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Elevated blood lead in pregnancy: evidence supporting enhanced surveillance
Ashley R Weaver1, Halimat Olaniyan1,2, Rejwi A Dahal1,2,3
1Indiana University School of Medicine, Indianapolis, IN, United States.
Introduction:
Prenatal lead exposure increases the risk of pregnancy complications and results in fetal neurodevelopmental damage. Despite well-documented risks, most clinicians predominantly rely on risk-based screening rather than on blood lead testing. The study aimed to measure whole blood lead levels (BLLs) in pregnant women from parts of Indiana and explore associations with maternal age, residential zip code, and median household income.
Methods:
Remnant whole blood samples submitted for hemoglobin electrophoresis were diluted 250-fold with aqueous diluent, and lead was measured by inductively coupled plasma tandem mass spectrometry. A BLL of 1 μg/dL or greater was classified as elevated in this study, although thresholds set for public health screening are higher.
Results:
Among 548 samples analyzed, 37 (6.8%) had a BLL of 1 µg/dL or higher, 2 samples were between 3.5 and 4.9 µg/dL, and 4 samples were 5 µg/dL or higher. We found no association between median household income based on zip code and elevated BLL. Participants were also grouped by age (analysis of variance P < .05), with Tukey honestly significant difference indicating higher mean BLL in participants 40 years of age or older.
Discussion:
Nearly 7% of the sampled pregnant population had elevated BLLs, which highlights continued need for surveillance of lead exposure in this vulnerable population.
