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Lead poisoning among pregnant women in New York City: Risk factors and screening practices

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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). Almost half of the women were diagnosed during their third trimester of pregnancy, often at their first prenatal visit. The median BLLs at incidence and at last report among women who were retested were 25 and 15 γ/dL, respectively, a 40% decline. The median incident BLL among newborns (n=25) was 12 μg/dL. The BLLs were inversely associated with maternal age and length of time in the United States and directly associated with gestational age and pica behavior. Cases were more than twice as likely to be foreign-born women than all women who gave birth in New York City. Prenatal care facilities employing a policy of universal blood lead testing of all pregnant women at the time of their first visit reported disproportionate numbers of cases, accounting for 77% of cases yet only 11% of all births citywide. The findings suggest that (1) the promulgation of recent rules and guidelines for lead risk assessment and screening among pregnant women appears to have been effective in identifying cases that might not have otherwise come to light; (2) case management and environmental interventions were initiated promptly; (3) cases experienced, on average, significant BLL reductions over time; and (4) there is a need for additional public health interventions for pregnant women in urban, multicultural centers. While the data suggest that universal screening may increase case finding among high-risk, immigrant populations, further studies and surveillance are needed to determine systematically the most effective approach.

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Authors and Affiliations

  1. Urban Health Program, Hunter College in the City University of New York, 425 East 25th Street, 10010, New York, NY

    Susan Klitzman (Associate Professor)

  2. North Central Bronx Hospital, Bronx, New York

    Anu Sharma

  3. Breathnet, Inc., New York, New York

    Leze Nicaj

Authors
  1. Susan Klitzman
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  2. Anu Sharma
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  3. Leze Nicaj
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  4. Ramona Vitkevich
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  5. Jessica Leighton
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Corresponding author

Correspondence to Susan Klitzman.

Additional information

All authors were affiliated with the New York City Department of Health at the time of their work on this project.

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Klitzman, S., Sharma, A., Nicaj, L. et al. Lead poisoning among pregnant women in New York City: Risk factors and screening practices. J Urban Health 79, 225–237 (2002). https://doi.org/10.1093/jurban/79.2.225

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