and in their healthy newborns at birth. The blood lead levels were higher in mothers as compared with neonates, with a linear correlation between maternal and neonatal levels. The blood lead levels were also higher in neonates as compared with infants aged 6–12 months, and, besides, 2.5% of the newborns had blood lead levels >10 µg/dl, the actual level of concern according to the Center for Disease Control. The study of blood and urinary lead levels during the 1st week of life showed a steady decrease of blood lead levels, together with increasing levels of urinary lead. The mechanism of renal elimination is important to avoid persistently high free blood lead levels, with possible deposition in tissues with high lead affinity, such as bone. In newborns, the possibility of a functional renal insufficiency during the first days of life suggests that newborns with high cord blood lead levels and impaired renal function could be at high risk of lead toxicity, so that it could be advisable to perform a careful and prolonged follow-up.

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“…Although some studies failed to find a relationship between lead concentrations in cord blood and preeclampsia (Angell and Lavery 1982), several authors demonstrated higher blood levels of lead, cadmium, and manganese in hypertensive or preeclampsia patients compared with normotensive women (Dawson et al 2000; Kosanovic et al 2002; Rothenberg et al 1999; Vigeh et al 2004). Other elements such as zinc and selenium were reported to be reduced in hypertensive pregnant women (Dawson et al 1999; Rayman et al 2003).…”

mentioning

confidence: 99%

Maternal Blood Lead Levels and the Risk of Pregnancy-Induced Hypertension: The EDEN Cohort Study

Yazbeck

Thiébaugeorges

Moreau

et al. 2009

Environ Health Perspect

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BackgroundPrior studies revealed associations of environmental lead exposure with risks of hypertension and elevated blood pressure.ObjectiveWe examined the effect of blood lead levels on blood pressure and the incidence of pregnancy-induced hypertension (PIH) in the second and third trimesters of pregnancy.MethodsOne thousand seventeen pregnant women were enrolled in two French municipalities between 2003 and 2005 for the EDEN (Etude des Déterminants pré et post natals du développement et de la santé de l′ Enfant) cohort study. Blood lead concentrations were measured by atomic absorption spectrometry in mothers between 24 and 28 weeks of gestation.ResultsPIH was diagnosed in 106 subjects (10.9%). Age, parity, weight gain, alcohol, smoking habits, and calcium supplementation were comparable between hypertensive and nonhypertensive women. Lead levels were significantly higher in PIH cases (mean ± SD, 2.2 ± 1.4 μg/dL) than in normotensive patients (1.9 ± 1.2 μg/dL; p = 0.02). Adjustment for potential confounder effects slightly attenuated but did not eliminate the significant association between blood lead levels and the risk of PIH (adjusted odds ratio of PIH = 3.3; 95% confidence interval, 1.1–9.7). We also observed geographic differences in lead exposure and in the incidence of PIH and found significant correlations between blood lead levels and unadjusted as well as adjusted systolic and diastolic blood pressures after 24 weeks of gestation.ConclusionsThese findings confirm the relationship between blood lead levels at mid-pregnancy and blood pressure and suggest that environmental lead exposure may play an etiologic role in PIH.

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The relationship of blood lead levels to obstetric outcome

Cited by 45 publications

References 15 publications

Maternal blood lead concentration, diet during pregnancy, and anthropometry predict neonatal blood lead in a socioeconomically disadvantaged population.

Maternal blood lead concentration, diet during pregnancy, and anthropometry predict neonatal blood lead in a socioeconomically disadvantaged population.

Maternal and Neonatal Lead Exposure in Southern Italy

Maternal Blood Lead Levels and the Risk of Pregnancy-Induced Hypertension: The EDEN Cohort Study

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