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Updated: Jun 6, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Lead Level ≥5 µg/dL and Neurodevelopmental Outcomes of Preterm Infants at Five Years of Age

Ashley Adams1, Michelle L Rogers2, Elisabeth C McGowan3

  • 1Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA.

Rhode Island Medical Journal (2013)
|November 22, 2024
PubMed

Insights

Elevated blood lead levels (BLL) in preterm infants are linked to developmental and behavioral issues, particularly sleep problems. Early screening and intervention are crucial for protecting vulnerable preterm children from lead exposure risks.

Area of Science:

  • Environmental Health
  • Pediatric Development
  • Neurotoxicology

Background:

  • Limited research exists on blood lead levels (BLL) in preterm infants.
  • Developmental and behavioral outcomes in this population are not well understood in relation to BLL.

Purpose of the Study:

  • To investigate the association between BLL and developmental/behavioral outcomes in preterm infants.
  • To determine the prevalence of elevated BLL in preterm children.

Main Methods:

  • Compared neonatal characteristics and developmental/behavioral scores.
  • Analyzed data from 354 preterm infants (born ≤32 weeks gestation).
  • Grouped infants by childhood BLL: ≥5 µg/dL (n=37) vs. <5 µg/dL (n=317).

Main Results:

  • Prevalence of BLL ≥5 µg/dL was 10% in this preterm cohort, higher than the general population.
  • Elevated BLL was associated with lower socioeconomic status (SES).
  • Preterm infants with BLL ≥5 µg/dL were twice as likely to exhibit sleep problems.

Conclusions:

  • Screening and follow-up for lead exposure are vital for preterm infants.
  • Higher lead levels correlate with adverse sleep outcomes, underscoring the need for continued screening and support services.
Abstract

Keywords:
behaviordevelopmentlead exposurepreterm infants

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