Assessment of Blood Lead Levels in Mothers Addicted to Opium and Their Neonates in Kerman: A Cross-sectional Study

Document Type : Original Article


1 Department of Pediatrics, Afzalipoor Hospital, Kerman University of Medical Sciences, Kerman, Iran

2 Department of Pediatrics, Bam University of Medical Sciences, Bam, Iran



Background: High blood lead levels (BLLs) in pregnant women are associated with poor outcome in neonates. One of the 
newest non-occupational sources of lead contamination is opium consumption. Accordingly, this study aimed to assess BLLs in 
mothers addicted to opium and their neonates in Kerman. 
Methods: This cross-sectional was conducted in Afzalipour hospital in Kerman, from February 2019 to February 2020. The BLLs 
were measured in 100 opium-addicted and non-addicted mothers and their newborns, and the lead levels higher than 5 μg/dL 
were considered contamination. Then, the demographic and anthropometric data were compared.
Findings: Based on the results of the present study, the BLLs of opium-addicted mothers (33.40±9.22 μg/dL vs 3.2±1.5 μg/dL) and 
their neonates (13.46±4.86 vs 1.1±0.9) were significantly higher (P=0.001) than those of non-addicts. Moreover, the average 
birth weight of the newborns in the addicted group was significantly lower than in the non-addicted group (2572.8±77.49 
vs 2946±46.87) (P=0.001). Besides, there was a significant relationship between the average birth weight and the BLL of the 
mother and baby, and the average weight of the babies was significantly lower at higher levels of lead. However, no correlation
was observed regarding the average height and head circumference of the neonates (P>0.05).
Conclusion: It seems that the serum level of lead in neonates of opium-addicted mothers contaminated with lead is significantly 
higher than that of non-addicts, but their anthropometric characteristics at birth were not different from those of the nonaddicted group. 


Fatemeh Sabzevari: (Google Scholar) (PubMed)

Maryam Ahmadipour: (Google Scholar) (PubMed)

Najmeh Nezamabadipour: (Google Scholar) (PubMed)

Abbas Jahanara: (Google Scholar) (PubMed)


1. Alarcon WA. Summary of notifiable noninfectious conditions 
and disease outbreaks: elevated blood lead levels among 
employed adults - United States, 1994-2012. MMWR Morb 
Mortal Wkly Rep. 2015;62(54):52-75. doi: 10.15585/mmwr.
2. Martins E, Varea A, Apezteguía M, González HF, Girardelli 
A, Caro LS, et al. Prenatal lead exposure and relationship 
with maternal exposure determinants in a public maternity 
hospital of La Plata, Argentina. Sci Total Environ. 2014;473-
474:43-7. doi: 10.1016/j.scitotenv.2013.11.128.
3. Golmohammadi T, Ansari M, Nikzamir A, Safary R, Elahi S.Association of lead concentration in colostrum, maternal and 
cord blood with newborn weight in polluted vs. non-polluted 
areas of Iran. Tehran Univ Med J. 2007;65(8):74-8. [Persian].
4. Hu H, Téllez-Rojo MM, Bellinger D, Smith D, Ettinger AS, 
Lamadrid-Figueroa H, et al. Fetal lead exposure at each stage 
of pregnancy as a predictor of infant mental development. 
Environ Health Perspect. 2006;114(11):1730-5. doi: 10.1289/
5. Masoodi M, Zali MR, Ehsani-Ardakani MJ, MohammadAlizadeh AH, Aiassofi K, Aghazadeh R, et al. Abdominal pain 
due to lead-contaminated opium: a new source of inorganic 
lead poisoning in Iran. Arch Iran Med. 2006;9(1):72-5.
6. Hayatbakhsh Abbasi MM, Ansari M, Shahesmaeili A, Qaraie 
A. Lead serum levels in opium-dependent individuals. Addict 
Health. 2009;1(2):106-9.
7. Fatemi R, Jafarzadeh F, Moosavi S, Afshar Amin F. Acute 
lead poisoning in an opium user: a case report. Gastroenterol 
Hepatol Bed Bench. 2008;1(3):139-42. doi: 10.22037/ghfbb.
8. Aghaee-Afshar M, Khazaeli P, Behnam B, Rezazadeh Kermani 
M, Ashraf-Ganjooei N. Presence of lead in opium. Arch Iran 
Med. 2008;11(5):553-4.
9. Soltaninejad K, Flückiger A, Shadnia S. Opium addiction 
and lead poisoning. J Subst Use. 2011;16(3):208-12. doi: 
10. Khatibi-Moghadam H, Khadem-Rezaiyan M, Afshari R. 
Comparison of serum and urine lead levels in opium addicts 
with healthy control group. Hum Exp Toxicol. 2016;35(8):861-
5. doi: 10.1177/0960327115607947.
11. Soltaninejad K, Shadnia S. Lead poisoning in opium abuser 
in Iran: a systematic review. Int J Prev Med. 2018;9:3. doi: 
12. Hayatbakhsh MM, Oghabian Z, Conlon E, Nakhaee S, 
Amirabadizadeh AR, Zahedi MJ, et al. Lead poisoning among 
opium users in Iran: an emerging health hazard. Subst Abuse 
Treat Prev Policy. 2017;12(1):43. doi: 10.1186/s13011-017-
13. Nemati A, Jafari S, Afshari M, Dahmardeh S, Tabrizian K. 
Comparing blood lead level among oral/inhaled opium 
addicts with a non-addict control group in the southeast of 
Iran. Addict Health. 2016;8(4):235-41.
14. Taylor CM, Golding J, Emond AM. Adverse effects of 
maternal lead levels on birth outcomes in the ALSPAC study: 
a prospective birth cohort study. BJOG. 2015;122(3):322-8. 
doi: 10.1111/1471-0528.12756.
15. González-Cossío T, Peterson KE, Sanín LH, Fishbein E, 
Palazuelos E, Aro A, et al. Decrease in birth weight in relation 
to maternal bone-lead burden. Pediatrics. 1997;100(5):856-
62. doi: 10.1542/peds.100.5.856.
16. Huang S, Hu H, Sánchez BN, Peterson KE, Ettinger AS, 
Lamadrid-Figueroa H, et al. Childhood blood lead levels and 
symptoms of attention deficit hyperactivity disorder (ADHD): 
a cross-sectional study of Mexican children. Environ Health 
Perspect. 2016;124(6):868-74. doi: 10.1289/ehp.1510067.
17. Committee on Obstetric Practice. Committee opinion 
No. 533: lead screening during pregnancy and lactation. 
Obstet Gynecol. 2012;120(2 Pt 1):416-20. doi: 10.1097/
18. Gulson BL, Mizon KJ, Korsch MJ, Palmer JM, Donnelly 
JB. Mobilization of lead from human bone tissue during 
pregnancy and lactation--a summary of long-term research. 
Sci Total Environ. 2003;303(1-2):79-104. doi: 10.1016/
19. Li J, Wang H, Hao JH, Chen YH, Liu L, Yu Z, et al. Maternal 
serum lead level during pregnancy is positively correlated 
with risk of preterm birth in a Chinese population. Environ 
Pollut. 2017;227:484-9. doi: 10.1016/j.envpol.2017.05.009.
20. Amaro H, Fried LE, Cabral H, Zuckerman B. Violence 
during pregnancy and substance use. Am J Public Health. 
1990;80(5):575-9. doi: 10.2105/ajph.80.5.575.
21. Hutchins E, DiPietro J. Psychosocial risk factors associated 
with cocaine use during pregnancy: a case-control study. 
Obstet Gynecol. 1997;90(1):142-7. doi: 10.1016/s0029-
22. Ebrahim SH, Gfroerer J. Pregnancy-related substance use 
in the United States during 1996-1998. Obstet Gynecol. 
2003;101(2):374-9. doi: 10.1016/s0029-7844(02)02588-7.
23. Vega WA, Kolody B, Hwang J, Noble A. Prevalence and 
magnitude of perinatal substance exposures in California. 
N Engl J Med. 1993;329(12):850-4. doi: 10.1056/
24. Chasnoff IJ, Landress HJ, Barrett ME. The prevalence of illicitdrug or alcohol use during pregnancy and discrepancies in 
mandatory reporting in Pinellas county, Florida. N Engl J Med. 
1990;322(17):1202-6. doi: 10.1056/nejm199004263221706.
25. Chasnoff IJ, McGourty RF, Bailey GW, Hutchins E, Lightfoot 
SO, Pawson LL, et al. The 4P’s Plus screen for substance use 
in pregnancy: clinical application and outcomes. J Perinatol. 
2005;25(6):368-74. doi: 10.1038/
26. Kuczkowski KM. Anesthetic implications of drug abuse in 
pregnancy. J Clin Anesth. 2003;15(5):382-94. doi: 10.1016/
27. Saleh Gargari S, Fallahian M, Haghighi L, HosseinnezhadYazdi M, Dashti E, Dolan K. Maternal and neonatal 
complications of substance abuse in Iranian pregnant women. 
Acta Med Iran. 2012;50(6):411-6.
28. Sheehan TJ. Stress and low birth weight: a structural 
modeling approach using real life stressors. Soc Sci Med. 
1998;47(10):1503-12. doi: 10.1016/s0277-9536(98)00236-
29. Reihani Kermani H, Niktab AR. The relationship between 
blood lead concentration and electroneurographic findings in 
lead-exposed subjects. J Qazvin Univ Med Sci. 2005;8(4):27-
31. [Persian].
30. Salehi H, Sayadi AR, Tashakori M, Yazdandoost R, Soltanpoor 
N, Sadeghi H, et al. Comparison of serum lead level in oral 
opium addicts with healthy control group. Arch Iran Med. 
31. Amiri M, Amini R. A comparison of blood-lead level (BLL) in 
opium-dependant addicts with healthy control group using 
the graphite furnace/atomic absorption spectroscopy (GFAAS) followed by chemometric analysis. Iran Red Crescent 
Med J. 2012;14(8):488-91.
32. Rahi E, Baneshi MR, Mirkamandar E, Haji Maghsoudi S, 
Rastegari A. A comparison between Apgar scores and birth 
weight in infants of addicted and non-addicted mothers. 
Addict Health. 2011;3(1-2):61-7.
33. Maghsoudlou S, Cnattingius S, Montgomery S, Aarabi M, 
Semnani S, Wikström AK, et al. Opium use during pregnancy 
and infant size at birth: a cohort study. BMC Pregnancy 
Childbirth. 2018;18(1):358. doi: 10.1186/s12884-018-1994-
34. Derakhshan R, Roodpeyma S, Balaee P, Bakhshi H. A 
case-control study on perinatal outcomes of opiumaddicted pregnant women and their offsprings in Rafsanjan, 
Iran. J Compr Ped. 2014;5(1):e14779. doi: 10.17795/