Andrews K W, Savitz D A, Hertz-Picciotto I
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill 27599.
Am J Ind Med. 1994 Jul;26(1):13-32. doi: 10.1002/ajim.4700260103.
Although the adverse effect on pregnancy outcomes at high levels of lead exposure in the workplace has been recognized for years, there is uncertainty regarding the impact of exposure at the lower community exposure levels commonly encountered today. This review summarizes the epidemiologic literature and discusses pertinent methodologic issues and possible sources of interstudy variation. The authors conclude that prenatal lead exposure is unlikely to increase the risk of premature membrane rupture but does appear to increase the risk of preterm delivery. Whether prenatal lead exposure decreases gestational age in terms of infants is unclear. Prenatal lead exposure also appears to be associated with reduced birth weight, but results vary in relation to study design and degree of control for confounding. Adjustment for gestational age, a possible confounder of the birth weight-lead exposure association, did not yield clearer results.
尽管多年来人们已经认识到工作场所高铅暴露对妊娠结局有不良影响，但对于如今常见的较低社区暴露水平的影响仍存在不确定性。本综述总结了流行病学文献，并讨论了相关的方法学问题以及研究间差异的可能来源。作者得出结论，产前铅暴露不太可能增加胎膜早破的风险，但似乎确实会增加早产风险。产前铅暴露是否会降低婴儿的孕周尚不清楚。产前铅暴露似乎也与出生体重降低有关，但结果因研究设计和混杂因素控制程度而异。对孕周（出生体重与铅暴露关联的一个可能混杂因素）进行调整并未得出更清晰的结果。
