Arthur E Poropat1, Mark A S Laidlaw2, Bruce Lanphear3, Andrew Ball4, Howard W Mielke5. 1. Griffith University - School of Applied Psychology, Brisbane, Australia. 2. RMIT University - Centre for Environmental Sustainability and Remediation (EnSuRe), School of Science, Bundoora, Victoria, Australia. Electronic address: mark.laidlaw@rmit.edu.au. 3. Simon Fraser University - Faculty of Health Sciences, Vancouver, British Columbia, Canada. 4. RMIT University - Centre for Environmental Sustainability and Remediation (EnSuRe), School of Science, Bundoora, Victoria, Australia. 5. Tulane University - Department of Pharmacology, Tulane University School of Medicine, New Orleans, LA, USA.
Abstract
BACKGROUND: Multiple cross-sectional studies suggest that there is an association between blood lead and preeclampsia. OBJECTIVES: We performed a systematic review and meta-analysis to summarize information on the association between preeclampsia and lead poisoning. METHODS: Searches of Medline, Web of Science, Scopus, Pubmed, Science Direct and ProQuest (dissertations and theses) identified 2089 reports, 46 of which were downloaded after reviewing the abstracts, and 11 studies were evaluated as meeting the selection criteria. Evaluation using the ROBINS-I template (Sterne, et al., 2016), indicated moderate risk of bias in all studies. RESULTS: We found that blood lead concentrations were significantly and substantially associated with preeclampsia (k = 12; N = 6069; Cohen's d = 1.26; odds ratio = 9.81; odds ratio LCL = 8.01; odds ratio UCL = 12.02; p = 0.005). Eliminating one study produced a homogeneous meta-analysis and stronger estimates, despite the remaining studies coming from eight separate countries and having countervailing risks of bias. CONCLUSIONS: Blood lead concentrations in pregnant women are a major risk factor for preeclampsia, with an increase of 1μg/dL associated with a 1.6% increase in likelihood of preeclampsia, which appears to be the strongest risk factor for preeclampsia yet reported. Pregnant women with historical lead exposure should routinely have blood lead concentrations tested, especially after mid-term. Women with concentrations higher than 5μg/dL should be actively monitored for preeclampsia and be advised to take prophylactic calcium supplementation. All pregnant women should be advised to actively avoid lead exposure.
BACKGROUND: Multiple cross-sectional studies suggest that there is an association between blood lead and preeclampsia. OBJECTIVES: We performed a systematic review and meta-analysis to summarize information on the association between preeclampsia and lead poisoning. METHODS: Searches of Medline, Web of Science, Scopus, Pubmed, Science Direct and ProQuest (dissertations and theses) identified 2089 reports, 46 of which were downloaded after reviewing the abstracts, and 11 studies were evaluated as meeting the selection criteria. Evaluation using the ROBINS-I template (Sterne, et al., 2016), indicated moderate risk of bias in all studies. RESULTS: We found that blood lead concentrations were significantly and substantially associated with preeclampsia (k = 12; N = 6069; Cohen's d = 1.26; odds ratio = 9.81; odds ratio LCL = 8.01; odds ratio UCL = 12.02; p = 0.005). Eliminating one study produced a homogeneous meta-analysis and stronger estimates, despite the remaining studies coming from eight separate countries and having countervailing risks of bias. CONCLUSIONS: Blood lead concentrations in pregnant women are a major risk factor for preeclampsia, with an increase of 1μg/dL associated with a 1.6% increase in likelihood of preeclampsia, which appears to be the strongest risk factor for preeclampsia yet reported. Pregnant women with historical lead exposure should routinely have blood lead concentrations tested, especially after mid-term. Women with concentrations higher than 5μg/dL should be actively monitored for preeclampsia and be advised to take prophylactic calcium supplementation. All pregnant women should be advised to actively avoid lead exposure.
Authors: Shahir Masri; Alana LeBrón; Michael Logue; Enrique Valencia; Abel Ruiz; Abigail Reyes; Jean M Lawrence; Jun Wu Journal: Sci Total Environ Date: 2020-07-06 Impact factor: 7.963
Authors: Emma M Rosen; Mg Isabel Muñoz; Thomas McElrath; David E Cantonwine; Kelly K Ferguson Journal: J Toxicol Environ Health B Crit Rev Date: 2018-12-24 Impact factor: 6.393
Authors: Weili Yang; Joseph M Braun; Ann M Vuong; Zana Percy; Yingying Xu; Changchun Xie; Ranjan Deka; Antonia M Calafat; Maria Ospina; Erika Werner; Kimberly Yolton; Kim M Cecil; Bruce P Lanphear; Aimin Chen Journal: Environ Res Date: 2021-10-15 Impact factor: 6.498
Authors: Clara G Sears; Joseph M Braun; Patrick H Ryan; Yingying Xu; Erika F Werner; Bruce P Lanphear; Gregory A Wellenius Journal: Environ Int Date: 2018-10-06 Impact factor: 9.621
Authors: Abee L Boyles; Brandiese E Beverly; Suzanne E Fenton; Chandra L Jackson; Anne Marie Z Jukic; Vicki L Sutherland; Donna D Baird; Gwen W Collman; Darlene Dixon; Kelly K Ferguson; Janet E Hall; Elizabeth M Martin; Thaddeus T Schug; Alexandra J White; Kelly J Chandler Journal: J Womens Health (Larchmt) Date: 2020-11-18 Impact factor: 2.681
Authors: Max T Aung; Kelly M Bakulski; Jason I Feinberg; John F Dou; John D Meeker; Bhramar Mukherjee; Rita Loch-Caruso; Christine Ladd-Acosta; Heather E Volk; Lisa A Croen; Irva Hertz-Picciotto; Craig J Newschaffer; M Daniele Fallin Journal: Epigenetics Date: 2021-04-02 Impact factor: 4.528
Authors: Katarzyna Gajewska; Marzena Laskowska; Agostinho Almeida; Edgar Pinto; Katarzyna Skórzyńska-Dziduszko; Anna Błażewicz Journal: Molecules Date: 2021-05-20 Impact factor: 4.411