Maternal blood lead levels and the risk of pregnancy-induced hypertension: the EDEN cohort study.
BACKGROUND
Prior studies revealed associations of environmental lead exposure with risks of hypertension and elevated blood pressure.


OBJECTIVE
We examined the effect of blood lead levels on blood pressure and the incidence of pregnancy-induced hypertension (PIH) in the second and third trimesters of pregnancy.


METHODS
One thousand seventeen pregnant women were enrolled in two French municipalities between 2003 and 2005 for the EDEN (Etude des Déterminants pré et post natals du développement et de la santé de l' Enfant) cohort study. Blood lead concentrations were measured by atomic absorption spectrometry in mothers between 24 and 28 weeks of gestation.


RESULTS
PIH was diagnosed in 106 subjects (10.9%). Age, parity, weight gain, alcohol, smoking habits, and calcium supplementation were comparable between hypertensive and nonhypertensive women. Lead levels were significantly higher in PIH cases (mean +/- SD, 2.2 +/- 1.4 microg/dL) than in normotensive patients (1.9 +/- 1.2 microg/dL; p = 0.02). Adjustment for potential confounder effects slightly attenuated but did not eliminate the significant association between blood lead levels and the risk of PIH (adjusted odds ratio of PIH = 3.3; 95% confidence interval, 1.1-9.7). We also observed geographic differences in lead exposure and in the incidence of PIH and found significant correlations between blood lead levels and unadjusted as well as adjusted systolic and diastolic blood pressures after 24 weeks of gestation.


CONCLUSIONS
These findings confirm the relationship between blood lead levels at mid-pregnancy and blood pressure and suggest that environmental lead exposure may play an etiologic role in PIH.
Yazbeck
Chadi
C
INSERM, U780, IFR69, Villejuif, France. chadi.yazbeck@inserm.fr
Thiebaugeorges
Olivier
O
Moreau
Thierry
T
Goua
Valérie
V
Debotte
Ginette
G
Sahuquillo
Josiane
J
Forhan
Anne
A
Foliguet
Bernard
B
Magnin
Guillaume
G
Slama
Rémy
R
Charles
Marie-Aline
MA
Huel
Guy
G
D000328:Adult; D001794:Blood Pressure; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood* / Q000209:etiology; D007854:Lead / Q000097:blood* / Q000633:toxicity; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D013054:Spectrophotometry, Atomic; D055815:Young Adult
D007854:Lead