title: Cadmium and Reproductive Health in Women: A Systematic Review of the Epidemiologic Evidence.
abstract: An evolving body of evidence supports that cadmium, a non-essential heavy metal, may be associated with multiple adverse women's reproductive health outcomes. Our objective was to conduct a systematic review of epidemiologic studies that evaluated cadmium exposure and the following reproductive health outcomes: puberty/menarche, fertility, time to pregnancy, pregnancy loss, preeclampsia, endometriosis, uterine leiomyoma, and menopause. Twenty-two studies were identified based upon our search criteria. Available evidence was inadequate to draw meaningful conclusions for most of the reproductive outcomes studied. The strongest evidence was for a possible association between cadmium and preeclampsia, which was limited to cross-sectional studies. Some evidence, although conflicting, was also observed for fertility related outcomes. This lack of evidence underscores the need for additional research on cadmium and women's reproductive health outcomes.
authors.affiliation: Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, USA.
authors.forename: Anna Z
authors.initials: AZ
authors.lastname: Pollack
authors.affiliation: Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, USA.
authors.forename: Shamika
authors.initials: S
authors.lastname: Ranasinghe
authors.affiliation: Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA.
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Sjaarda
authors.affiliation: Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA.
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
keywords: Cadmium; Endometriosis; Epidemiologic evidence; Fertility; Leiomyoma; Menarche; Menopause; Metal; Preeclampsia; Pregnancy loss; Reproduction; Reproductive health; Women