Meghan Perkins1, Robert O Wright2, Chitra J Amarasiriwardena3, Innocent Jayawardene3, Sheryl L Rifas-Shiman1, Emily Oken4. 1. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. 2. Departments of Preventive Medicine and Pediatrics, Icahn School of Medicine at Mt. Sinai, New York, NY. 3. Channing Laboratory, Brigham and Women׳s Hospital and Harvard Medical School, Boston, MA. 4. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Electronic address: Emily_Oken@hphc.org.
Abstract
PURPOSE: Maternal lead exposure is associated with poor birth outcomes in populations with moderate to high blood levels. However, no studies have looked at exposure levels commonly experienced by US women. METHODS: We evaluated the relationship between maternal red blood cell (RBC) lead levels in midpregnancy and birth outcomes in 949 mother-child pairs in a prebirth cohort. We used multiple linear regression and logistic regression, adjusted for potential confounders including maternal age, race, prepregnancy body mass index, and smoking to relate maternal lead to infant birth size and risk for preterm birth (<37 weeks). RESULTS: Mean RBC lead level was 1.2 μg/dL (range, 0.0-5.0). Mean (standard deviation) birthweight was 3505 (520) g, birthweight for gestational age z-score 0.22 (0.93), and length of gestation 39.5 (1.7) weeks. Mothers in the highest versus lowest lead quartile did not have higher odds (OR, 1.85; 95% confidence interval [CI], 0.79-4.34) of preterm delivery; after stratifying by child sex, there was an association among males (OR, 5.51; 95% CI, 1.21-25.15) but not females (OR, 0.82; 95% CI, 0.24-2.85). Maternal RBC lead was not associated with any continuous outcomes in combined or sex-stratified analyses. CONCLUSIONS: Maternal lead exposure, even at very low levels, may adversely affect some childbirth outcomes, particularly preterm birth among males.
PURPOSE: Maternal lead exposure is associated with poor birth outcomes in populations with moderate to high blood levels. However, no studies have looked at exposure levels commonly experienced by US women. METHODS: We evaluated the relationship between maternal red blood cell (RBC) lead levels in midpregnancy and birth outcomes in 949 mother-child pairs in a prebirth cohort. We used multiple linear regression and logistic regression, adjusted for potential confounders including maternal age, race, prepregnancy body mass index, and smoking to relate maternal lead to infant birth size and risk for preterm birth (<37 weeks). RESULTS: Mean RBC lead level was 1.2 μg/dL (range, 0.0-5.0). Mean (standard deviation) birthweight was 3505 (520) g, birthweight for gestational age z-score 0.22 (0.93), and length of gestation 39.5 (1.7) weeks. Mothers in the highest versus lowest lead quartile did not have higher odds (OR, 1.85; 95% confidence interval [CI], 0.79-4.34) of preterm delivery; after stratifying by child sex, there was an association among males (OR, 5.51; 95% CI, 1.21-25.15) but not females (OR, 0.82; 95% CI, 0.24-2.85). Maternal RBC lead was not associated with any continuous outcomes in combined or sex-stratified analyses. CONCLUSIONS: Maternal lead exposure, even at very low levels, may adversely affect some childbirth outcomes, particularly preterm birth among males.
Authors: Emily Oken; Andrea A Baccarelli; Diane R Gold; Ken P Kleinman; Augusto A Litonjua; Dawn De Meo; Janet W Rich-Edwards; Sheryl L Rifas-Shiman; Sharon Sagiv; Elsie M Taveras; Scott T Weiss; Mandy B Belfort; Heather H Burris; Carlos A Camargo; Susanna Y Huh; Christos Mantzoros; Margaret G Parker; Matthew W Gillman Journal: Int J Epidemiol Date: 2014-03-16 Impact factor: 7.196
Authors: A F M van Abeelen; S R de Rooij; C Osmond; R C Painter; M V E Veenendaal; P M M Bossuyt; S G Elias; D E Grobbee; Y T van der Schouw; D J P Barker; T J Roseboom Journal: Placenta Date: 2011-07-13 Impact factor: 3.481
Authors: Colin P Hawkes; Jonathan O'B Hourihane; Louise C Kenny; Alan D Irvine; Mairead Kiely; Deirdre M Murray Journal: Pediatrics Date: 2011-08-08 Impact factor: 7.124
Authors: Claudia Gundacker; Sonja Fröhlich; Klaudia Graf-Rohrmeister; Barbara Eibenberger; Verena Jessenig; Dijana Gicic; Susanne Prinz; Karl Johann Wittmann; Harald Zeisler; Birgit Vallant; Arnold Pollak; Peter Husslein Journal: Sci Total Environ Date: 2010-09-09 Impact factor: 7.963
Authors: Motao Zhu; Edward F Fitzgerald; Kitty H Gelberg; Shao Lin; Charlotte M Druschel Journal: Environ Health Perspect Date: 2010-05-18 Impact factor: 9.031
Authors: Nolwenn Regnault; Matthew W Gillman; Sheryl L Rifas-Shiman; Emma Eggleston; Emily Oken Journal: Diabetes Care Date: 2013-07-22 Impact factor: 19.112
Authors: Andrea E Cassidy-Bushrow; Kuan-Han Hank Wu; Alexandra R Sitarik; Sung Kyun Park; Lawrence F Bielak; Christine Austin; Chris Gennings; Paul Curtin; Christine Cole Johnson; Manish Arora Journal: Environ Res Date: 2019-01-31 Impact factor: 6.498
Authors: Juliana Stone; Pragna Sutrave; Emily Gascoigne; Matthew B Givens; Rebecca C Fry; Tracy A Manuck Journal: Am J Obstet Gynecol MFM Date: 2021-01-11
Authors: Victoria Fruh; Sheryl L Rifas-Shiman; Chitra Amarasiriwardena; Andres Cardenas; David C Bellinger; Lauren A Wise; Roberta F White; Robert O Wright; Emily Oken; Birgit Claus Henn Journal: Neurotoxicology Date: 2019-09-09 Impact factor: 4.294
Authors: Michael S Bloom; Germaine M Buck Louis; Rajeshwari Sundaram; Jose M Maisog; Amy J Steuerwald; Patrick J Parsons Journal: Environ Res Date: 2015-02-20 Impact factor: 6.498
Authors: Pahriya Ashrap; Deborah J Watkins; Bhramar Mukherjee; Jonathan Boss; Michael J Richards; Zaira Rosario; Carmen M Vélez-Vega; Akram Alshawabkeh; José F Cordero; John D Meeker Journal: Environ Int Date: 2020-03-13 Impact factor: 9.621
Authors: Alison P Sanders; Heather H Burris; Allan C Just; Valeria Motta; Chitra Amarasiriwardena; Katherine Svensson; Emily Oken; Maritsa Solano-Gonzalez; Adriana Mercado-Garcia; Ivan Pantic; Joel Schwartz; Martha M Tellez-Rojo; Andrea A Baccarelli; Robert O Wright Journal: Epigenomics Date: 2015-09-29 Impact factor: 4.778