Inadequate prenatal care and elevated blood lead levels among children born in providence, Rhode Island: A population-based study

Objective. This study was conducted to determine whether children born to mothers receiving inadequate prenatal care are at an increased risk for having an elevated blood lead level during early childhood. Methods. The authors conducted a population-based study of children born in Providence, Rhode Island, from 1997 to 2001 whose mothers had received adequate, intermediate, or inadequate prenatal care. The children's blood lead levels were compared between groups using bivariate and logistic regression. To understand the regulatory implications and public health impact of changing the definition of an elevated blood lead level, "elevated" was defined as 5 mu g/dL, 10 mu g/dL, and 15 mu g/dL. Results. Children born to mothers who received inadequate prenatal care were at an elevated risk for having an elevated blood lead level later in life. This relationship remained statistically significant for each definition of elevated blood lead level and after controlling for other socio-economic status measures and birthweight (at 5 mu g/dL, odds ratio [OR] = 1.36, 95% confidence interval [CI] 1.09, 1.68, p = 0.006; at 10 mu g/dL, CR = 1.68, 95%CI 1.26, 2.24, p < 0.0004; at 15 mu g/dL, OR = 1.83, 95%CI 1.10, 3.04, p = 0.019) represent an opportune moment to identify expectant mothers living in lead-contaminated environments. Conclusions. Results suggest that conducting lead screening as a regular part of prenatal care provision could help identify women possibly experiencing ongoing lead exposure and help reduce or prevent exposures to their offspring.