Kidney Week

Abstract: SA-OR043

The Effect of Prenatal Lead Exposure and Gestational Age on Blood Pressure among Children

Session Information

• Pediatric Nephrology and Developmental Biology
  November 04, 2017 | Location: Room 285, Morial Convention Center
  Abstract Time: 04:54 PM - 05:06 PM

Category: Developmental Biology and Inherited Kidney Diseases

• 403 Pediatric Nephrology

Authors

• Sanders, Alison P., Icahn School of Medicine at Mount Sinai, New York, New York, United States

Alison P. Sanders, PhD



https://www.linkedin.com/in/alisonpsanders/

• Svensson, Katherine, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Katherine Svensson,

• Gennings, Chris, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Chris Gennings,

• Amarasiriwardena, Chitra, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Chitra Amarasiriwardena,

• Basnet, Priyanka, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Priyanka Basnet,

• Pizano, Maria Luisa, National Institute of Perinatology, Mexico City, Mexico

Maria Luisa Pizano,

• Schnaas, Lourdes, National Institute of Perinatology, Mexico City, Mexico

Lourdes Schnaas,

• Tamayo y ortiz, Marcela, National Council of Science and Technology (CONACYT) - National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico

Marcela Tamayo y ortiz,

• Satlin, Lisa M., Icahn School of Medicine at Mount Sinai, New York, New York, United States

Lisa M. Satlin,

• Baccarelli, Andrea A, Columbia University, New York, New York, United States

Andrea A Baccarelli,

• Tellez-Rojo, Martha M., National Institute of Public Health, Cuernavaca, Morelos, Mexico

Martha M. Tellez-Rojo,

• Wright, Robert O., Icahn School of Medicine at Mount Sinai, New York, New York, United States

Robert O. Wright,

Background

Prenatal metal exposure occurs during a susceptible period of renal development and may program later life cardiovascular and renal disease. Our objective was to evaluate the association between prenatal lead exposure and gestational age on childhood blood pressure measured at 4 years of age.

Methods

Maternal blood lead levels (BLLs) collected in the second trimester were analyzed via inductively coupled plasma-mass spectrometry. Resting blood pressure was obtained using a Dinamap automated oscillometer from 565 children between 4 and 6 years of age in the PROGRESS cohort located in Mexico City, Mexico. We performed nonlinear piecewise regression to examine the association between prenatal lead levels and gestational age on children’s systolic blood pressure (SBP) adjusting for child’s age, sex, and height.

Results

Maternal second trimester BLLs ranged from 0.7 to 17.8 μg/dL with 112 (20%) above the CDC guideline level of 5 μg/dL. We identified a threshold lead level of concern of 2.5 μg/dL. When data were stratified at this lead level, shorter gestations were associated with increased SBP for subjects with BLLs ≥ 2.5 μg/dL, whereas shorter gestations were not associated with SBP for BLLs < 2.5 μg/dL. Specifically, for BLLs ≥ 2.5 μg/dL, SBP was 1.6 (95%CI: 0.4, 2.9) mmHg higher per each week shorter gestation among gestations shorter than 36.9 weeks; and among gestations longer than 36.9 weeks, this relationship was attenuated yet remained significant [β: 0.9, 95%CI (0.2, 1.6)].

Conclusion

Prenatal lead exposure may contribute to subclinical changes in the developing kidney or cardiovascular system leading to elevated SBP in childhood. We found that higher prenatal blood lead modified the association between shorter gestation and higher blood pressure. Ongoing studies will assess renal molecular changes due to early life lead exposure.

Funding

• Other NIH Support