PRENATAL LEAD-EXPOSURE IN RELATION TO GESTATIONAL-AGE AND BIRTH-WEIGHT - A REVIEW OF EPIDEMIOLOGIC STUDIES

Although the adverse effect on pregnancy outcomes at high levels of le ad exposure in the workplace has been recognized for years, there is u ncertainty regarding the impact of exposure at the lower community exp osure levels commonly encountered today. This review summarizes the ep idemiologic literature and discusses pertinent methodologic issues and possible sources of interstudy variation. The authors conclude that p renatal lead exposure is unlikely to increase the risk of premature me mbrane rupture but does appear to increase the risk of preterm deliver y. Whether prenatal lead exposure decreases gestational age in terms o f infants is unclear. Prenatal lead exposure also appears to be associ ated with reduced birth weight, but results vary in relation to study design and degree of control for confounding. Adjustment for gestation al age, a possible confounder of the birth weight-lead exposure associ ation, did not yield clearer results. (C) 1994 Wiley-Liss, Inc.