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dc.contributor.advisorOdland, Jon Øyvind
dc.contributor.advisorSripada, Kam
dc.contributor.advisorHansen, Solrunn
dc.contributor.authorXu, Shanshan
dc.date.accessioned2021-09-25T16:19:07Z
dc.date.available2021-09-25T16:19:07Z
dc.date.issued2020
dc.identifierno.ntnu:inspera:60189664:34552550
dc.identifier.urihttps://hdl.handle.net/11250/2782756
dc.description.abstract
dc.description.abstractBackground: The EMASAR assessed concentrations of environmental toxins in the blood of delivering women to investigate maternal and fetal health risks related to food security and exposure to persistent toxic substances in two regions of Argentina (Ushuaia and Salta). Objectives: To determine the blood lead levels and identify related risk factors among delivering women in Argentina and to evaluate the relationships between maternal lead exposure and birth outcomes. Methods: Blood samples derived from EMASAR study were analyzed. A total of 696 maternal serum samples collected from Ushuaia (n = 198) and Salta (n = 498) singleton women at 36±12 hours after delivery. Data of health and sociodemographic characteristics of the mother and their child were obtained from the medical records and questionnaires. Multiple linear regression models were applied to describe the relationships between lead exposure and related maternal risk factors, as well as the associations between levels of maternal blood lead and birth outcomes while adjusting for the possible confounders and covariates. Adjusted logistic regression analyses were used to examine the relationships between quartile of maternal blood lead levels and preterm birth, and low birth weight. Results: Blood lead levels were higher in women from Salta than those in Ushuaia (p < 0.001), with geometric mean blood lead levels of 15.8 μg/L and 10.1 μg/L, respectively. The geographic differences in blood lead levels can be explained by the differences in socioeconomic conditions, prior or current industry emissions and potential contributors of regional pollution. Age and smoking were positively associated with the blood lead levels. Women with primary education had significant higher levels of lead in serum than those who attended tertiary education. Blood lead levels were higher in women in urban areas than in those that live in rural areas. Adjusted models of multiple linear regression analyses suggested that increasing blood lead levels were related to increase in the gestational age in the overall sample. Significant negative associations were found between blood lead levels and birth weight, and birth length in the Salta sample. No significant associations between lead exposure and birth outcomes were observed in the Ushuaia sample. There were no clear relationships between quartile of blood lead levels and preterm birth or low birth weight were evident in the adjusted logistic regression models. Conclusions: Maternal lead exposure was mainly related with residence, age, smoking and education. Blood lead levels showed a positive association with gestational age in the overall sample. Inversely, even maternal low-level lead exposure may adversely affect birth weight and birth length in the Salta sample. There was no evidence to suggest dose-response relationships for the effect of blood lead levels on birth outcomes. Blood lead levels should be kept as low as possible especially during pregnancy to minimize undesirable effects. Keywords: EMASAR; Lead; Maternal serum; Risk factors; Birth outcomes; Argentina
dc.language
dc.publisherNTNU
dc.titleAssociations Between Maternal Lead Exposure and Birth Outcomes in Argentina. The EMASAR Study
dc.typeMaster thesis


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