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Did Flint's water crisis lead to more miscarriages?

May 24, 2016

Studies suggest even low levels of lead exposure can hurt a fetus’ development in the womb.

And for months now, the state health department has been looking into whether the Flint water crisis caused problems with pregnancies.  

Meanwhile, researchers at Hurley Medical Center are investigating whether the lead in the water increased the number of miscarriages.

But it turns out that trying to track miscarriages is really tough.

A difficult question to answer: how many miscarriages were there?

When a kid gets exposed to lead in Flint’s water, at least there’s a test for that: you do a blood test, you get a result, and the lead levels are either high at that moment in time – or they’re not.  

But when you try and measure what that same water might have done to pregnancies?

That’s much, much harder.

"Because miscarriages are things that don’t necessarily get reported. Women don’t necessarily go to the doctor. They obviously don’t have to go to hospital, necessarily,” says Jenny LaChance, a clinical researcher at Hurley Medical Center in Flint. “And truthfully sometimes they may not even know they’ve had a miscarriage, right? If it’s very early on in the pregnancy…it may not even have been known.”

So LaChance and her team know they’re going to miss a lot of miscarriages that will just never be tracked.

Using what hospital data they do have, to compare before and after the crisis

But what they can track are the miscarriages that do get reported, in three different ways.

Number one: any miscarriages that do come through Hurley’s emergency room.

Number two: surgery data.

“For women who have a miscarriage, they may need a follow up procedure,” LaChance says. “So it’s a surgical procedure, a D&C [dilation and curettage.] And so we can look to see in the hospital, you know, how many women had that specific procedure [specifically after a miscarriage].”

And number three: they’re tracking how many women made appointments with their doctors at Hurley because they had a miscarriage.  

So right now, they’re gathering all that data. And then they’ll compare that number of miscarriages BEFORE the city started using Flint River water – specifically, they’re looking at a period of time from January through September 15th in 2013.

And they’ll compare those numbers with the miscarriage data they gather from a period of time during the water crisis: again, January through September 15th in 2015.

But here’s the thing: because there are so many miscarriages that just never get reported, even if there WAS a spike in miscarriages, and even if it WAS caused by the lead -- they may never be able to actually track it.

Sometime studies find that there’s no change, but then, everybody thinks: well, we really think there is,” LaChance says. “It’s just, the change wasn’t able to be detected.”

What one study found happened to fetal death rates in D.C.’s lead crisis

There is already some evidence that lead exposure during pregnancy can actually end that pregnancy.

"Lead was the [one of the] first means of controlling family size, back about 150 years ago; to abort children, women would actually ingest lead [pills]," says Marc Edwards, the Virginia Tech professor who helped expose Flint’s water crisis.

He studied the same issue in Washington, D.C., when that city experienced its own lead contamination crisis in the early 2000s.

Edwards’ study found that D.C.’s fetal death rates – which is when a fetus dies later in a pregnancy – spiked during the crisis.

“We could not prove that lead in water caused the reduced birth rates and the high rates of fetal death,” he says. “However, there was an association.”

Still, Edwards says in a big city like D.C., which had even higher rates of lead exposure than Flint, those connections are easier to establish.

But that doesn’t mean the same hypothesis doesn’t hold for Flint, he says.

“I think that what you can say, is clearly, the lead exposures that occurred, would be expected to have increased adverse pregnancy outcomes significantly,” Edwards says. “What you’re really just trying to do here is say, was there an association, basically, during this time period of high lead in water? Did in fact that prediction, as horrible as it is, come true?”

But at this point, there just aren’t that many studies linking lead exposure to miscarriages or stillbirths.

The state health department is analyzing birth rate data and the number of stillbirths in Flint, but doesn’t have updates for the public yet.

The Hurley research team is hoping to have its results put together and ready to share in two to three months.