The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65815

Sunita Q. Miles, BS, Laura L. Jelliffe-Pawlowski, PhD, Joseph G. Courtney, PhD, and Valerie Charlton, MD, MPH. Childhood Lead Poisoning Prevention Branch, California Department of Health Services, 1515 Clay Street, Suite 1801, Oakland, CA 94612, 510-622-2045, squick1@dhs.ca.gov

The compulsive ingestion of non-food substances containing lead (pica) is known to occur in pregnant and nursing women. Elevated blood-lead levels (EBLL’s) among pregnant women with pica could potentially result in high infant lead levels, leading to cognitive and developmental abnormalities. As part of a pilot study of lead poisoning among pregnant women and their children based on California data from 1992-2002, the California Department of Health Services, Childhood Lead Poisoning Prevention Branch (CLPPB) identified 43 cases of childhood lead poisoning (EBLL ≥ 15µg/dL, range = 15 to 114 µg/dL) where maternal pica behavior during pregnancy appeared to be a source of lead poisoning. Report of pica behavior during pregnancy was obtained as part of a nursing investigation done in response to a laboratory report of an elevated EBLL for the child (age range 0-days to 12.6 years, mean age at testing = 9.5 months). Common reasons given for pica behavior during pregnancy were having “learned it” (typically “in Mexico”) or having “craved” the substance. Other additional lead hazards were noted in the majority of pica-reporting households (n = 27, 62.7%). Most of the maternal pica cases were Hispanic (n = 42, 97.7%), were living in Los Angeles (n = 20, 46.5%), and were from neighborhoods where most housing was built before 1980 (n = 33, 76.7%). The study highlights the need for increased awareness of pica as a contributing source of lead poisoning in pregnancy, often associated with additional lead hazards, particularly in Hispanic women with specific cultural practices.

Learning Objectives:

At the conclusion of the session, the participant will be able to:
• Describe non-food items ingested by women with maternal pica behavior.
• Identify demographic groups with the highest risk for maternal pica behavior.
• Understand the importance of increased awareness of maternal pica as a contributing source of childhood lead poisoning.

Keywords: Lead, Hispanic

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.