The Effects of Lead Exposure During Pregnancy, and Why African-American Children Have The Highest Levels in the U.S.

 A 2017 study has described the current state of lead exposure as a "crisis", and has expressed a dire need for everyone to better understand exposure to environmental toxins, particularly in higher risk groups. Those higher risk groups, unfortunately being African-Americans. This study noted that African-American children have the highest prevalence of elevated blood levels in the United States. The researchers suggest that this disproportionate lead exposure may be due a multitude of reasons, but one of the main reasons that they mention is that many African-Americans are living in urban areas, where the pollution is high (Cassidy-Bushrow et al., 2017).  

The other purpose of this study was to try to find out when exactly the first lead exposure happens. Is it during pregnancy? Is It during childhood? When is the earliest that we can detect lead exposure in a human's life? The researchers found that lead exposures may in fact be detected during pregnancy. After testing lead levels in 71 pregnant African-American women, the researchers noted that the children of those women had 2.2 times higher lead levels in the second and third trimesters, and 1.9 times higher lead levels postnatally in the first year of life, as compared to the children of the pregnant white women they tested (Cassidy-Bushrow et al., 2017).  That means that the babies they tested had been exposed to lead even before they were born, potentially contributing to some adverse effects during development and persisting into early childhood.  

The American College of Obstetrics and Gynecologists (ACOG) specifies that lead can cross the placenta, which means that it can be transferred from Mamma to baby. It has even been detected in the fetal brain as early as the end of the first trimester.  

According to the ACOG (2019), prenatal lead exposure has known adverse effects on maternal health and infant outcomes across a wide range of maternal blood lead levels. 

*Here are some of the potential adverse effects of lead exposure during pregnancy, according to the ACOG:  

• Gestational hypertension 

• Spontaneous abortion 

• Low birth weight 

• Impaired neurodevelopment  

•  The ACOG’s main recommendations for pregnant women with elevated blood lead levels are:

• Women with 5 micrograms/dL or higher should:  

  1. Try to identify their exposure and prevent further exposure.  

  2. Consider supplementing with calcium and iron, as they may help to decrease lead levels.  

• Women with confirmed blood lead levels of 45 micrograms/dL or more should be treated in consultation with clinicians experienced in the management of lead toxicity and high-risk pregnancy. 

•  A breastfeeding woman with a confirmed blood lead level of 40 micrograms/dL or higher should be advised to pump and discard her breast milk until her blood lead level has decreased to less than 40 micrograms/dL. 

•  If no external source is identified, and the maternal blood lead level is greater than 20 micrograms/dL and the infant blood lead level is 5 micrograms/dL or more, it is suggested that breastfeeding should be temporarily stopped until the maternal blood lead level goes down.

*Here are some potential risk factors for lead exposure (according to the ACOG, 2019):  

• Recent emigration from or residency in areas where ambient lead contamination is high—women from countries where leaded gasoline is still being used (or was recently phased out) or where industrial emissions are not well controlled. 

• Living near a point source of lead—examples include lead mines, smelters, or battery recycling plants (even if the establishment is closed). 

• Working with lead or living with someone who does—women who work in or who have family members who work in an industry that uses lead (eg, lead production, battery manufacturing, paint manufacturing, ship building, ammunition production, or plastic manufacturing). 

• Using lead-glazed ceramic pottery—women who cook, store, or serve food in lead-glazed ceramic pottery made in a traditional process and usually imported by individuals outside the normal commercial channels. 

• Eating nonfood substances (pica) —women who eat or mouth nonfood items that may be contaminated with lead, such as soil or lead-glazed ceramic pottery. 

Though it may be hard for people to change where they live, being aware of the potential dangers of lead exposure may give women opportunity to reduce it as much as possible in their own lives. At Cha Cha Mamma, we envision a world where every woman, no matter her race, her class, her education level, or any other factor, should have access to reliable and easy-to-follow information regarding her own health and the health of her children. This is our time to educate ourselves, and to do better in support of the black community.