Dataset Information

Maternal lead exposure and premature rupture of membranes: a birth cohort study in China.

ABSTRACT:

Objectives

Maternal exposure to lead (Pb) has been suggested to correlate with adverse birth outcomes, but evidence supporting an association between Pb exposure and premature rupture of membranes (PROM) is limited. The aim of our study was to investigate whether maternal Pb exposure was associated with PROM and preterm PROM.

Design

Cross-sectional cohort study.

Study population

The present study involved 7290 pregnant women from the Healthy Baby Cohort in Wuhan, China, during 2012-2014.

Main outcome measures

PROM was defined as spontaneous rupture of amniotic membranes before the onset of labour and was determined with a pH ?6.5 for vaginal fluid. Maternal urinary Pb level was adjusted by creatinine concentration, and its relationship with PROM was analysed by logistic regression.

Results

The IQR of maternal urinary Pb concentrations of the study population was 2.30-5.64?µg/g creatinine with a median of 3.44?µg/g creatinine. Increased risk of PROM was significantly associated with elevated levels of Pb in maternal urine (adjusted OR 1.23, 95% CI 1.0 to 1.47 for the medium tertile; adjusted OR 1.51, 95%?CI 1.27 to 1.80 for the highest tertile). The risk of preterm PROM associated with Pb levels was significantly higher when compared with the lowest tertile (adjusted OR 1.24, 95%?CI 0.80 to 1.92 for the medium tertile; adjusted OR 1.73, 95%?CI 1.15 to 2.60 for the highest tertile). In addition, the relationship between Pb and PROM was more pronounced among primiparous women than multiparous women (p for interaction <0.01).

Conclusions

Our study found that higher levels of maternal Pb exposure was associated with increased risk of PROM, indicating that exposure to Pb during pregnancy may be an important risk factor for PROM.

SUBMITTER: Huang S

PROVIDER: S-EPMC6059302 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Maternal lead exposure and premature rupture of membranes: a birth cohort study in China.

Huang Sha S Xia Wei W Sheng Xia X Qiu Lin L Zhang Bin B Chen Tian T Xu Shunqing S Li Yuanyuan Y

BMJ open 20180723 7

<h4>Objectives</h4>Maternal exposure to lead (Pb) has been suggested to correlate with adverse birth outcomes, but evidence supporting an association between Pb exposure and premature rupture of membranes (PROM) is limited. The aim of our study was to investigate whether maternal Pb exposure was associated with PROM and preterm PROM.<h4>Design</h4>Cross-sectional cohort study.<h4>Study population</h4>The present study involved 7290 pregnant women from the Healthy Baby Cohort in Wuhan, China, dur ...[more]

PMID: 30037873

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Project description:BACKGROUND:The associations between maternal exposure to ambient PM2.5 during pregnancy and the risk of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) are controversial. And no relevant study has been conducted in Asia. This study aimed to determine the association between maternal exposure to ambient PM2.5 during pregnancy and the risk of (P)PROM. METHODS:A cohort study including all singleton births in a hospital located in Central China from January 2015 through December 2017 was conducted. Multivariable logistic regression models, stratified analysis, generalized additive model, and two-piece-wise linear regression were conducted to evaluate how exposure to ambient PM2.5 during pregnancy is associated with the risks of PROM and PPROM. RESULTS:A total of 4364 participants were included in the final analysis, where 11.71 and 2.34% of births were complicated by PROM and PPROM, respectively. The level of PM2.5 exhibited a degree of seasonal variation, and its median concentrations were 63.7, 59.3, 55.8, and 61.8??g/m3 for the first trimester, second trimester, third trimester, and the whole duration of pregnancy, respectively. After adjustment for potential confounders, PROM was positively associated with PM2.5 exposure (per 10??g/m3) [Odds Ratio (OR)?=?1.14, 95% Confidence Interval (CI), 1.02-1.26 for the first trimester; OR?=?1.09, 95% CI, 1.00-1.18 for the second trimester; OR?=?1.13, 95% CI, 1.03-1.24 for the third trimester; OR?=?1.35, 95% CI, 1.12-1.63 for the whole pregnancy]. PPROM had positive relationship with PM2.5 exposure (per 10??g/m3) (OR?=?1.17, 95% CI, 0.94-1.45 for first trimester; OR?=?1.11, 95% CI, 0.92-1.33 for second trimester; OR?=?1.19, 95% CI, 0.99-1.44 for third trimester; OR?=?1.53, 95% CI, 1.03-2.27 for the whole pregnancy) Positive trends between the acute exposure window (mean concentration of PM2.5 in the last week and day of pregnancy) and risks of PROM and PPROM were also observed. CONCLUSIONS:Exposure to ambient PM2.5 during pregnancy was associated with the risk of PROM and PPROM.

Project description:BackgroundSignificant mortality and morbidity in pregnant women and their offspring are linked to premature rupture of membranes (PROM). Epidemiological evidence for heat-related PROM risk is extremely limited. We investigated associations between acute heatwave exposure and spontaneous PROM.MethodsWe conducted this retrospective cohort study among mothers in Kaiser Permanente Southern California who experienced membrane ruptures during the warm season (May-September) from 2008 to 2018. Twelve definitions of heatwaves with different cut-off percentiles (75th, 90th, 95th, and 98th) and durations (≥ 2, 3, and 4 consecutive days) were developed using the daily maximum heat index, which incorporates both daily maximum temperature and minimum relative humidity in the last gestational week. Cox proportional hazards models were fitted separately for spontaneous PROM, term PROM (TPROM), and preterm PROM (PPROM) with zip codes as the random effect and gestational week as the temporal unit. Effect modification by air pollution (i.e., PM2.5 and NO2), climate adaptation measures (i.e., green space and air conditioning [AC] penetration), sociodemographic factors, and smoking behavior was examined.ResultsIn total, we included 190,767 subjects with 16,490 (8.6%) spontaneous PROMs. We identified a 9-14% increase in PROM risks associated with less intense heatwaves. Similar patterns as PROM were found for TPROM and PPROM. The heat-related PROM risks were greater among mothers exposed to a higher level of PM2.5 during pregnancy, under 25 years old, with lower education and household income level, and who smoked. Even though climate adaptation factors were not statistically significant effect modifiers, mothers living with lower green space or lower AC penetration were at consistently higher heat-related PROM risks compared to their counterparts.ConclusionUsing a rich and high-quality clinical database, we detected harmful heat exposure for spontaneous PROM in preterm and term deliveries. Some subgroups with specific characteristics were more susceptible to heat-related PROM risk.

Dataset Information

Maternal lead exposure and premature rupture of membranes: a birth cohort study in China.

Objectives

Design

Study population

Main outcome measures

Results

Conclusions

Publications

Maternal lead exposure and premature rupture of membranes: a birth cohort study in China.

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