Changes in low levels of lead over the course of pregnancy and the association with birth outcomes

Rabito, Felicia A.; Kocak, Mehmet; Werthmann, Derek; Tylavsky, Frances A.; Palmer, Christopher D.; Parsons, Patrick J.

doi:10.1016/j.reprotox.2014.10.006

Cited by 34 publications

(24 citation statements)

References 35 publications

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“…We performed additional analyses by using third trimester or mean (from third and second trimester) maternal BLL in our linear regression models but our findings were unchanged as compared to when we used second trimester BLL (Tables S1 and S2; Supplementary Material). Rabito et al measured maternal BLL in the first, second, and third trimester and found that second trimester is possibly the most critical window for the association between prenatal lead exposure and birthweight (Rabito et al 2014). Last, to ensure our findings were robust by using second trimester BMI instead of pre-pregnancy BMI, we performed additional sensitivity analysis which showed no changes in the β coefficient when we used pre-pregnancy BMI (β=−0.06, 95% CI: −0.13, 0.001; P =0.05), as compared to when we used second trimester BMI (β=−0.06, 95% CI: −0.13, 0.003; P =0.06) (Table S3; Supplementary Material).…”

Section: Discussionmentioning

confidence: 99%

Prenatal lead exposure and fetal growth: Smaller infants have heightened susceptibility

Rodosthenous

Burris²,

Svensson

et al. 2017

Environment International

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Background As population lead levels decrease, the toxic effects of lead may be distributed to more sensitive populations, such as infants with poor fetal growth. Objectives To determine the association of prenatal lead exposure and fetal growth; and to evaluate whether infants with poor fetal growth are more susceptible to lead toxicity than those with normal fetal growth. Methods We examined the association of second trimester maternal blood lead levels (BLL) with birthweight-for-gestational age (BWGA) z-score in 944 mother-infant participants of the PROGRESS cohort. We determined the association between maternal BLL and BWGA z-score by using both linear and quantile regression. We estimated odds ratios for small-for-gestational age (SGA) infants between maternal BLL quartiles using logistic regression. Maternal age, body mass index, socioeconomic status, parity, household smoking exposure, hemoglobin levels, and infant sex were included as confounders. Results While linear regression showed a negative association between maternal BLL and BWGA z-score (β=−0.06 z-score units per log2 BLL increase; 95% CI: −0.13, 0.003; P=0.06), quantile regression revealed larger magnitudes of this association in the <30th percentiles of BWGA z-score (β range [−0.08, −0.13] z-score units per log2 BLL increase; all P values <0.05). Mothers in the highest BLL quartile had an odds ratio of 1.62 (95% CI: 0.99–2.65) for having a SGA infant compared to the lowest BLL quartile. Conclusions While both linear and quantile regression showed a negative association between prenatal lead exposure and birthweight, quantile regression revealed that smaller infants may represent a more susceptible subpopulation.

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Section: Discussionmentioning

confidence: 99%

Prenatal lead exposure and fetal growth: Smaller infants have heightened susceptibility

Rodosthenous

Burris²,

Svensson

et al. 2017

Environment International

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“…It has recently been suggested, however, for Pb concentrations <10 µg/dl the deficit in birth weight per 1 µg/dl increase in B-Pb is greater at lower than at higher concentrations, without evidence of a lower threshold of effect [ 9 ]. This is of importance given the high prevalence of low level B-Pb exposure among pregnant women in developed countries [ 10 – 13 ] and the controversy regarding the recommended level of concern for maternal B-Pb [ 8 ]. We have previously shown adverse effects of increased maternal B-Pb concentrations on birth outcomes, including birth weight, head circumference and crown–heel length, in a large cohort of pregnant women in the UK (the Avon Longitudinal Study of Parents and Children, ALSPAC) using adjusted linear and logistic regression models [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Low level lead exposure and pregnancy outcomes in an observational birth cohort study: dose–response relationships

et al. 2016

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BackgroundNational and international guidelines on safe levels for blood Pb in pregnancy focus on a threshold above which exposure is of concern. However, it has recently been suggested that the decrease in birth weight per unit increase in blood Pb is actually greater at lower than at higher concentrations of Pb without evidence of a lower threshold of effect. Our aim was to investigate whether there was evidence for a differential effect of maternal Pb levels on birth outcomes and/or a threshold value for effects.MethodsBlood samples from pregnant women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. Data collected on the infants included anthropometric variables. We fitted adjusted multivariable fractional polynomial models for birth outcomes.ResultsAdjusted models that assumed a linear relationship between untransformed blood Pb and the outcomes provided the best fit: an increase of 1 µg/dl was associated with changes in birth weight of −9.93 (95 % CI −20.27, 0.41) g, head circumference −0.03 (95 % CI −0.06, 0.00) cm and crown–heel length −0.05 (95 % CI −0.10, 0.00) cm.ConclusionThere was no evidence in this study to suggest a supralinear dose–response relationship or a lower threshold for the effect of maternal blood Pb on birth outcomes. This has implications for consideration of national and international guidelines on levels of concern in pregnancy. Exposure to Pb should be kept as low as possible during pregnancy to minimise adverse outcomes.

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“…A reference dose has not been established by the EPA, because health effects may be caused with BBL at incredibly low levels (IRIS, 2004). Since the CDC also declared that there may not be a threshold below which lead exposure may be acceptable, Rabito et al (2014) tested a cohort of pregnant women with average blood lead levels under 1 µg/dL. Their results demonstrated a significant rise in material BLL from the second trimester to delivery.…”

Section: Children's Blood Lead Levelsmentioning

confidence: 99%

Geospatial Analysis of Risk Components for Elevated Blood Lead Levels: Geologic and Anthropogenic Factors

Galinskaya

Williams

Wang

et al. 2017

Geological Society of America Abstracts With Programs

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Children are the demographic most susceptible to and affected by lead poisoning. Lead contamination in soil has been recorded as being primarily from lead-based paint, historic leaded gasoline emissions, and from lead point-source emitters. The highest risk of elevated blood lead level (BLL) is correlated with living in an area dominated by pre-1950's housing. From 1976 to 1994, midst the phasing out and removal of lead from gasoline, the blood lead levels of children in the United States decreased from 16 µg/dL to 3.2 µg/dL. There is evidence showing the irreversible effects of intellectual impairment still occur at levels of BLL below 10 µg/dL. In Kansas, Barton and Ellis counties residential soils were sampled, and chemical composition was examined with a handheld XRF and an HR ICP-MS. Particle size and pH were recorded for all samples. The presence or lack of of lead sulfate and lead carbonate was identified using XRD. Chemical tests revealed elevated Zn and As with increasing Pb concentrations. There was weak

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Changes in low levels of lead over the course of pregnancy and the association with birth outcomes

Cited by 34 publications

References 35 publications

Prenatal lead exposure and fetal growth: Smaller infants have heightened susceptibility

Prenatal lead exposure and fetal growth: Smaller infants have heightened susceptibility

Low level lead exposure and pregnancy outcomes in an observational birth cohort study: dose–response relationships

Geospatial Analysis of Risk Components for Elevated Blood Lead Levels: Geologic and Anthropogenic Factors

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