Elevated blood lead levels in pregnant women: identification of a high-risk population and interventions
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Shantanu Rastogi
Abstract
There has been a significant decrease in the number of preschool children with elevated blood lead levels (BLL), from 88.2 to 4.4 per 10,000 children over the last three decades as shown by National Health and Nutritional Examination Survey (NHANES) data. However, there are still certain high-risk populations that have not been well studied. One such group is that of pregnant women. During pregnancy, BLL tends to increase due to greater bone turnover, which causes release of lead stored in bone. This increase may not affect the pregnant woman's health directly but could be extremely harmful to the rapidly developing central nervous system in the fetus as it crosses the placenta easily. This current study was undertaken to estimate the prevalence of elevated BLL in pregnant women in a community hospital, monitor the effect of routine preventive practices on maternal BLL, and to elucidate the relationship between maternal and neonatal BLL and their anthropometric indices.
A retrospective chart review was conducted on all hospital deliveries occurring in the first six years after the initiation of universal blood lead screening of pregnant women (n=6880). The prevalence of elevated lead (≥10 μg/dL) in our patient population was 1.7%. The factors associated with elevated lead levels were recent immigration to the US, poor socioeconomic status and low educational levels. Simple interventions such as hand washing as well as calcium and iron supplementation significantly reduced maternal BLL from 16.82±9.5 to 11.48±9.3 μg/dL (P<0.0001). A significant correlation (r=0.4, P<0.007) is present between the post-intervention but not the pre-intervention maternal BLL and the neonatal BLL.
Given the vulnerability of the developing fetal brain and that CNS complications are associated with elevated lead levels, antenatal lead screening should be part of routine prenatal care. Simple preventive measures may play a role in decreasing maternal BLL and thereby decreasing transplacental transfer of lead to the fetus.
©2007 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Index Volume 35 (2007)
- Index - Authors
- Acknowledgement
- Index - Subjects
- Editorial
- The Istanbul international consensus statement on the perinatal care of multiple pregnancy
- Uterine activity monitoring during labor
- Is non-directive counseling for patient choice cesarean delivery ethically justified?
- GDM women in good glycemic control: which meal-related measure enhances fetal well-being?
- Intrahepatic cholestasis of pregnancy: detection with urinary bile acid assays
- Elevated blood lead levels in pregnant women: identification of a high-risk population and interventions
- Correlation of transthoracic echocardiography and right heart catheterization in pregnancy
- Adiponectin in severe preeclampsia
- Resistin: a hormone which induces insulin resistance is increased in normal pregnancy
- Plasma adiponectin concentrations in non-pregnant, normal and overweight pregnant women
- Impact of the new French clinical practice recommendations in embolization in postpartum and post-abortion hemorrhage: study of 48 cases
- The relationship between congenital malformations and preterm birth
- Obstetrical factors for death and brain injury among extremely-low-birth-weight infants
- Early detection of a congenital coronary artery fistula in a neonate by Doppler color flow mapping
- The exit procedure (ex-utero intrapartum treatment): management of giant fetal cervical teratoma
- Intestinal trefoil factor in treatment of neonatal necrotizing enterocolitis in the rat model
- Intestinal trefoil factor in treatment of neonatal necrotizing enterocolitis in the rat model
- Recurrent pregnancy loss
- Congress Calendar
Articles in the same Issue
- Index Volume 35 (2007)
- Index - Authors
- Acknowledgement
- Index - Subjects
- Editorial
- The Istanbul international consensus statement on the perinatal care of multiple pregnancy
- Uterine activity monitoring during labor
- Is non-directive counseling for patient choice cesarean delivery ethically justified?
- GDM women in good glycemic control: which meal-related measure enhances fetal well-being?
- Intrahepatic cholestasis of pregnancy: detection with urinary bile acid assays
- Elevated blood lead levels in pregnant women: identification of a high-risk population and interventions
- Correlation of transthoracic echocardiography and right heart catheterization in pregnancy
- Adiponectin in severe preeclampsia
- Resistin: a hormone which induces insulin resistance is increased in normal pregnancy
- Plasma adiponectin concentrations in non-pregnant, normal and overweight pregnant women
- Impact of the new French clinical practice recommendations in embolization in postpartum and post-abortion hemorrhage: study of 48 cases
- The relationship between congenital malformations and preterm birth
- Obstetrical factors for death and brain injury among extremely-low-birth-weight infants
- Early detection of a congenital coronary artery fistula in a neonate by Doppler color flow mapping
- The exit procedure (ex-utero intrapartum treatment): management of giant fetal cervical teratoma
- Intestinal trefoil factor in treatment of neonatal necrotizing enterocolitis in the rat model
- Intestinal trefoil factor in treatment of neonatal necrotizing enterocolitis in the rat model
- Recurrent pregnancy loss
- Congress Calendar
