Examining pica in NYC pregnant women with elevated blood lead levels.
We sought to describe the impact of pica, the craving for and intentional ingestion of substances not defined as food, as a risk factor for lead poisoning in New York City (NYC) pregnant women. In order to describe pregnant women with elevated blood lead levels (BLLs) who report pica, NYC health department data from 491 cases of lead-poisoned pregnant women from January 2001 to June 2009 were reviewed. Descriptive frequencies were obtained for women reporting pica. Data were compared between women reporting and not reporting pica. In NYC, of the 43 (9%) lead-poisoned pregnant women reporting pica, 42 (97.7%) were immigrants and 28 (64.6%) had consumed soil. Compared to lead-poisoned pregnant women not reporting pica, women reporting pica had higher peak BLLs (29.5 vs. 23.8 μg/dL, P = 0.0001), were more likely to have had a BLL ≥ 45 μg/dL (OR = 3.3, 95% CI, 1.25, 8.68) and receive chelation (OR = 10.88, 95% CI, 1.49, 79.25), more likely to have emigrated from Mexico (OR = 3.05, 95% CI, 1.38–6.72), and less likely to have completed high school (OR = indeterminate; 0 vs. 34%; P = 0.003). Among NYC lead-poisoned pregnant women, pica was associated with higher peak BLLs. Providers in NYC, and possibly other urban settings, should be vigilant and question pregnant women, especially immigrants, about pica and strongly consider testing this at-risk population for lead poisoning.
Bureau of Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY 11101-4132, USA. sthihalo@health.nyc.gov
Sayone
S
Thihalolipavan
Barbara M
BM
Candalla
Jacqueline
J
Ehrlich
D000328:Adult; D016001:Confidence Intervals; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data; D004785:Environmental Pollutants / Q000097:blood; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000453:epidemiology / Q000209:etiology*; D018811:Maternal Exposure / Q000706:statistics & numerical data; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D010842:Pica / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D037841:Pregnant People; D012307:Risk Factors; D055815:Young Adult
D004785:Environmental Pollutants; D007854:Lead