Pregnant women who eat dirt or other non-food items, a practice known as "pica" that is found among some women from Mexico and the Caribbean, could be at an increased risk of lead poisoning, Long Island Newsday reports. As lead can "pas[s] freely across the placenta" and harm the fetus, the consumption of dirt and other non-food items that may contain lead, such as pottery, could lead to stillbirth, low birthweight and developmental disabilities in the fetus. Two recent studies of the practice among pregnant women in New York demonstrate that doctors should be made more aware of the issue and consider testing all pregnant women for lead, according to Newsday. In one study, conducted by the New York City Department of Health and Mental Hygiene, researchers interviewed 32 women who were pregnant between 1996 and 1999 and at the time had "severely elevated" blood lead levels -- more than 20 micrograms per deciliter. Thirty of the women were immigrants and 13 of them had practiced pica. The other cases were attributed to the use of lead-based pottery for cooking or to eating lead-contaminated imported food. Of the 13 women who engaged in the practice, eight said they had eaten dirt, two said they had eaten "pulverized" pottery and two others said they had eaten both dirt and pottery. Jessica Leighton, assistant commissioner of the health department's bureau of environmental disease, said, "There really wasn't a lot of data on this and we wanted to start monitoring it. The most important point we wanted to get across was that doctors need to be talking to pregnant women more carefully about lead."

Case Study
In a case study published in the January issue of the Journal of Midwifery & Women's Health, a pregnant woman from Jamaica living in New York who engaged in pica was found to have a blood-lead level of 26 micrograms per deciliter -- a "dangerous level." Anne Katz-Jacobson, a midwife at the North Central Hospital in New York City and co-author of the case study, said that the woman was counseled to stop eating dirt. She added, "I try to respect their culture, but also tell them how it is hurting them and their baby." Currently, New York requires hospitals and clinics to question pregnant women about their lead exposure and to conduct blood tests on women at risk, Newsday reports. However, several health advocates say that all hospitals and clinics should test everyone. Dr. John Rosen of New York's Montefiore Medical Center's lead clinic said, "The law is not being implemented as vigorously as it should be, nor is the screening" (Ramirez, Long Island Newsday, 3/9).