Lead Exposure and Hypertension Across the Reproductive Lifespan
Description: Although lead exposure has declined over time, many communities, particularly lower-income and racially or ethnically diverse populations, remain at risk due to sources such as lead service lines and aging housing infrastructure. Literature suggests that lead exposure may increase blood pressure (BP) and contribute to hypertensive disorders of pregnancy (HDP). HDPs are significant contributors to maternal morbidity and mortality in the United States, disproportionately affecting minorities, older individuals, and those in low-income communities. Furthermore, the prevalence of HDPs continues to increase, yet the mechanisms linking blood lead levels (BLLs) and HDPs remain understudied. The placenta may provide insight into these pathways, as lead exposure during pregnancy can impair placental vascular remodeling, contributing to preeclampsia. Furthermore, no blood lead level is considered safe, yet the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists do not currently recommend universal lead testing for pregnant individuals, leaving many cases undetected. Additionally, gaps remain in identifying at-risk populations and opportunities for clinical intervention. To address these gaps, we will investigate the association between lead exposure and BP profiles using multiple datasets. First, we will analyze National Health and Nutrition Examination Survey data to assess the relationship between BLLs and BP in a nationally representative sample of pregnant individuals, providing insight into population-level disparities. Second, we will leverage the Columbia Center for Children's Environmental Health Fair Start Cohort, which includes placental tissue samples analyzed for lead and longitudinal BP measurements collected during pregnancy and postpartum, to explore windows of susceptibility and potential biological mechanisms. Third, we will utilize hospital records in New York City to examine pregnancies with documented maternal BLLs and HDPs, identifying potential clinical intervention opportunities. Our findings will contribute to efforts to establish universal lead screening for pregnant individuals, improve adverse pregnancy outcomes, and reducing disparities in maternal cardiovascular health.
Funder: American Heart Association
Amount: $70,680
Funding type: training
Funder scheme: Predoctoral Fellowship
Start date: 2026-06-01
End date: 2028-05-31
Investigators: Sharon Kulali, Sharon Kulali
Institution: The Trustees of Columbia University in the City of New York
Funded outputs count: 0
Funder award ID: 26PRE1544324
OpenAlex ID: G196425781