Sociodemographic and maternal predictors of elevated blood lead levels during pregnancy in Adjara, Georgia

Background: Exposure to lead is a major public health concern throughout the world, particularly for susceptible groups such as pregnant women and children. Despite recent declines in blood lead levels (BLLs), lead exposure remains a health issue in Georgia. The present study was designed to identify predictors of elevated BLLs in pregnant women in the Adjara region of Georgia. Methods: Data were collected from the state health program “Lead biomonitoring program of pregnant and breastfeeding women in Adjara” (2020–2023) and the Georgian Birth Registry. The study included 8203 women who gave birth to 8337 babies. BLL groups among pregnant women were defined as <5, 5–9.99, and ≥10 µg/dL. Differences in characteristics between BLL groups were assessed with a chi-square test for categorical data and analysis of variance for continuous data. Multivariable logistic regression was used for identifying predictors of elevated BLL. Results: In the study sample, 50.5% of the subjects had BLLs <5 µg/dL, 35.5% had BLLs 5–9.99 µg/dL, while 14.0% had BLLs ≥10 µg/dL. Women with primary school as their highest completed education (adjusted odds ratio [aOR] = 1.65, 95% confidence interval [CI] = 1.19, 2.30) were more likely to be associated with BLLs ≥5 µg/dL compared with those with higher education. Obesity versus normal weight (aOR = 1.32, 95% CI = 1.15, 1.51) was significantly associated with BLLs ≥5 µg/dL. Living in a rural area was associated with slightly higher odds of BLLs of ≥5 µg/dL (aOR = 1.25, 95% CI = 1.13, 1.29). BLL declined over the testing period. Conclusion: Elevated BLLs in pregnant women in Adjara remain an important public health issue. Low education, obesity, rural residency, and timing of BLL testing were significantly associated with BLLs ≥5 and ≥10 µg/dL. According to these findings, continued surveillance is required for interventions to reduce lead exposure in vulnerable populations.