Lead Poisoning Among Pregnant Women in New York City: Risk Factors and Screening Practices

Klitzman, Susan; Sharma, Anu; Nicaj, Leze; Vitkevich, Ramona; Leighton, Jessica

doi:10.1093/jurban/79.2.225

Cited by 35 publications

(27 citation statements)

References 22 publications

(15 reference statements)

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“…Although a strong inverse relationship was found between blood lead level and number of years in the United States, the rate of decline was shallow, suggesting that the women arrived in the United States with substantial bone lead burdens. Similarly, in a study of pregnant women in New York City, the proportion of "foreign born" women who had blood lead levels Ͼ20 g/dl was twice as high as the proportion of foreign-born women among all women giving birth in New York City during the same period (Klitzman et al, 2002). As in the studies of Rothenberg et al (1999bRothenberg et al ( , 2000, blood lead level was inversely related to the length of time a woman had resided in the United States.…”

Section: Population Subgroups At Increased Riskmentioning

confidence: 73%

“…These habits include smoking and alcohol consumption (Rhainds and Levallois, 1997), pica for soil or clay (Rothenberg et al, 1999b;Klitzman et al, 2002;Shannon, 2003), the use of certain ethnic remedies, cosmetics, and complementary medications (e.g., Ayervedic medicines) (Anderson et al, 2001;Tait et al, 2002;CDC, 2004), and food preparation methods that involve lead-glazed vessels that were not fired at temperatures that were sufficiently high (AzconaCruz et al, 2000;Brown et al, 2000;Rothenberg et al, 2000). Women with low dietary calcium intakes are also at increased risk.…”

Section: Population Subgroups At Increased Riskmentioning

confidence: 99%

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Teratogen update: Lead and pregnancy

Bellinger

2005

Birth Defects Research

286

153

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This review focuses on the impacts of lead exposure on reproductive health and outcomes. High levels of paternal lead exposure (Ͼ40 g/dl or Ͼ25 g/dl for a period of years) appear to reduce fertility and to increase the risks of spontaneous abortion and reduced fetal growth (preterm delivery, low birth weight). Maternal blood lead levels of approximately 10 g/dl have been linked to increased risks of pregnancy hypertension, spontaneous abortion, and reduced offspring neurobehavioral development. Somewhat higher maternal lead levels have been linked to reduced fetal growth. Some studies suggest a link between increased parental lead exposure and congenital malformations, although considerable uncertainty remains regarding the specific malformations and the dose-response relationships. Common methodological weaknesses of studies include potential exposure misclassifications due to the frequent unavailability of exposure biomarker measurements at biologically appropriate times and uncertainty regarding the best exposure biomarker(s) for the various outcomes. A special concern with regard to the pregnant woman is the possibility that a fetus might be exposed to lead mobilized from bone stores as a result of pregnancy-related metabolic changes, making fetal lead exposure the result of exposure to exogenous lead during pregnancy and exposure to endogenous lead accumulated by the woman prior to pregnancy. By reducing bone resorption, increased calcium intake during the second half of pregnancy might reduce the mobilization of lead from bone compartments, even at low blood lead levels. Subgroups of women who incurred substantial exposures to lead prior to pregnancy should be considered to be at increased risk. Birth Defects Research (Part A) 73:409-420, 2005.

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Section: Population Subgroups At Increased Riskmentioning

confidence: 73%

Section: Population Subgroups At Increased Riskmentioning

confidence: 99%

Teratogen update: Lead and pregnancy

Bellinger

2005

Birth Defects Research

286

153

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“…Since this study shows geophagia to be particularly prevalent in pregnant women from countries elsewhere in Africa, similar measures may be of benefit across a large cross-section of the African continent, as well as in African diaspora communities across the globe. [13,20,21] …”

Section: Discussionmentioning

confidence: 99%

A cross-sectional analytical study of geophagia practices and blood metal concentrations in pregnant women in Johannesburg, South Africa

Mathee¹,

Naicker

Kootbodien

et al. 2014

S Afr Med J

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Background. Geophagia, a form of pica, has been shown to be widely practised in sub-Saharan Africa, especially among pregnant women. Objective. To assess the prevalence of geophagia and examine exposure to selected metals and associated risk factors in women attending an antenatal clinic at Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa, during June and July 2010. Methods. We conducted a cross-sectional study on a convenience sample of 307 pregnant women, ranging in age from 18 to 46 years. Structured interviews were conducted to understand geophagia practices. Blood samples were collected to determine haemoglobin values and concentrations of arsenic, cadmium, mercury and lead. Statistical analyses using the χ 2 test, Wilcoxon's rank-sum test and logistic regression analyses were performed as appropriate. Results. Mean parity was 1.4 and the mean (standard deviation) gestational age 30.3 (6.0) weeks. Geophagia was reported by 60 women (19.5%), and the majority purchased soil from street vendors (83.3%). The prevalence of anaemia in the study sample was 16.9% (95% confidence interval 13.1 -21.6%). Geophagic women had significantly higher blood lead levels than non-geophagic women (2.1 v. 1.4 µg/dl; p<0.001). Anaemia, the use of African traditional medicines and craving of non-nutritive substances in a previous pregnancy were associated with geophagia. Conclusions. Geophagia is practised by a considerable proportion of pregnant women in Johannesburg, especially migrant women. Greater vigilance in respect of pica, especially geophagia, may be needed as part of antenatal care programmes to avoid potentially detrimental health effects of the practice.

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“…A number of studies have identified immigrant status as a primary risk factor for lead poisoning in women and young children in the United States (Klitzman et al 2002;Tehranifar et al 2008). Immigrant status is a risk fac tor for blood lead levels much higher than concurrent blood lead levels in U.S. women of childbearing age in at least three ways.…”

Section: Recent Immigration To the United Statesmentioning

confidence: 99%

“…None of the women were exposed to lead at work. Klitzman et al (2002) reported on thirty-three pregnant women in New York City with blood lead levels of 20 µg/dL or higher identified from 1996-1999 by the New York City Department of Health and Mental Hygiene blood lead surveillance program. Ninety percent of individuals were foreign born, the majority being from Mexico (57%), with a median time in the United States of 6 years (range 1 month to 20 years).…”

Section: Recent Immigration To the United Statesmentioning

confidence: 99%

Chronic Ayurvedic medicine use associated with major and fatal congenital abnormalities

Wong

Dargan

Koutsogiannis

et al. 2015

Medical Journal of Australia

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Lead Poisoning Among Pregnant Women in New York City: Risk Factors and Screening Practices

Abstract: This article presents information on pregnant women with incident blood lead levels (BLLs) of 20 µg per deciliter or greater as reported to the New York City Department of Health between September 1996 and June 1999 (n = 33)

Cited by 35 publications

References 22 publications

Teratogen update: Lead and pregnancy

Teratogen update: Lead and pregnancy

A cross-sectional analytical study of geophagia practices and blood metal concentrations in pregnant women in Johannesburg, South Africa

Chronic Ayurvedic medicine use associated with major and fatal congenital abnormalities

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