Structural variables leading to childhood lead poisoning, teen pregnancy, and tobacco use

Social workers who work with pregnant teens tend to stress individual-level risk factors in preventing repeat pregnancies. This study analyzes the effects of childhood lead exposure (CLE) and the neighborhood context (macro-level variables) in which CLE occurs on 1,111 pregnant teenage females (age 15 to 19) in Syracuse, NY. A multilevel methodological approach integrating ethnographic epidemiology, and environmental methods were used to compare CLE with subsequent behaviors among the pregnant teens who had the highest levels of CLE (n=719). Two logistic regression analyses were performed in which CLE served as the independent variable and repeat birth served as the dependent variable in the first analysis and tobacco use as the dependent variable in the second while race and age served as control variables. CLE was found to be a risk factor for tobacco use and subsequent births. Among the mothers not receiving Medicaid, the odds of having an elevated CLE among smokers was 4.25 (CI 1.89, 9.57) times the odds of having an elevated CLE among non-smokers. Among those receiving Medicaid, the odds of CLE among smokers was 1.26 (CI 0.79, 2.03) times the odds of having an elevated CLE among non-smokers. The odds of CLE among those having a second pregnancy was 1.59 (CI 1.04, 2.43) times the odds of elevated CLE among those having their first child. The results indicate that repeat teen pregnancy and cigarette smoking are significantly associated with childhood lead poisoning, race (white females smoke more), and age (older teens have more repeat births).