Date: December 2016, Version 2a

What is lead and how might I be exposed to it?

Lead is a heavy metal that occurs naturally at low levels in soil, air, and water. Consequently, a small amount of lead is detectable in most people’s blood and this generally does not cause problems.

Exposure to high levels of lead is toxic and can cause illness and problems with the brain and nervous system. High level lead exposure can occur through contact with dust from the removal of lead-containing paint, use of some ethnic medicines and cosmetics such as traditional kohl eyeliners, and occasionally drinking water supplied through old lead water pipes. People who work with wood preservatives, pesticides, dyes, varnishes, catalysts, waterproofing chemicals, or paint and pottery glazes may also be at risk of being exposed to high levels of lead.

What are the risks of high level lead exposure during pregnancy?

Exposure to high levels of lead in pregnancy has been linked to miscarriage, reduced growth of the baby in the womb, and premature labour. High lead levels can also affect the development of a baby’s brain and nervous system causing permanent problems with learning as the child gets older.

How can I avoid high level lead exposure during pregnancy?

It is recommended that pregnant women avoid activities with a risk of high levels of lead exposure. If they cannot (for example at work), then use of personal protective equipment to limit the exposure is advised. The use of traditional medicines and cosmetics is not recommended, especially where the ingredients are unknown and/or the products may be unregulated (such as unbranded items bought on the internet).

What if I think I have been exposed to high levels of lead during pregnancy?

If you think you may have been exposed to a high level of lead, you are advised to speak to your doctor, who will arrange blood tests. If a high level of lead is found, the local public health team will offer advice, including on how to avoid further lead exposure.

Is there any treatment for high lead levels?

Yes, women with high blood lead levels may be offered a medicine called a chelating agent to help remove the lead from the body. Although there is not much information on use of chelating agents in pregnancy, they do not appear to be harmful to a baby in the womb, In any case, the benefits of reducing high lead levels during pregnancy are likely to outweigh any possible risk posed by these medicines. Pregnant women can discuss the possible risks and benefits of treatment with their doctor.

Will my baby need extra monitoring during pregnancy?

As part of their routine antenatal care most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

If blood tests have shown high levels of lead during pregnancy, additional monitoring to check that the baby is growing as expected is likely to be offered, as well as further blood tests to ensure that lead levels are returning to normal.

Are there any risks to my baby if the father has been exposed to high levels of lead?

There is some evidence that that miscarriage and reduced growth of the baby in the womb may be more likely in pregnancies where the father had high blood lead levels around the time of conception. However, more research is required to confirm this finding.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.