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A national survey of 1,932 pregnant women in Bangladesh found that 17.7% had blood lead levels at or above 3.5 micrograms per deciliter, with a geometric mean of 2.05 micrograms per deciliter. Blood lead elevation varied dramatically by geography, with Greater Dhaka accounting for 64% of women with levels at or above 5 micrograms per deciliter despite holding only 12% of the pregnant population. Maternal blood lead levels were associated with elevated lead in children living in the same household, though most exposed children lived with women below the analytical cutoff.
Why it matters
These findings identify Greater Dhaka as a priority area for investigating lead exposure sources and implementing targeted screening programs for pregnant women and young children. The association between maternal and child lead levels suggests household-level exposures that could be addressed through public health interventions, while the lack of association with expected sources like cosmetics or batteries indicates unknown exposure pathways requiring investigation.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Background. Lead crosses the placenta and harms the developing brain, and no safe level is known. Bangladesh lacks national estimates of lead exposure in pregnancy. Objectives. We estimated blood lead in pregnant women nationally, described where and in whom it was raised, and examined links with child lead and haemoglobin. Methods. In the Bangladesh Multiple Indicator Cluster Survey 2025, 1,932 of 2,711 eligible pregnant women (71%) had valid venous blood results. Survey-weighted modified Poisson models estimated prevalence ratios (PR) for blood lead of 3.5 microgram/dL or more, an analytical cut-off. We also studied 540 households with a tested child aged 12 to 59 months. Results. Among tested women, geometric mean blood lead was 2.05 microgram/dL (95% CI 1.99 to 2.12). In all, 17.7% (15.7 to 19.9) had 3.5 microgram/dL or more and 7.6% (6.1 to 9.3) had 5 microgram/dL or more. Greater Dhaka, defined after inspecting district estimates, held 12% of pregnant women but 64% (54 to 73) of those at 5 microgram/dL or more. The richest quintile had a crude PR of 3.06 (2.02 to 4.63, P<0.001), attenuated to 1.09 (0.72 to 1.67, P=0.678) after adjustment for place. No clear association was seen with cosmetics, indoor smoking or nearby battery sites. A woman’s lead of 3.5 microgram/dL or more was associated with child lead of 5 microgram/dL or more (adjusted PR 1.50, 1.16 to 1.96, P=0.002). This cut-off identified only 23% (16 to 30) of them. Conclusions. Raised blood lead in pregnancy varied sharply by place and was highest in greater Dhaka. The crude wealth association was markedly attenuated after adjustment for place. Maternal lead was linked with child lead, but most exposed children lived with women below the cut-off. These findings support source investigation in greater Dhaka and evaluation of targeted lead assessment for women and children.