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Adverse effects of maternal lead levels on birth outcomes in the ALSPAC study: a prospective birth cohort study.

ABSTRACT: To study the associations of prenatal blood lead levels (B-Pb) with pregnancy outcomes in a large cohort of mother-child pairs in the UK.Prospective birth cohort study.Avon area of Bristol, UK.Pregnant women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC).Whole blood samples were collected and analysed by inductively coupled plasma dynamic reaction cell mass spectrometry (n = 4285). Data collected on the infants included anthropometric variables and gestational age at delivery. Linear regression models for continuous outcomes and logistic regression models for categorical outcomes were adjusted for covariates including maternal height, smoking, parity, sex of the baby and gestational age.Birthweight, head circumference and crown-heel length, preterm delivery and low birthweight.The mean blood lead level (B-Pb) was 3.67 ± 1.47 ?g/dl. B-Pb ? 5 ?g/dl significantly increased the risk of preterm delivery (adjusted odds ratio [OR] 2.00 95% confidence interval [95% CI] 1.35-3.00) but not of having a low birthweight baby (adjusted OR 1.37, 95% CI 0.86-2.18) in multivariable binary logistic models. Increasing B-Pb was significantly associated with reductions in birth weight (? -13.23, 95% CI -23.75 to -2.70), head circumference (? -0.04, 95% CI -0.07 to -0.06) and crown-heel length (? -0.05, 95% CI -0.10 to -0.00) in multivariable linear regression models.There was evidence for adverse effects of maternal B-Pb on the incidence of preterm delivery, birthweight, head circumference and crown-heel length, but not on the incidence of low birthweight, in this group of women.

SUBMITTER: Taylor CM

PROVIDER: S-EPMC4322474 | biostudies-other | 2015 Feb

REPOSITORIES: biostudies-other

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Adverse effects of maternal lead levels on birth outcomes in the ALSPAC study: a prospective birth cohort study.

Taylor C M CM Golding J J Emond A M AM

BJOG : an international journal of obstetrics and gynaecology 20140514 3

<h4>Objective</h4>To study the associations of prenatal blood lead levels (B-Pb) with pregnancy outcomes in a large cohort of mother-child pairs in the UK.<h4>Design</h4>Prospective birth cohort study.<h4>Setting</h4>Avon area of Bristol, UK.<h4>Population</h4>Pregnant women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC).<h4>Methods</h4>Whole blood samples were collected and analysed by inductively coupled plasma dynamic reaction cell mass spectrometry (n = 4285). Data ...[more]

PMID: 24824048

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Project description:BackgroundAdolescent pregnancy is considered a major contributor to maternal and child morbidity and mortality, the greatest concern of developing countries and an important public health issue globally. Adolescents are responsible for eleven percent of births worldwide and they face several pregnancy and childbirth related complications. However, in low-income countries like Ethiopia, there are limited researches conducted to investigate outcomes of adolescent pregnancy. Therefore, this study was conducted to assess the adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia.MethodsA prospective cohort study was conducted in 12 health facilities from seven districts in East Gojjam zone, Northwest Ethiopia. A total of 418 adolescents (15-19 years old) and 836 adult women (20-34 years old) who attended randomly selected health facilities in East Gojjam zone were included. Data were collected starting from admission to the maternity ward for labor and delivery, and postnatal depression was measured at six weeks' postpartum period using the Edinburgh Postnatal Depression Scale. Generalized estimating equations (GEE) was used to account for the within subject correlation and assess the effect of different known factors that could influence the outcome of this study.ResultsA lower percentage of adolescent (58.4%) than adult (71.2%) women had their first antenatal care booking before 16 weeks of gestation. After adjusting for different confounding factors, the adverse outcome that was significantly associated with adolescent pregnancy was postpartum depression (AOR: 2.29; 95% CI, 1.42, 3.7, p-value = 0.001). Assisted vaginal delivery (AOR: 0.44; 95% CI, 0.23, 0.86, p-value 0.016) and cesarean section (AOR: 0.43; 95% CI, 0.19, 0.97, p-value = 0.042) were significantly lower among adolescent women.ConclusionsAdolescent pregnancy is associated with higher odds of postpartum depression, and lower odds to undergo cesarean section and assisted vaginal delivery than adult women. Perinatal care services should be more adolescent-friendly to ensure early diagnosis and treatment of postpartum depression. School and community-based awareness programs regarding use of contraception to prevent unwanted adolescent pregnancy, early antenatal care booking and adverse pregnancy outcomes of adolescent pregnancy and provision of psychosocial support are recommended.

Project description:BACKGROUND:Pregnancy among adolescents, whether intended or not, is a public health concern as it is generally considered high risk for both mothers and their newborns. In Zambia, where many women engage in early sexual behaviour or marry at a young age, 28.5% of girls aged 15-19 years were pregnant with their first child in the year 2013-2014. This study sought to explore associations between maternal age and neonatal outcomes among pregnant women in Lusaka, Zambia. METHODS:This was a secondary analysis of data nested within a larger population-based prospective cohort study which was implemented in three government health facilities-two first level hospitals and one clinic in Lusaka, Zambia. Women presenting to the study sites for antenatal care were enrolled into the study and followed up for collection of maternal and neonatal outcomes at 7, 28 and 42 days postpartum. The study's primary outcomes were the incidence of maternal and newborn complications and factors associated with adverse neonatal outcomes. Statistical significance was evaluated at a significance level of P?<?0.05. RESULTS:The study included 11,501 women, 15.6% of whom were adolescents aged 10-19 years. Generally, adolescence did not have statistically significant associations with poor maternal health outcomes. However, the risk of experiencing obstructed labour, premature rupture of membranes and postpartum hemorrhage was higher among adolescents than women aged 20-24 years while the risk of severe infection was lower and non-significant. Adolescents also had 1.36 times the odds of having a low birthweight baby (95% CI 1.12, 1.66) and were at risk of preterm birth (aOR?=?1.40, 95% CI 1.06, 1.84). Their newborns were in need of bag and mask resuscitation at birth (aOR?=?0.62, 95% CI 0.41, 0.93). Advanced maternal age was significantly associated with increased odds of hypertension/ pre-eclampsia (95% CI 1.54, 5.89) and preterm labour (aOR?=?2.78, 95% CI 1.24, 6.21). CONCLUSIONS:Adolescence is a risk factor for selected pregnancy outcomes in urban health facilities in Lusaka, Zambia. Health care workers should intensify the provision of targeted services to improve neonatal health outcomes. TRIAL REGISTRATION:Clinical trial number and URL: NCT03923023 (Retrospectively registered). Clinical trial registration date: April 22, 2019.

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Adverse effects of maternal lead levels on birth outcomes in the ALSPAC study: a prospective birth cohort study.

Publications

Adverse effects of maternal lead levels on birth outcomes in the ALSPAC study: a prospective birth cohort study.

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