Table 2.
Comparison of blood lead levels in women of childbearing age from developed and other developing countries.
| References | Country (City) | Year of survey | Age (Years) |
Sample size (n) |
Mean ± SD (Range) BLL (μg/dl) | BLL ≥10 μg/dl (%) | Population description | Exposure Source(s) | Exposure effect(s) | Risk factors for elevated BLL |
|---|---|---|---|---|---|---|---|---|---|---|
| DEVELOPED COUNTRIES | ||||||||||
| McMichael et al. (58) | Australia (Port Pirie) | 1979–1982 | NR | 512 | 11.2 ± 2.1 | NR | Port Pirie pregnant women | Lead Smelter | Positive association with pre-term | NR |
| 150 | 7.5 ± 0.25 | Non- Port Pirie pregnant women | delivery. | |||||||
| Flanigan et al. (59) | USA | 1988–1989 | 15–44 | 541 | 7.9a | 26.8 | Pregnant women | NR | NR | NR |
| 315 | 8.8a | 34.5 | Non-pregnant women of childbearing age | |||||||
| West et al. (60) | USA (Columbia) | 1985–1990 | 16–35 | 97 | 6.36 ± 0.19 (2.7–12.6) | NR | African American pregnant women attending prenatal clinics | NR | No association with birth weight | NR |
| Sowers et al. (27) | USA (New Jersey) | NR | 12–34 | 705 | 1.2a | NR | Pregnant women in prenatal clinic | NR | Positive association with hypertension in pregnancy/toxemia |
NR |
| Schell et al. (61) | USA (Albany New York) | 1992–1998 | 23.5 ± 5.49 | 211 | 1.9 ± 1.68 | 0.47 | Women in 1st, 2nd trimester, 3rd trimesters, respectively from socioeconomically disadvantaged population |
NR | Positive association with newborn blood lead concentration | NR |
| 1.8 ± 1.63 | ||||||||||
| 1.8 ± 1.65 | ||||||||||
| Harville et al. (62) | USA (Pittsburgh) | 1992–1995 | NR | 140 | 1.96a 0.5–4.7 | None | Pregnant women in prenatal clinic | NR | NR | NR |
| Lee et al. (63) | USA | NR | 20–49 | 4394 | 1.78a | NR | Women of childbearing age in USA (NHANES) | NR | Inverse association with hematocrit | Inversely associated with poverty income ratio, education level, intake of thiamine. |
| Positively associated with ethnicity [Black, Hispanic], living in urban areas, age, alcohol consumption, cigarette smoking, serum protoporphyrin, and intake of pyridoxine, iron, and folate | ||||||||||
| Sanders et al. (64) | USA (North Carolina) | 2009–2011 | 15–43 | 211 | 0.890a | None | Pregnant women residing in North Carolina | NR | NR | Maternal county of residence and race |
| Taylor et al. (65, 66) | UK (Bristol) | 1991–1992 | 4,285 | 3.67 ± 1.47 (0.41–19.14) | NR | Pregnant women in ALSPAC STUDY | NR | Positively associated with preterm delivery, birth weight, head circumference and crown–heel length, but not on the incidence of low birth weight. | Positively associated with higher education attainment, cigarette smoking, alcohol and coffee drinking, and heating the home with a coal fire | |
| Canas et al. (67) | Spain | 2009–2010 | 18–45 | 700 | 1.8a | NR | Women of childbearing age in a general adult population study (BIOAMBIENTS project) | NR | NR | NR |
| King et al. (68) | USA | 2009–2011 | NR | 310 | 0.34b (0.16–0.83) | NR | Pregnant women | NR | NR | Living in urban environment |
| DEVELOPING COUNTRIES | ||||||||||
| Ong et al. (69) | Singapore | 1989 | NR | 36 | 5.3 ± 2.26 (1.4–9.9) | None | Pregnant women at delivery | NR | NR | NR |
| Awasthi et al. (70) | India (Lucknow) | NR | NR | 500 | 14.3a | 63.8 | Pregnant women living in slums of India | NR | NR | Living near heavy traffic road, Higher parity |
| Hisham et al. (71) | Malaysia | 1996 | NR | 97 | 8.59a | 27.8 | Pregnant women admitted for delivery. | NR | NR | Ethnicity: IndianBeing a house wife |
| Borja-Aburto et al. (35) | Mexico city | 1994-1996 | NR | 35 | 12.03a | NR | Pregnant women who had spontaneous abortion | NR | Positively associated with spontaneous abortion | NR |
| 60 | 10.09a | Pregnant women who did not have spontaneous abortion | ||||||||
| Srivastava et al. (72) | India (Lucknow) | NR | NR | 24 | 13.88 ± 8.1 (2.42–33.76) | 53 | Mothers whose babies had IUGR | NR | Positively associated with IUGR | NR |
| 10.29 ± 5.69 (2.64–25.02) | Mothers with normal babies | |||||||||
| Vigeh et al. (73) | Iran (Tehran) | NR | 17–40 | 55 | 4.8 ± 1.9 (1.9 −10.6) |
NR | Normotensive pregnant women in their 3rd trimester | NR | Positively associated with hypertension in pregnancy | NR |
| 5.7 ± 2 (2.2–12.6) | Hypertensive pregnant women in their 3rd trimester | |||||||||
| Magri et al. (28) | Malta | NR | 30 ± 6 | 30 | 9.6 ± 6 | Hypertensive pregnant women in their 3rd trimester | NR | Positively associated with blood pressure and hypertension in pregnancy | NR | |
| 27 ± 6 | 93 | 5.8 ± 3 | Normotensive pregnant women in their 3rd trimester | |||||||
| Kirel et al. (74) | Turkey (Eskisehir) | NR | NR | 143 | 2.8 ± 1.5 | NR | Pregnant women | NR | NR | NR |
| Lamadrid-Figueroa et al. (37) | Mexico city | 1997–2004 | 27.76 | 207 | 6.47 ± 4.9 | NR | Pregnant women who have had no previous miscarriages | NR | Plasma/whole blood Pb ratio associated with higher risk of miscarriages | NR |
| 5.8 ± 3.41 | Pregnant women who had ≥1 previous miscarriage(s) | |||||||||
| Lee et al. (75) | Korea | 2006–2007 | 32.6 ± 4.1 | 422 | 1.6 ± 0.77 | NR | Pregnant women at mid pregnancy | Consumption of meat and meat products | NR | NR |
| Vigeh et al. (76) | Iran (Tehran) | 2003–2004 | 16–35 | 332 | 4.61 ± 2.37 | Women with premature rupture of membrane | NR | Positively associated with premature rupture of membrane | NR | |
| 3.69 ± 1.85 | Women without premature rupture of membrane | |||||||||
| Vigeh et al. (77) | Iran (Tehran) | 2003–2004 | 16–35 | 348 | 3.8a (1.0–20.5) | Total number of pregnant women | NR | Positively associated with preterm birth | NR | |
| 304 | 3.72 ± 2.03 | Term birth | ||||||||
| 44 | 4.52 ± 1.63 | Preterm birth | ||||||||
| Rahman et al. (78) | Kuwait | NR | 17–42 | 194 | 5.8 ± 6.5 (0.2–41.8) | 28 | Pregnant women at delivery | NR | No association with birth weight, head circumference, Crown–heel length and gestational age. | NR |
| Tiwari et al. (79) | India (Lucknow) | 24–41 | 50 | 0.12 | NR | Pregnant women without anemia | NR | Positively associated with oxidative stress and anemia | NR | |
| 50 | 1.98 ± 0.13 | Mild anemia | ||||||||
| 50 | 2.61 ± 0.11 | Moderate anemia | ||||||||
| 25 | 3.62 ± 0.17 | Severe anemia | ||||||||
| Bakhireva et al. (80) | New Mexico | 2009–2010 | 26.1 ± 5.5 | 140 | NR | None | Pregnant women on ante-natal care in a clinic. | NR | NR | Pica symptoms |
| History of elevated BLLs before pregnancy | ||||||||||
| Use of non-commercial pottery | ||||||||||
| Living in older houses | ||||||||||
| Farhat et al. (81) | Iran | NR | NR | 60 | 7.59 ± 3.1 (2.3–20.8) | 13.3 | Mothers of exclusively fed infants | NR | NR | NR |
| Rahman et al. (82) | Bangladesh | 2008–2009 | 18–40 | 50 | 13.0 ± 4.52 | NR | Women with unexplained infertility | NR | Positive association with FSH level | NR |
| 7.83 ± 3.64 | Fertile women | |||||||||
| Motawei et al. (31) | Egypt (Dakahlia) | NR | 115 | 37.68 ± 9.17 | NR | Preeclamptic pregnant women | NR | Positive association with Preeclampsia | NR | |
| 25 | 14.5 ± 3.18 | Healthy pregnant women | ||||||||
| Lei et al. (44) | Taiwan | 2008–2010 | 18–45 | 367 | 1.73 ± 0.81 | Infertile women | NR | Positive association with infertility but not levels of reproductive hormones. | Use of Chinese herbal medicine | |
| 1.26 ± 0.46 | Fertile women | |||||||||
| Kim et al. (83) | South Korea (Busan) | 2013 | 22–46 | 142 | 1.02 ± 1.39 1.03 ± 1.34 |
NR | Pregnant women at 2nd trimester, delivery and 1 year after birth, respectively | NR | NR | NR |
| 1.08 ± 1.34 | ||||||||||
| Bayat et al. (32) | Iran (Zanjan) | 2015–2016 | 15–40 | 158 | 8.04 ± 3.4 | NR | Pre-eclamptic pregnant women | NR | Positive association with Preeclampsia | NR |
| 6.24 ± 1.74 | Normal pregnant women | |||||||||
| La-Llave-Leon et al. (84) | Mexico (Durango) | 2007–2008 | 24.32 ± 6.7 | 299 | 4.00 ± 4.08 | 8.7b | Occupationally exposed pregnant women | Occupationally exposure | NR | NR |
| 2.65 ± 1.75 | Non- Occupationally exposed pregnant women | |||||||||
| La-Llave-Leon et al. (85) | Mexico (Durango) | 2014–2016 | 13–43 | 633 | 2.09 ± 2.34 | 4.1b | Healthy pregnant women | NR | Negatively correlated with ALAD activity. | NR |
| (0.48–26.85) | ||||||||||
| Li et al. (86) | China (shanghai) | 2010 | NR | 1931 | 3-97a (0.8–14.84) | NR | Pregnant women in 28–36 weeks of gestation | NR | Positive but non-linear association with emotional stress | NR |
a
Geometric mean.
b
Prevalence of BLL ≥ 5 μg/dl.