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S Schoenbaum

Publications and source records attributed to S Schoenbaum.

12 recordsLinked to original sources
PubMed1993

Pre- and postnatal low-level lead exposure and children's dysfunction in school.

The contributions of pre- and postnatal low-level lead exposures to the risk of learning problems were evaluated among 1923 children who were born in one Boston hospital in 1979-1980 and followed to age 8 years. In this relatively privileged group, more than 20% of the children had a mother with some formal postgraduate education. Prenatal lead exposure was estimated with a measurement of umbilical cord blood lead content, and postnatal lead exposure was approximated with measurement of lead in the dentin of an exfoliated deciduous tooth. Information about potential confounders and effect modifiers was obtained from maternal interview shortly after delivery and from a mailed questionnaire completed and returned when the child was approximately 6 years old. An assessment of each child's function in school was provided by the teacher, who completed a questionnaire near the end of the school year in which the child reached the age of 8 years. We considered a learning problem to be related to lead exposure if its adjusted prevalence increased with each loge increase in lead, and if the adjusted prevalence was elevated among children with high levels (i.e., approximating the highest decile) of umbilical cord blood lead (i.e., > or = 10 micrograms/dl) or dentin lead (i.e., > or = 5 micrograms/g). Girls with elevated umbilical cord blood lead levels were more likely than their peers to be dependent and inpersistent and to display an inflexible and inappropriate approach to tasks (defined as the "tasks" cluster). Boys with elevated umbilical cord blood lead levels were more likely than others to have difficulty with both simple directions and sequences of directions. Among girls, elevated deciduous tooth dentin lead content was associated with reading and spelling difficulties, the tasks cluster, and with "not functioning as well as peers." Elevated dentin lead levels were not overrepresented among boys with any of the assessed learning clusters. These findings are consistent with the inference that lead levels still prevalent among children (i.e., blood < 15 micrograms/dl) are associated with some learning problems in girls.

Child↗
PubMed1991

Weight gain and maturity in fetuses exposed to low levels of lead.

The relationship between prenatal low-level lead exposure and fetal growth was evaluated in a sample of 4354 pregnancies in which the mean umbilical cord blood lead level was 7.0 micrograms/dl (SD = 3.3; 10th percentile, 3.4 micrograms/dl, 90th percentile, 10.9 micrograms/dl). Higher cord blood lead levels were significantly associated with gestations of slightly longer duration. Comparing infants with cord blood lead levels greater than or equal to 15 micrograms/dl to those with levels less than 5 micrograms/dl, adjusted risk ratios of 1.5 to 2.5 were observed for low birth weight (less than 2500 g) and for fetal growth indices that express birth weight as a function of length of gestation (e.g., small-for-gestational age, intrauterine growth retardation). The 95% confidence intervals of these risk ratios included 1, however, precluding rejection of the null hypothesis of no association. We conclude that the risk of adverse fetal growth is not increased at cord blood lead levels less than 15 micrograms/dl but that modest increases in risk may be associated with levels greater than or equal to 15 micrograms/dl.

Body Weight↗
PubMed1987

Pregnancy hypertension, blood pressure during labor, and blood lead levels.

Pregnancy hypertension, blood pressure during labor, and the umbilical cord blood lead concentration were assessed in 3851 women for whom additional demographic, medical, and personal information was available. Lead levels correlated with both systolic (Pearson r = 0.081, p = 0.0001) and diastolic (r = 0.051, p = 0.002) blood pressures during labor. The incidence of pregnancy hypertension increased with lead level. Multivariate models of pregnancy hypertension and systolic blood pressure as a function of maternal age, parity, hematocrit, ponderal index, race, and diabetes were improved by including lead as a predictor variable. At these observed levels of exposure (mean blood lead, 6.9 +/- 3.3 [SD] micrograms/dl), lead appears to have a small but demonstrable association with pregnancy hypertension and blood pressure at the time of delivery, but not with preeclampsia.

Adult↗
PubMed1984

The relationship between prenatal exposure to lead and congenital anomalies.

We obtained umbilical cord blood from 5,183 consecutive deliveries of at least 20 weeks' gestation and analyzed them for lead concentration. Those demographic and socioeconomic variables, including lead, which were shown on univariate analysis to be associated with increased risk for congenital anomalies were evaluated and controlled by entering them into a stepwise logistic-regression model with malformation as the outcome. Coffee, alcohol, tobacco, and marijuana use, which were associated with lead level, but not risk of malformation, were also controlled. The model was reduced in steps by eliminating the variables with the highest P value, until the most parsimonious model was created. The relative risk for anomalies associated with lead was then calculated while holding other covariates constant. Lead was found to be associated, in a dose-related fashion, with an increased risk for minor anomalies.

Abnormalities, Drug-Induced↗
PubMed1983

The association of alcohol consumption with outcome of pregnancy.

Patterns of alcohol consumption were assessed in 12,440 pregnant women interviewed at the time of delivery. Only 92 women (0.7 per cent) reported drinking 14 or more drinks per week, with most consuming fewer than 21 drinks per week. In the crude data, alcohol intake of 14 or more drinks per week was associated with a variety of adverse pregnancy outcomes, including low birthweight, gestational age under 37 weeks, stillbirth, and placenta abruptio. After use of logistic regression to control for confounding by demographic characteristics, smoking, parity and obstetric history, only the association of placenta abruptio with alcohol consumption of 14 or more drinks per week remained statistically significant. With the exception of placenta abruptio, alcohol intake of fewer than 14 drinks per week was not associated with and increased risk of any adverse outcome. No association was seen with congenital malformations at any level of alcohol intake.

Adult↗
PubMed1978

Gray-scale ultrasound in tubal pregnancy.

Sonographic signs were correlated with clinical data, surgical findings, and pathology in 15 patients withtubal pregnancy. Sonograms showed absence of intrauterine gestation in 12 patients. In 3, structures resembling gestational sacs were produced by decidual reaction and blood in the uterine cavity separating the endometrial echoes. The uterus was normal in size in 6 cases. Almost all sonograms showed a pelvic mass (usually adnexal) displacing the uterus. Seven patients had predominantly sonolucent masses, 3 had complex masses, and 4 had both types. Only one woman exhibited a definite gestational sac in an extrauterine location. Four patients had a negative pregnancy test at the time of sonography. Meticulous sonographic technique and a high index of suspicion will facilitate the diagnosis of tubal pregnancy in most cases.

Female↗
PubMed1976

Vertebral osteomyelitis in insulin-dependent diabetics.

Vertebral osteomyelitis continues to be a diagnostically and therapeutically challenging disease with a relatively high incidence in diabetics. The clinical features, investigations and treatment of 7 insulin-dependent diabetics with vertebral osteomyelitis are presented and possible aetiological factors in this group are discussed.

Aged↗