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Environmental Toxicant Exposure During Pregnancy

Red, Rebecca T. BS*; Richards, Sean M. PhD; Torres, Carlos MD; Adair, C. David MD§

Obstetrical & Gynecological Survey: March 2011 - Volume 66 - Issue 3 - p 159-169
doi: 10.1097/OGX.0b013e3182219014
CME Program: CME REVIEW ARTICLE 8

This literature review is meant to serve as a brief reference for acute and chronic poisonings in pregnant women, specifically involving environmental toxicants commonly present in the home or workplace. These scenarios are familiar to primary care providers but cause great confusion for practitioners and anxiety in the pregnant patient. Herein, we review metals and metalloids, organic solvents, disinfectant byproducts, pesticides, plasticizers, and multiple air pollutants. Reviews of specific studies involving these toxicants are provided to assist practitioners in providing information to patients regarding potential sources, mechanism of action, current laboratory and epidemiological studies, and possible treatments. Literature-based associations with specific toxicants and various pregnancy outcomes are also outlined. Finally, a contact list of important federal and state toxicology support services is provided.

Target Audience: Obstetricians & Gynecologists

Learning objectives: After completing this CME activity, physicians should be better able to assess both acute and chronic consequences of various environmental toxic exposures in pregnancy; to evaluate possible pregnancy related specific events surrounding environmental pollutants; and to identify common exposure routes and implement therapeutic interventions where appropriate.

*Medical Student, Quillen College of Medicine, East Tennessee State University, Johnson City, TN; †Associate Professor, Biological and Environmental Sciences, University of Tennessee at Chattanooga, Chattanooga, TN; and ‡Assistant Professor, §Professor and Vice Chairman, Regional Obstetrical Consultants, Chattanooga, TN

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA Category 1 Credits™ can be earned in 2011. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commerical organizations pertaining to this educational activity.

Correspondence requests to: C. David Adair, MD, Regional Obstetrical Consultants, 902 McCallie Ave, Chattanooga, TN 37403. E-mail: dave@rocob.com.

© 2011 Lippincott Williams & Wilkins, Inc.