Parental lead exposure and total anomalous pulmonary venous return.
BACKGROUND
Investigators from the Baltimore-Washington Infant Study (BWIS) reported an association between self-reported maternal lead exposure and total anomalous pulmonary venous return (TAPVR) in their offspring. This association was further evaluated in the BWIS population using a more sensitive exposure estimate.


METHODS
Cases included 54 live-born infants with TAPVR; controls were a stratified random sample of 522 live-born infants from the BWIS control group. Parental lead exposure was based on three assessment methods, including: an industrial hygiene assessment, an a priori job exposure matrix, and self-reported exposures. A parent was classified as exposed to lead if he/she was classified as exposed by any one of the assessment methods.


RESULTS
Approximately 17% of case mothers and 11% of control mothers were classified as exposed to lead during the three months prior to conception through the first trimester (odds ratio [OR], 1.57; 95% confidence interval [CI], 0.64-3.47). Among fathers, 61% of case fathers and 46% of control fathers were classified as exposed to lead during the six months prior to conception (paternal critical period) (OR, 1.83; 95% CI, 1.00-3.42). During the paternal critical period, when only the father was exposed compared to neither parent exposed, the OR for any lead exposure and TAPVR was 1.65 (95% CI, 0.84-3.25).


CONCLUSIONS
This study supports a possible association between paternal lead exposure and TAPVR. Further studies are warranted using validated assessment methods for occupational and nonoccupational lead exposures to corroborate this association and to elucidate the possible biological mechanism. Birth Defects Research (Part A), 2004.
Jackson
Leila W
LW
National Institute of Child Health and Human Development, Rockville, Maryland, USA. jacksole@mail.nih.gov
Correa-Villaseñor
Adolfo
A
Lees
Peter S J
PS
Dominici
Francesca
F
Stewart
Patricia A
PA
Breysse
Patrick N
PN
Matanoski
Genevieve
G
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007854:Lead / Q000009:adverse effects*; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects; D011247:Pregnancy; D011667:Pulmonary Veins / Q000002:abnormalities / Q000187:drug effects*
D007854:Lead