Frequency of maternal blood lead follow-up testing during pregnancy

Venous* blood lead level (BLL; microgram/dL)	Perform follow-up test(s)^¶
<5	None (no follow-up testing is indicated).
5 to 14	Within 1 month. Obtain a maternal BLL^Δ or cord BLL at delivery.
15 to 24	Within 1 month and then every 2 to 3 months. Obtain a maternal BLL^Δ or cord BLL at delivery. More frequent testing may be indicated based on risk factor history.
25 to 44	Within 1 to 4 weeks and then every month. Obtain a maternal BLL^Δ or cord BLL at delivery.
≥45	Within 24 hours and then at frequent intervals depending on clinical interventions and trend in BLLs. Consultation with a clinician experienced in the management of pregnant women with BLLs in this range is strongly advised. Obtain a maternal BLL or cord BLL at delivery.

* Venous blood sample is recommended for maternal blood lead testing.
¶ The higher the blood lead level on the screening test, the more urgent the need for confirmatory testing.
Δ If possible, obtain a maternal blood lead level before delivery because blood lead levels tend to increase over the course of pregnancy.

Reproduced from: Centers for Disease Control and Prevention. Guidelines for the identification and management of lead exposure in pregnant and lactating women. Available at: https://www.cdc.gov/nceh/lead/publications/leadandpregnancy2010.pdf (Accessed on March 24, 2021).
Supported by:

Committee on Obstetric Practice. Committee opinion No. 533: lead screening during pregnancy and lactation. Obstet Gynecol 2012; 120:416. Reaffirmed 2018.

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Frequency of maternal blood lead follow-up testing during pregnancy