Neonatal lead intoxication following maternal pica: A case report and review of the literature

Pica is a significant risk factor for lead exposure during pregnancy and may often go unrecognized. Lead exposure in the pregnant woman may be extremely toxic to the fetus due to unencumbered transport across the placenta. Long term neurological effects of in utero and neonatal lead exposure are largely unknown, and the efficacies of current therapies are controversial. We report a case of a pregnant woman with elevated blood lead levels secondary to pica that was not identified by a routine screening survey. Her full term baby girl had a blood lead level of 70.8 μg/dL. Neonatal therapy with double-volume exchange transfusion followed by a 3 day course of intravenous Edetate Calcium Disodium is described as well as the slow steady decline of her blood lead levels. Neurocognitive development to 18 months is also reported.

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