Susan Lashley

University of Virginia, Charlottesville, Virginia, United States

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Publications (12)43.39 Total impact

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    ABSTRACT: We evaluated in utero exposures to pesticides by measuring maternal and cord serum biomarkers in a New Jersey cohort of pregnant women and the birth outcomes of their neonates. The study was based on 150 women that underwent an elective cesarean delivery at term in a hospital in central New Jersey. We evaluated the following pesticide compounds in both maternal and umbilical cord sera: chlorpyrifos, diazinon, carbofuran, chlorothalonil, dacthal, metolachlor, trifluralin and diethyl-m-toluamide (DEET). Of these compounds, chlorpyrifos, carbofuran, chlorothalonil, trifluralin, metolachlor and DEET were the pesticides most frequently detected in the serum samples. We found high (> or =75th percentile) metolachlor concentrations in cord blood that were related to birth weight (3605 g in upper quartile vs 3399 g; p=0.05). We also observed an increase in abdominal circumference with increasing cord dichloran concentrations (p=0.031). These observations suggest that in utero exposures to certain pesticides may alter birth outcomes.
    No preview · Article · Nov 2009 · Science of The Total Environment
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    ABSTRACT: Gestational exposure to pesticides may adversely affect fetal development and birth outcomes. However, data on fetal exposure and associated health effects in newborns remain sparse. We measured a variety of pesticides and metabolites in maternal urine, maternal serum, cord serum, amniotic fluid, and meconium samples collected at the time of cesarean delivery from 150 women in central New Jersey, USA. Women who used pesticides at home had higher concentrations of pesticides or metabolites in cord serum [e.g., dacthal (p = .007), diethyltoluamide (p = .043), and phthalimide (p = .030)] than those who did not use pesticides, suggesting that residential use of pesticides may contribute to overall exposure as assessed by biomonitoring. Except for orthophenylphenol, the concentrations of most pesticides in biological matrices of this study population were either comparable to or lower than the levels reported in previous studies and in the U.S. general population. The daily exposure estimates of two representative organophosphorus insecticides (chlorpyrifos and diazinon) were lower than most regulatory protection limits (USEPA oral benchmark dose10/100, USEPA reference oral dose, or ATSDR minimal risk levels); however, they were near or at the USEPA's population-adjusted doses for children and women. No abnormal birth outcomes or other clinical endpoints were noted in those newborns who had higher concentrations of orthophenylphenol during the perinatal period.
    No preview · Article · Oct 2009 · Human and Ecological Risk Assessment
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    ABSTRACT: Perchlorate is a commonly occurring environmental toxicant that may be transported across the placental barrier by the sodium-iodide symporter (NIS), possibly resulting in both increased perchlorate exposure and decreased iodide uptake by the fetus. Therefore, we measured levels of three physiologically relevant NIS-inhibitors (perchlorate, nitrate, and thiocyanate) and iodide in maternal and fetal fluids collected during cesarean-section surgeries on 150 U.S. women. Geometric means of perchlorate, thiocyanate, and nitrate levels in maternal urine (2.90, 947, and 47900 microg/L, respectively) were similar to previously published results, while urinary iodide levels (1420 microg/L) were significantly higher (p < 0.0001), likely because of prevalent prenatal vitamin use in the study population (74%). Thiocyanate levels were higher in the maternal serum, cord serum, and amniotic fluid of smokers compared to women with environmental tobacco smoke exposure and nonsmokers (p-values of 0.0006, 0.0011, and 0.0026, respectively). Perchlorate was detected in most samples: urine (100%), maternal serum (94%), cord serum (67%), and amniotic fluid (97%). Maternal urinary perchlorate levels were positively correlated with perchlorate levels in amniotic fluid (r = 0.57), indicating that maternal urine perchlorate is an effective biomarker of fetal perchlorate exposure. Maternal serum perchlorate was generally higher than cord serum perchlorate (median ratio 2.4:1 for paired samples), and maternal urine perchlorate was always higher than fetal amniotic fluid perchlorate levels (mean ratio 22:1); conversely, iodide levels were typically higher in fetal fluids compared to maternal fluids. We found no evidence of either disproportionate perchlorate accumulation or lack of iodide in the fetal compartment. In this panel of healthy infants, we found no association between cord blood levels of these anions and newborn weight length, and head circumference.
    Full-text · Article · Oct 2009 · Environmental Science and Technology
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    ABSTRACT: Phthalates are known reproductive and developmental toxicants in experimental animals. However, in humans, there are few data on the exposure of pregnant women that can be used to assess the potential developmental exposure experienced by the fetus. We measured several phthalate metabolites in maternal urine, maternal serum, and cord serum samples collected at the time of delivery from 150 pregnant women from central New Jersey. The urinary concentrations of most metabolites were comparable to or less than among the U.S. general population, except for mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), three metabolites of di(2-ethylhexyl) phthalate (DEHP). The median urinary concentrations of MEHHP (109 mug/l) and MEOHP (95.1 mug/l) were more than 5 times their population-based concentrations, whereas the median urinary concentration of MEHP was more than 20 times higher. High concentration of MEHP may indicate a recent exposure to the parent chemical DEHP in the hospital shortly before the collection of the samples. Calculation of daily intakes using the urinary biomarker data reveals that none of the pregnant women tested had integrated exposures to DEHP greater than the Agency for Toxic Substances and Disease Registry's minimal risk levels (MRLs chronic 60, intermediate 100 mug/kg/day). No abnormal birth outcomes (e .g., birth weight, Apgar Score, and gestational age) were noted in those newborns whose mothers had relatively greater exposure to DEHP during the perinatal period than others in this study. Significantly greater concentrations and detection frequencies in maternal urine than in maternal serum and cord serum suggest that the urinary concentrations of the phthalate metabolites may be more reliable biomarkers of exposure than their concentrations in other biological specimens.
    Full-text · Article · May 2009 · Human and Ecological Risk Assessment

  • No preview · Article · Dec 2004 · American Journal of Obstetrics and Gynecology
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    ABSTRACT: We describe a case of placenta previa at 37 weeks' gestation in which transvaginal sonography revealed a complete placenta previa overlying a dilated internal cervical os in the absence of any vaginal bleeding or uterine contractions. To our knowledge, no similar case has been described.
    No preview · Article · Oct 2004 · Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine
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    ABSTRACT: To evaluate outcomes and predictors of neonatal survival in pregnancies complicated by vasa previa and to compare outcomes in prenatally diagnosed cases of vasa previa with those not diagnosed prenatally. We performed a multicenter study of 155 pregnancies complicated by vasa previa. Cases were obtained from the Vasa Previa Foundation and 6 large hospitals. Comparisons were made between groups based on prenatal diagnosis status and neonatal survival. The overall perinatal mortality was 36% (55 of 155). In 61 cases (39%), vasa previa was diagnosed prenatally; 59 of 61 (97%) infants from these pregnancies survived compared with 41 of 94 (44%) in cases not diagnosed prenatally (P <.001). Median 1- and 5-minute Apgar scores in cases diagnosed prenatally were 8 and 9, respectively, compared with 1 and 4 among survivors in cases not diagnosed prenatally (P <.001). More than half (24 of 41) of surviving neonates born to women without prenatal diagnosis required blood transfusions compared with 2 of 59 diagnosed prenatally (P <.001). Multivariable logistic regression analysis showed that the only significant predictors of neonatal survival were prenatal diagnosis (P <.001) and gestational age at delivery (P =.01). Good outcomes with vasa previa depend primarily on prenatal diagnosis and cesarean delivery at 35 weeks of gestation or earlier should rupture of membranes, labor, or significant bleeding occur.
    Full-text · Article · Jun 2004 · Obstetrics and Gynecology

  • No preview · Article · Dec 2003 · American Journal of Obstetrics and Gynecology

  • No preview · Article · Dec 2003 · American Journal of Obstetrics and Gynecology
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    ABSTRACT: This study was undertaken to construct an institution-specific transverse cerebellar (transcerebellar) diameter nomogram with special emphasis in the third trimester and to compare its ability to predict gestational age with previously published nomograms. A cross-sectional nomogram was constructed using transcerebellar diameter measurements in 24,026 well-dated singleton fetuses by using linear regression models. Third-trimester measurements from 2,010 fetuses were included. The performance of previously established transcerebellar diameter nomograms for predicting gestational age was assessed in our population to determine comparability between nomograms. Interobserver and intraobserver variabilities in the second and third trimesters were 3.1% to 3.7% and 3.4% to 3.8%, respectively. Between 14 and 27 weeks' gestation, there were no clinically important differences between our nomogram and those previously published in terms of the predicted gestational age. However, predicted gestational age in the third trimester was considerably different by using our nomogram by 1 to 2 weeks from 28 to 30 weeks and by 4 to 6 weeks after 32 weeks. Transcerebellar measurements had a similar relationship with gestational age across previously published nomograms before 28 weeks. However, clinically significant differences in predicting gestational age appear later, especially after 32 weeks. These findings suggest that this new nomogram may be particularly useful for accurate dating of pregnancies in the third trimester.
    No preview · Article · Nov 2003 · American Journal of Obstetrics and Gynecology
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    ABSTRACT: Trisomy 9 was first reported in 1973 through blood lymphocyte testing in a newborn male with multiple congenital anomalies. Since that time, only approximately 30 cases of mosaic or nonmosaic trisomy 9 have been reported; therefore, this is a relatively rare chromosomal abnormality, constituting only 2.7% of all trisomic cases. Nonmosaic or complete trisomy 9 is a lethal diagnosis, with most fetuses dying prenatally or during the early postnatal period. Those who survive usually have mosaic trisomy 9 and have severe motor and mental deficiencies. With mosaic trisomy 9, the prevalence and severity of malformations and mental deficiency correlate with the percentages of trisomic cells in different tissues. Because most complete trisomy 9 cases end in spontaneous abortion in the first trimester, there is a paucity of reports regarding the prenatal sonographic findings of complete trisomy 9. To our knowledge, only 7 cases of nonmosaic trisomy 9 that were specifically detected on prenatal sonography have been reported in the literature: first trimester (n = 2), second trimester (n = 2), and third trimester (n = 3). There are distinct features associated with complete trisomy 9. Clinical and sonographic findings that have been described include intrauterine growth restriction, central nervous system abnormalities, cranial and facial anomalies, skeletal defects, congenital heart defects, and urogenital abnormalities. The purpose of this report is to describe the prenatal sonographic findings in a second-trimester fetus with trisomy 9 and also to review the sonographic findings of all published cases of nonmosaic trisomy 9 that were specifically detected on sonography.
    Preview · Article · May 2003 · Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine

  • No preview · Article · Dec 2001 · American Journal of Obstetrics and Gynecology

Publication Stats

220 Citations
43.39 Total Impact Points


  • 2009
    • University of Virginia
      Charlottesville, Virginia, United States
  • 2004
    • Yale University
      • Section of Comparative Medicine
      New Haven, Connecticut, United States
  • 2003-2004
    • Robert Wood Johnson University Hospital
      Нью-Брансуик, New Jersey, United States
  • 2001
    • University of Maryland, Baltimore
      • Department of Obstetrics, Gynecology and Reproductive Sciences
      Baltimore, Maryland, United States