Lead - Reproductive and Developmental Impacts

Tools to help you talk to your patients about reproductive and developmental impacts from lead.

Patient Handouts and Education

Provider Resources

Evidence-based Messaging

Reprinted from the American Journal of Obstetrics and Gynecology, Vol 207 (6), Sheela Sathyanarayana, MD MPH et al., Environmental exposures: how to counsel preconception and prenatal patients in the clinical setting, pages: 463-470, 2012 with permission from Elsevier.


Key Points

  • Lead is neurotoxic to the developing fetus.
  • Risk factors for lead exposure include recent immigration to the United States, pica practices, occupational exposure, culturally specific practices that include the use of traditional remedies, imported cosmetics, the use of lead-glazed pottery, and renovating or remodeling a home that was built before 1978.
  • Women at high risk for lead exposure should be screened with a venous blood lead level test.
  • A maternal blood lead level as low as 10 g/dL and under is associated with an increased risk of impaired fetal growth and neurodevelopment; higher blood lead level concentrations are associated with birth defects, spontaneous abortion, and gestational hypertension.
  • A pregnant woman with a blood lead level of 5 g/dL should be counseled to reduce exposure and have follow-up testing.
  • A pregnant woman with a blood lead level of 10 g/dL should be counseled to reduce exposure, to have follow-up testing, and be referred to a local health department for home investigation of lead sources.
Exposure Reduction
  • Never eat or mouth nonfood items (such as clay, soil, pottery, or paint chips) because they may be contaminated with lead.
  • Avoid jobs or hobbies that may involve lead exposure and take precautions to avoid take-home lead dust if a household member works with lead (eg, construction or home renovation/repair in pre-1978 homes and lead battery manufacturing or recycling).
  • Stay away from repair, repainting, renovation, and remodeling work being done in homes built before 1978 to avoid possible exposure to lead-contaminated dust from old lead-based paint; avoid exposure to deteriorated lead-based paint in older homes; have water tested if you suspect lead contamination from wells or solder in pipes.
  • Eat a balanced diet with adequate intakes of iron and calcium.
  • Avoid alternative cosmetics, food additives, and medicines that were imported from overseas.
  • Shoes should be removed at the door to prevent tracking in lead and other pollutants.
  • Reproductive health providers can use the evidence-based guidelines published in 2010 by the Centers for Disease Control and Prevention (www.cdc.gov/nceh/lead/publications/Leadandpregnancy2010.pdf) for further information on health impacts of prenatal lead exposure, biomarker measurement, and prevention/management.
  • Reproductive health providers with pregnant patients with blood lead levels of 20 g/dL should contact a toxicologist at their local poison control center (http://www.aapcc.org) or an occupational and environmental medicine physician/pediatric environmental health specialist (www.aoec.org) for advice on testing and chelation.

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