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Environmental contaminants and pregnancy outcomes.

Abstract：

OBJECTIVE:To review selected environmental, occupational, and other important risk factors for the following adverse pregnancy outcomes: low birth weight (LBW), intrauterine growth retardation (IUGR), and preterm delivery (PTD). DESIGN:The evidence is explored in greater detail for environmental tobacco smoke, drinking water disinfection byproducts, and organochlorine (DDT) and organophosphate pesticides, partly using a weight of evidence approach. MAIN OUTCOME MEASURE(S):Low birth weight and IUGR are surrogate measures of fetal growth that are determined at delivery. Low birth weight is defined as <2,500 grams, and occurs in about 7% of US births. Intrauterine growth retardation is commonly defined as birth weight less than the tenth percentile for gestational week, using a standard population. Preterm delivery is birth at <37 weeks gestational age, and occurs in approximately 12% of US births. RESULT(S):Numerous factors are associated with these endpoints that may be important to consider in studies of environmental exposures, such as young or old maternal age, race/ethnicity, multiple births, low socioeconomic status, inadequate prenatal care, low maternal weight gain, and infections and premature rupture of the membranes. Environmental contaminants found associated with increased risk of one or more of the endpoints include: tobacco smoke, carbon monoxide, air pollutants, heavy metals, pesticides, chlorination byproducts, and solvents. CONCLUSION(S):Future research directions include measurement of exposure biomarkers during critical windows and consideration of genetic polymorphisms.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Windham G,Fenster L

doi

10.1016/j.fertnstert.2007.12.041

subject

Has Abstract

pub_date

2008-02-01 00:00:00

pages

e111-6; discussion e117

issue

2 Suppl

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(07)04320-8

journal_volume

89

pub_type

杂志文章,评审

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