Lead and Pregnancy Work Group Charge

Research findings suggest that prenatal exposure to lead can adversely affect child health across a wide range of maternal lead levels, as measured by blood or bone methods of analysis. A limited number of publications are available to guide the clinician regarding: 1) assessment and screening of pregnant women for lead exposure; 2) evaluation of sources of lead exposure and lead poisoning; 3) management of elevated blood lead levels in pregnant women; 4) addressing the cultural and behavioral issues influencing lead poisoning in pregnant women; and 5) recommendations for breast feeding in the face of elevated maternal lead levels.

There are currently no national recommendations that cover lead risks and management during pregnancy and lactation by any obstetric or pediatric groups. Currently, New York is the only known state to issue guidelines for lead risk assessment and screening for prenatal care providers. Other states may be considering implementation of similar guidelines, with apparently limited scientific discussion of these issues.

The Lead and Pregnancy Work Group will review the existing evidence for adverse effects of past and current maternal lead exposure on maternal fertility and on the developing fetus, infant and child in prenatal and postnatal states. The work group will then evaluate the data and issue recommendations regarding 1) prevention of lead exposure for women of child-bearing ages and pregnant women, 2) risk assessment and screening of pregnant women, 3) medical and environmental management, 4) breast feeding, and 5) follow-up of infants and children of mothers with elevated blood lead levels. It will also describe data gaps and make recommendations for further research and health education needs in this field. The work group will create, in conjunction with the committee, a summary of the evidence and recommendations for publication.