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.