Lead Level ≥5 µg/dL and Neurodevelopmental Outcomes of Preterm Infants at Five Years of Age.

Introduction: Prior studies have not examined blood lead levels (BLL) in the preterm population relative to their developmental and behavioral outcomes.

Methods: Neonatal demographic and clinical characteristics and results on scales of intelligence, development, and behavior were compared between children born ≤32 weeks gestation (n=354) with detected lead levels in childhood of ≥5 µg/dL (n=37, 10%) and <5 µg/dL (n=317, 90%).

Results: The 10% rate of BLL ≥5 µg/dL for this cohort was higher than rates previously reported for the general population, and was associated with low SES. Preterm infants with a lead level of ≥5 µg/dL were twice as likely to score in the borderline to clinical range for sleep problems on the Childhood Behavioral Checklist.

Conclusions: Robust screening and follow-up may protect against negative developmental outcomes in the setting of elevated lead levels. The association of higher lead levels with poor sleep supports continued lead screening efforts and appropriate support services for preterm children.