Evidence map›Paper›PMID 35020085›Full record

ArticleMaternal and child health journal2022

Risk-Factor Based Lead Screening and Correlation with Blood Lead Levels in Pregnancy.

Katherine M Johnson, Aaron J Specht, Jessica M Hart, Saira Salahuddin, Adrienne L Erlinger, Michele R Hacker, Alan D Woolf, Marissa Hauptman, S Ananth Karumanchi, Karen O'Brien and 1 more

Open access · greenAbstract read
In one paragraph

Article in Maternal and child health journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Katherine M JohnsonDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA. katherine.johnson@umassmemorial.org.ORCID http://orcid.org/0000-0002-5127-8139
Aaron J SpechtHarvard T. H. Chan School of Public Health, Boston, MA, 02215, USA.
Jessica M HartDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
Saira SalahuddinDepartment of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
Adrienne L ErlingerDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
Michele R HackerDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
Alan D WoolfPediatric Environmental Health Center, Division of General Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA.
Marissa HauptmanPediatric Environmental Health Center, Division of General Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA.
S Ananth KarumanchiCenter for Vascular Biology Research, Beth Israel Deaconess Medical Center/Harvard Medical School, 99 Brookline Avenue, RN 359, Boston, MA, 02215, USA.
Karen O'BrienDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
Blair J WylieDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
Beth Israel Deaconess Medical Center · USBoston Children's Hospital · USHarvard University · USCedars-Sinai Medical Center · US

Funding

The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
ANALYZE AND EVALUATE POTENTIAL RISK FACTORS FOR AMYOTROPHIC LATERAL SCLEROSIS (ALS)R01TS000296 · TS · DARTMOUTH-HITCHCOCK CLINIC · PI STOMMEL, ELIJAH W · 2019 to 2019
$56k
ACL HHS K01OH011648ATSDR CDC HHS 1 NU61TS000296-01-00ATSDR CDC HHS R01 TS000296NCATS NIH HHS UL1 TR002541NCATS NIH HHS UL 1TR002541NIH HHS NIOSH 1K01 OH011648NIOSH CDC HHS K01 OH011648
6 · The paper itself

Abstract

objectivesLead exposure has devastating neurologic consequences for children and may begin in utero. The American College of Obstetricians and Gynecologists recommends prenatal lead screening using a risk factor-based approach rather than universal blood testing. The clinical utility of this approach has not been studied. We evaluated a risk-factor based questionnaire to detect elevated blood lead levels in pregnancy.

methodsWe performed a secondary analysis of a cohort of parturients enrolled to evaluate the association of lead with hypertensive disorders of pregnancy. We included participants in this analysis if they had a singleton pregnancy ≥ 34 weeks' gestation with blood lead levels recorded. Participants completed a lead risk factor survey modified for pregnancy. We defined elevated blood lead as ≥ 2 μg/dL, as this was the clinically reportable level.

resultsOf 102 participants enrolled in the cohort, 92 had blood lead measured as part of the study. The vast majority (78%) had 1 or more risk factor for elevated lead using the questionnaire yet none had clinical blood lead testing during routine visits. Only two participants (2.2%) had elevated blood lead levels. The questionnaire had high sensitivity but poor specificity for predicting detectable lead levels (sensitivity 100%, specificity 22%). CONCLUSIONS FOR PRACTICE: Prenatal risk-factor based lead screening appears underutilized in practice and does not adequately discriminate between those with and without elevated blood levels. Given the complexity of the risk factor-based approach and underutilization, the benefit and cost-effectiveness of universal lead testing should be further explored.

Indexed as

HypertensionLeadChildFemaleGestational AgeHumansMass ScreeningPregnancyRisk FactorsLeadLead exposurePregnancyPrenatal screeningRisk factors

Identifiers

PMID35020085
PMCPMC8826746
OpenAlexW4206161079

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.