ABSTRACT: Excessive lead exposure, not only from lead-based paint in older homes, but also in yard soils, remains a public health problem in America despite centuries of knowledge of the poisonous nature of lead. Heightened concern about communitywide lead exposure has followed recent research findings that show lead to be toxic at levels previously thought to have no effect. Because mothers and children have been considered to be at particular risk, pregnant women and those responsible for perinatal care require greater understanding of the sources and effects of lead.

In a study of 4354 women, the risk of pregnancy hypertension and of congenital anomalies doubled as umbilical cord lead levels increased from about 1 to 10 μg per dL. A subgroup of about 240 was further studied for environmental sources of lead and follow-up of the children's development. This is a continuing longitudinal study; many of its published results are summarized here, with information from other studies. The effects of pregnancy on lead metabolism are also discussed.