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Guidelines for the identification and management of lead exposure in pregnant and lactating women
  • Published Date:
    November 2010
Filetype[PDF - 4.25 MB]


Details:
  • Corporate Authors:
    CDC Work Group on Lead and Pregnancy ; National Center for Environmental Health (U.S.), Division of Emergency and Environmental Health Services. ;
  • Description:
    Preface -- Executive summary -- Summary of public health actions based on maternal and infant blood lead levels -- Members of the Work Group on Lead and Pregnancy -- Acknowledgments -- Members of the Advisory Committee on Childhood Lead Poisoning Prevention -- Glossary . -- 1. Introduction -- 2. Adverse health effects of lead exposure in pregnancy -- 3. Biokinetics and biomarkers of lead in pregnancy and lactation -- 4. Distribution of BLLs, risk factors for and sources of lead exposure in pregnant and lactating women -- 5. Blood lead testing in pregnancy and early infancy -- 6. Management of pregnant and lactating women exposed to lead -- 7. Nutrition and lead in pregnancy and lactation -- 8. Chelation of pregnant women, fetuses, and newborn infants -- 9. Breastfeeding -- 10. Research, policy, and health education recommendations -- 11. Resources and referral information --

    "Lead exposure during pregnancy and breastfeeding can result in lasting adverse health effects independent of lead exposure during other life stages. However, to date there has been limited guidance available for clinicians and the public health community regarding the screening and management of pregnant and lactating women exposed to high levels of lead. Recognizing the need for national recommendations, the Centers for Disease Control and Prevention and the Advisory Committee on Childhood Lead Poisoning Prevention convened a workgroup of recognized experts to review the existing evidence for adverse effects of past and current maternal lead exposure on maternal health and fertility and on the developing fetus, infant, and child in prenatal and postnatal states and to propose evidence-based strategies for intervention. These Guidelines for the Identification and Management of Lead Exposure in Pregnant and Lactating Women are based on scientific data and practical considerations regarding preventing lead exposure during pregnancy, assessment and blood lead testing during pregnancy, medical and environmental management to reduce fetal exposure, breastfeeding, and follow up of infants and children exposed to lead in utero. The guidelines also outline a research agenda that will provide crucial information for future efforts to prevent and treat lead exposure during pregnancy and lactation. Further research is needed for a better understanding of lead's effect on pregnancy outcomes and infant development; lead kinetics across the placenta and in breast milk and their relationship to long-term health effects; genetic susceptibility to damage from lead; as well as the pharmacokinetics, effectiveness, and safety of chelating agents in the pregnant woman. Research is also needed to address important clinical and public health needs including validation of risk questionnaires for pregnant women, optimal timing of blood lead testing, and effective strategies for identification and treatment of pica in pregnant women." - p. i

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