š‹’š‹¥†ŠÖš

Royal Thai Navy Medical Journal

ÖćøÿĆöñĆÿÿćøêąÖĆęüĒúąñúÖøąìïêŠĂÿč×õćóĀâĉÜêĆĚÜÙøøõŤĒúąđéĘÖ
Lead Exposure and Health Effects in Pregnant
Women and Children
éúøüĊǰĒüđ÷Ü* ÿčõćõøèŤǰ÷ĉĚöđìĊę÷Ü**
Donrawee Waeyeng,* Supabhorn Yimthiang**
ǰîĆÖýċÖþćĀúĆÖÿĎêøðøĆßâćéčþãĊïĆèæĉêǰ(đìÙēîēú÷ĊÿĉęÜĒüéúšĂöǰÙüćöðúĂéõĆ÷ǰĒúąÿč×õćó) ÿĞćîĆÖüĉßćÿćíćøèÿč×ýćÿêøŤ
öĀćüĉì÷ćúĆ÷üúĆ÷úĆÖþèŤǰÝîÙøýøĊíøøöøćß
* Student in Doctor of Philosophy Program (Environmental, Safety Technology and Health),
School of Public Health, Walailak University, Nakhon Si Thammarat Province
* Ùèąüĉì÷ćýćÿêøŤĒúąđìÙēîēú÷Ċǰÿć×ćÿćíćøèÿč×ßčößîǰöĀćüĉì÷ćúĆ÷ĀćéĔĀâŠǰÝÿÜ×úć
* Faculty of Science and Technology (Community Public Health), Hatyai University, Songkhla Province
** ÿĞćîĆÖüĉßćÿćíćøèÿč×ýćÿêøŤǰöĀćüĉì÷ćúĆ÷üúĆ÷úĆÖþèŤǰÝîÙøýøĊíøøöøćß
** School of Public Health, Walailak University, Nakhon Si Thammarat Province
* Corresponding AVUIPSǰEPOSBXFFXBF!HNBJMDPN

ïìÙĆé÷ŠĂ
ÿćøêąÖĆęüđðŨîēúĀąĀîĆÖìĊę öĊÖćøðîđðŚŪĂîĔîÿĉęÜĒüéúšĂöĒúąñúĉêõĆ è æŤ×ĂÜĔßšĔîßĊüĉêðøąÝĞćüĆîǰ
ÿŠÜñúÖøąìïøšć÷ĒøÜêŠĂÿč×õćó×ĂÜöîčþ÷ŤǰÿćøêąÖĆęüÿćöćøëđךćÿĎŠøŠćÜÖć÷ĕéšìćÜÖćøĀć÷ĔÝǰÖćøÖĉîǰÖćøéĎéàċö
ñŠćîìćÜñĉüĀîĆÜǰĒúąÖćøéĎéàċöñŠćîìćÜøÖǰÖćøÿĆöñĆÿÿćøêąÖĆęüߊüÜÖŠĂîĒúąĀúĆÜÙúĂéĔîöćøéćÝĆéđðŨîÖćø
ÿĆöñĆÿìĊęöĊÙüćöđÿĊę÷ÜÿĎÜìĆĚÜêŠĂöćøéćĒúąìćøÖǰÿŠÜñúĔĀšöćøéćöĊõćüąđÿĊę÷ÜêŠĂõćüąēúĀĉêÝćÜǰÙüćöéĆîēúĀĉêÿĎÜ
×èąêĆĚÜÙøøõŤǰĒúąÖćøĒìšÜǰîĂÖÝćÖîĊĚÿćøêąÖĆęü÷ĆÜÿŠÜñúÖøąìïìĊęøčîĒøÜêŠĂÖøąïüîÖćøìĞćÜćî×ĂÜÿöĂÜǰ
ĒúąÖćøđÝøĉâđêĉïēê×ĂÜøŠćÜÖć÷×ĂÜìćøÖǰÝćÖøć÷ÜćîÖćøýċÖþćüĉÝĆ÷ìĊęñŠćîöćïŠÜßĊĚĔĀšđĀĘîñúÖøąìïÝćÖ
ÿćøêąÖĆęüìĊęđÖĉé×ċĚîÖĆïđéĘÖǰĕéšĒÖŠǰÙüćöïÖóøŠĂÜìćÜÿêĉðŦââćǰóĆçîćÖćøúŠćßšćǰēøÙÿöćíĉÿĚĆîǰđðŨîêšîǰÝćÖÖćø
êøüÝüĆéøąéĆïÿćøêąÖĆęüÖŠĂîÙúĂéÝćÖÿć÷ÿąéČĂ×ĂÜđéĘÖǰóïüŠćǰÙŠćøąéĆïÿćøêąÖĆęüĔîđúČĂéìĊęĂ÷ĎŠĔîߊüÜǰ
ǰëċÜǰ μg/dL öĊÙüćöÿĆöóĆîíŤÖĆïÙüćöñĉéðÖêĉ×ĂÜÖøąïüîÖćøìĞćÜćî×ĂÜÿöĂÜēé÷đÞóćąĔîđéĘÖñĎšßć÷
ìĊęĂć÷čǰǰđéČĂîǰ÷ĉęÜĕðÖüŠćîĆĚîđéĘÖìĊęöĊøąéĆïÿćøêąÖĆęüĔîđúČĂéĒöšÝąêęĞćÖüŠćøąéĆïǰ μg/dL ÝąìĞćĔĀšöĊøąéĆï
ÙüćöÞúćéìćÜđßćüŤðŦââćêęĞćǰöĊðŦâĀćĔîđøČęĂÜÖćøđøĊ÷îøĎšǰóĆçîćÖćøúŠćßšćǰõćüąêĆüđêĊĚ÷ǰ×ćéÿöćíĉǰĒúą
ĂćÝÝąöĊðŦâĀćđøČęĂÜóùêĉÖøøöÖćøđךćÿĆÜÙöđöČęĂđךćÿĎŠüĆ÷ñĎšĔĀâŠǰÝćÖøć÷ÜćîÖćøýċÖþćüĉÝĆ÷ĔîìüĊðđĂđàĊ÷Ēúą
ĒĂôøĉÖć óïüŠć ÖćøÿĆöñĆÿÿćøêąÖĆęüĔîߊüÜêĆĚÜÙøøõŤÿŠÜñúÖøąìïìĊęøčî ĒøÜêŠĂöćøéćĒúąìćøÖĔîÙøøõŤǰ
ÿĞćĀøĆïðøąđìýĕì÷ĔîðŦÝÝčïĆîîĆĚî÷ĆÜĕöŠðøćÖäךĂöĎúÿëćîÖćøèŤøąéĆïÿćøêąÖĆęüĔîđúČĂé×ĂÜĀâĉÜêĆĚÜÙøøõŤ
ĒêŠĂ÷ŠćÜĕøÖĘêćööĊĀúĆÖåćîóïÖćøðîđðŚŪĂîÿćøêąÖĆęüĔîÿĉęÜĒüéúšĂöǰĔîÖúčŠöñĎšðøąÖĂïĂćßĊóìĊęđÖĊę÷üךĂÜÖĆï
Received: December 25, 2020, Revised: March 2, 2021; Accepted: March 10, 2021
š‹’š‹‹šŠ¤|Ÿ•ƒÊ¬q‚™‚¬i™ŠšŠ€™šl‰ 
 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal

ÿćøêąÖĆęüǰĒúąĔîđéĘÖìĊę ĂćýĆ ÷Ă÷ĎŠÖĆï ñĎšð ÖÙøĂÜìĊęð øąÖĂïĂćßĊó đÖĊę÷ üÖĆï ÿćøêąÖĆę üĀøČĂĂ÷ĎŠĔÖúšÖĆï ĒĀúŠ Ü
ĂčêÿćĀÖøøö
ÖćøýċÖþćÿëćîÖćøèŤÖćøÿĆöñĆÿÿćøêąÖĆęüĔîĀâĉÜêĆĚÜÙøøõŤǰÖćøÖĞćĀîéĒîüìćÜêĉéêćöđòŜćøąüĆÜ
ÖćøÿĆöñĆÿÿćøêąÖĆęü ÖćøÙĆéÖøĂÜÖćøÿĆöñĆÿÿćøêąÖĆęüĔîĀâĉÜêĆĚÜÙøøõŤêĆĚÜĒêŠĕêøöćÿìĊęǰ1 ÝċÜöĊÙüćöÿĞćÙĆâ
Ă÷ŠćÜ÷ĉęÜĔîÖćøúéñúÖøąìïìĊęÝąđÖĉé×ċĚî ĀîŠü÷ÜćîìĊęđÖĊę÷üךĂÜÙüøÝĆéìĞćĒîüìćÜÖćøêøüÝÙĆéÖøĂÜÙüćöđÿĊę÷Ü
ÝćÖÖćøÿĆöñĆÿÿćøêąÖĆęüĔîĀâĉÜêĆĚÜÙøøõŤìčÖÙîĔîðøąđìýĕì÷ ÙüïÙĎŠÖĆïÖćøéĞćđîĉîÖćøêøüÝüĆéøąéĆïÿćø
êąÖĆęüĔîÿĉęÜĒüéúšĂö×ĂÜßčößî đóČęĂðŜĂÜÖĆîñúÖøąìïêŠĂÿč×õćó×ĂÜĀâĉÜêĆĚÜÙøøõŤǰĒúąñúÖøąìïøčîĒøÜêŠĂ
ÿöĂÜĒúąøąïïðøąÿćì×ĂÜìćøÖ øüöìĆĚÜÖćøđÖĉéēøÙđøČĚĂøĆÜĔîĂîćÙê
ÙĞćÿĞćÙĆâ: ÖćøÿĆöñĆÿÿćøêąÖĆęü ñúÖøąìïÿćøêąÖĆüę ĀâĉÜêĆĚÜÙøøõŤ ìćøÖ
Abstract
-FBEǰJTǰBǰIFBWZǰNFUBMǰUIBUǰDPOUBNJOBUFTǰUIFǰFOWJSPONFOUǰBOEǰFWFSZEBZǰQSPEVDUTǰ
-FBEǰIBTǰBǰTFSJPVTǰJNQBDUǰPOǰIVNBOǰIFBMUIǰ-FBEǰDBOǰFOUFSǰUIFǰCPEZǰUISPVHIǰCSFBUIJOH ǰ
JOHFTUJPO ǰ BCTPSQUJPOǰ UISPVHIǰ UIFǰ TLJO ǰ BOEǰ BCTPSQUJPOǰ UISPVHIǰ UIFǰ QMBDFOUBǰ 1SF- and
post-OBUBMǰMFBEǰFYQPTVSFǰJOǰUIFǰNPUIFSǰQSFTFOUTǰBǰIJHIǰSJTLǰUPǰCPUIǰUIFǰNPUIFSǰBOEǰUIFǰDIJMEǰ
It will put the mother at risk of anemia, gestational hypertension, spontaneous abortion and
also has a serious impact on a child's brain function BOEǰCPEZǰHSPXUIǰ/VNerous studies have
shown the effects of lead on children’s health such as intellectual disability, delayed
EFWFMPQNFOU ǰ"UUFOUJPOǰ%FGJDJUǰ)ZQFSBDUJWJUZǰ%JTPSEFS ǰFUDǰThe measurement of pre-natal
lead levels from the umbilical cord of a child found that the blood lead levels ranged
from  to  μg/dL, demonstrating a correlation with limited cognitive function, especially
in boys aged  NPOUITǰMoreover, children with blood lead levels below 10 μg/dL will have
low Intelligence Quotient (IQ), learning problems, short stature, developmental delays, a
lack of concentration and may have problems with social behavior when entering BEVMUIPPEǰ
According to research studies in Asia and Africa, lead exposure during pregnancy has severe
FGGFDUTǰPOǰUIFǰNPUIFSǰBOEǰGFUVTǰ*Oǰ5IBJMBOE, the data on the impact of blood lead levels of
QSFHOBOUǰXPNFOǰJTǰOPUǰBWBJMBCMFǰ)PXFWFS ǰUIFSFǰJTǰFWJEFODFǰPGǰMFBEǰDPOUBNJOBUJPO in the
environment, occupational exposure to lead (both in the workers themselves and in their
DIJMESFO
ǰBOEǰFYQPTVSFǰUISPVHIǰMJWJOHǰDMPTFǰUPǰDFSUBJOǰJOEVTUSJBMǰTJUFT
Studying the status of lead exposure in pregnant women, launching guidelines for
the monitoring of lead exposure, and screening for lead exposure in pregnant women from the
GJSTUǰ USJNFTUFSǰ JTǰ WFSZǰ JNQPSUBOUǰ UPǰ NJOJNJ[Fǰ UIFǰ FGGFDUTǰ 3FMFWBOUǰ BHFODJFTǰ TIPVMEǰ
establish guidelines for the screening of lead exposure in all pregnant women in Thailand
Alongside this, there should be the implementation of environmental lead assessment in

 Volume 48 No.3 September - December 2021


the community, to prevent negative effects on the health of pregnant women, and severe
effects on infants’ brains and nervous systems, including the occurrence of chronic diseases
in the future
Keywords: lead exposure, effects of lead, pregnant women, infants
ïìîĞć
ÿćøêąÖĆęüđðŨîēúĀąĀîĆÖìĊęöĊÙüćöđðŨîóĉþ
êŠĂöîčþ÷ŤĒúąÿĉęÜĒüéúšĂöǰĒúąĕöŠÿćöćøëÿúć÷êĆü
ĕéšēé÷ÖøąïüîÖćøíøøößćêĉǰìĞćĔĀšöĊÖćøÿąÿöĔî
øąéĆïêŠćÜėǰ×ĂÜĀŠüÜēàŠĂćĀćøǰðŦÝÝčïîĆ ĒĀúŠÜÖĞćđîĉé
ĀúĆ Ö ×ĂÜÿćøêąÖĆę ü öćÝćÖēøÜÜćîĂč ê ÿćĀÖøøö
đߊîǰēøÜÜćîøĊĕàđÙĉúĒïêđêĂøĊęǰēøÜÜćîđĀöČĂÜǰÖćø
ðîđðŚŪ ĂîĔîĂćĀćøĒúąÿöč îĕóøǰđߊî ǰíĆâ óČ ß ìĊę öĊ
ÖćøðúĎÖĔîéĉîìĊęðîđðŚŪĂîÿćøêąÖĆęü ÖćøðøąÖĂï
ĂćßĊóđÖĊę÷üÖĆïÖćøðøąöÜ đߊîǰÖćøöćéĂüîǰàċęÜöĊ
×ĆĚ î êĂîÖćøøš Ă ÷úĎ Ö êąÖĆę ü đך ć ÖĆ ï Ăüî 1 øüöëċ Ü
ñúĉêõĆèæŤêŠćÜėǰìĊęöĊÖćøĔßšÿćøêąÖĆęüđðŨîĂÜÙŤðøąÖĂï
đóČę Ăđóĉę ö Ùüćöÿé×ĂÜÿĊ đߊ î ǰúĉ ð ÿêĉ Ö ǰöćÿÙćøŠ ćǰ
ñúĉêõĆèæŤ÷šĂöÿĊñöǰ×ĂÜđúŠîđéĘÖ ÝċÜìĞćĔĀšðŦÝÝčïĆî
ðøąßćßî÷ĆÜÙÜđÿĊę÷ÜêŠĂÖćøøĆïÿĆöñĆÿÿćøêąÖĆęüđךćÿĎŠ
øŠć ÜÖć÷ǰēé÷đÞóćąđéĘ Ö đúĘ Ö ĒúąĀâĉ ÜêĆĚ ÜÙøøõŤ ìĊę
đðŨîÖúčŠöĂŠĂîĕĀüêŠĂÿćøêąÖĆęüǰÿëćîÖćøèŤøąéĆï
ÿćøêąÖĆęüĔîđúČĂéĔîĀâĉÜêĆĚÜÙøøõŤîĆĚîđðŨîðŦâĀćìĊę
Āúć÷ðøąđìýĕéšĔĀšÙüćöÿĞćÙĆâǰđîČęĂÜÝćÖìýüøøþ
ìĊęñŠćîöćöĊÜćîüĉÝĆ÷ÝĞćîüîöćÖïŠÜßĊĚüŠćÖćøÿĆö ñĆÿ
ÿćøêąÖĆęüĔîߊüÜêĆĚÜÙøøõŤÿŠÜñúÖøąìïìĊęøčîĒøÜêŠĂ
öćøéćĒúąìćøÖǰēé÷ĀâĉÜêĆĚÜÙøøõŤĔîìüĊðđĂđßĊ÷ǰ
đߊî ǰðøąđìýÝĊîǰðøąđìýĂĉ îđéĊ÷ǰÝąöĊ øąéĆïÿćø
êąÖĆę üĔîđúČ ĂéđÞúĊę ÷ǰǰëċ ÜǰǰwHE-2- ĒêŠ Ā ćÖ
đðŨîĀâĉÜêĆĚÜÙøøõŤĔîìüĊðĒĂôøĉÖćÝąóïøąéĆïÿćø
êąÖĆęüĔîđúČĂéđÞúĊę ÷ÿĎÜëċ ÜǰǰwHE-5 ÿĞ ćĀøĆï
ðøąđìýĕì÷ĔîðŦÝÝčïĆîîĆĚî÷ĆÜĕöŠðøćÖäךĂöĎúøąéĆï
ÿćøêąÖĆęüĔîđúČĂé×ĂÜĀâĉÜêĆĚÜÙøøõŤǰĒêŠĂ÷ŠćÜĕøÖĘêćö
öĊ øć÷ÜćîÖćøðîđðŚŪ ĂîÿćøêąÖĆę ü Ĕîÿĉę ÜĒüéúš Ă ö
š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal
ĔîÖúčŠöñĎšðøąÖĂïĂćßĊó ìĊęđÖĊę÷üךĂÜÖĆïÿćøêąÖĆęü
ĒúąĔîđéĘ Ö ìĊę Ă ćýĆ ÷ Ă÷ĎŠ ÖĆ ï ñĎš ð ÖÙøĂÜìĊę ð øąÖĂï
ĂćßĊ ó đÖĊę ÷ üÖĆ ï ÿćøêąÖĆę ü ĀøČ Ă Ă÷ĎŠ Ĕ Öúš ÖĆ ï ĒĀúŠ Ü
ĂčêÿćĀÖøøö1 àċęÜÝąÿŠÜñúÖøąìïêŠĂÿč×õćóđéĘÖ
đøČĚĂøĆÜĒúąøšć÷ĒøÜĔîĂîćÙêǰēé÷đÞóćąĀćÖđéĘÖ
ĕéšøĆïÿćøêąÖĆęüêĆĚÜĒêŠĂ÷ĎŠĔîÙøøõŤǰéĆÜîĆĚîïìÙüćöîĊĚ
ÝċÜĕéšìïìüîÖćøøĆïÿĆöñĆÿÿćøêąÖĆęüǰĒúąñúÖøąìï
ìĊęđÖĉé×ċĚîêŠĂÿč×õćó×ĂÜĀâĉÜêĆĚÜÙøøõŤ ìćøÖǰĒúąđéĘÖ
ĒúąîĞćđÿîĂĒîüìćÜĔîÖćøêĉéêćöđòŜćøąüĆÜÖćø
ÿĆöñĆÿÿćøêąÖĆęüđóČęĂðŜĂÜÖĆîñúÖøąìïøčîĒøÜêŠĂ
ĀâĉÜêĆĚÜÙøøõŤ ìćøÖǰĒúąđéĘÖ
ÖćøøĆïÿĆöñĆÿÿćøêąÖĆęü
×ĂÜĀâĉÜêĆĚÜÙøøõŤ
ÖćøøĆïÿĆöñĆÿÿćøêąÖĆęü×ĂÜĀâĉÜêĆĚÜÙøøõŤ
ĕéš öĊ Ö ćøýċ Ö þćĒúąêĉ é êćöđòŜ ć øąüĆ Ü ĔîĀúć÷
ðøąđìýìĆę üēúÖǰàċęÜöĊÖćøÖĞ ćĀîéÙŠćĂšćÜĂĉÜøąéĆ ï
ÿćøêąÖĆęüĔîđúČĂéĔîĀâĉ ÜêĆĚÜÙøøõŤĂ÷ĎŠìĊę 5 μg/dL
ēé÷ĀâĉÜêĆĚÜÙøøõŤĔîìüĊðđĂđßĊ÷ǰđߊîǰðøąđìýĂĉîđéĊ÷
ðøąđìýÝĂøŤĒéî ÝąöĊøąéĆïÿćøêąÖĆęüĔîđúČĂéđÞúĊę÷
 ëċÜ  μg/dL ĒêŠĀćÖđðŨî Āâĉ ÜêĆĚÜÙøøõŤ Ĕî
ìüĊðĒĂôøĉÖćÝąóïøąéĆïÿćøêąÖĆęüĔîđúČĂéđÞúĊę÷
ÿĎÜëċÜǰǰμg/dL êćøćÜìĊęǰ1) ÿĞćĀøĆïðøąđìýĕì÷
îĆĚî ðŦÝ ÝčïĆî ÷ĆÜ ĕöŠð øćÖäךà öĎú øąéĆï ÿćøêąÖĆęü
ĔîđúČ Ă é×ĂÜĀ âĉ ÜêĆĚ Ü ÙøøõŤ Ē êŠ Ö ćøýċ Ö þ ćĔî
êŠ ć ÜðøąđìýìĊę ñŠ ć îöćÿćöćøëîĞ ć öćđðŨ î ך Ă öĎ ú
óČĚ î åćîĔîÖćøÿøš ć ÜÙüćöêøąĀîĆ Ö đÖĊę ÷ üÖĆ ï
ĂĆîêøć÷×ĂÜÿćøêąÖĆęüĔîđúČĂéìĊęöĊêŠĂöćøéć ìćøÖ
ĒúąđéĘÖĕéš
š‹’š‹‹šŠ¤|Ÿ•ƒÊ¬q‚™‚¬i™ŠšŠ€™šl‰ 
 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal

êćøćÜìĊęǰǰÿëćîÖćøèŤøąéĆïÿćøêąÖĆęüĔîđúČĂé×ĂÜĀâĉÜêĆĚÜÙøøõŤĔîêŠćÜðøąđìý
Mean ± SD Range
Authors Countries/region n
(μg/dL) (μg/dL)
 2 ± 2 -
Disha ĒúąÙèą India
  ± 21 -
Hamadneh ĒúąÙèą Jordan 120 121 ± 1  - 0
Hassanian-Moghaddam ĒúąÙèą Iran 100  1 - 0
Rimbaud ĒúąÙèą9 French   -
Taylor, Golding & Emond10 Sub-Saharan Africa -  0 - 99
Taylor ĒúąÙèą11 United Kingdom   ± 1 0 - 19
La-Llave-León ĒúąÙèą12 Mexico 299 2 ± 2 0ǰ- 

ÖćøøĆï ÿĆöñĆÿ ÿćøêąÖĆęüĔîĀâĉ ÜêĆĚ ÜÙøøõŤ øŠćÜÖć÷ĕéšđóĊ÷ÜóĂ đߊîǰÖćøéČęöîöàċęÜÿćöćøëúé

ĒïŠÜĕéšđðŨîǰ2 ðŦÝÝĆ÷ĀúĆÖ ĕéšĒÖŠǰðŦÝÝĆ÷ÿŠüîïčÙÙúǰ
ĒúąðŦÝÝĆ÷ÿĉęÜĒüéúšĂöǰøć÷úąđĂĊ÷ééĆÜîĊĚ
ðŦÝÝĆ÷ÿŠüîïčÙÙúǰĕéšĒÖŠ øąéĆïÖćøýċÖþćǰ
øć÷ĕéšǰìĊęĂ÷ĎŠĂćýĆ÷ǰÖćøÿĎïïčĀøĊęǰÿč×üĉì÷ćÿŠüîïčÙÙúǰ
ÖćøðøąÖĂïĂćßĊ ó ǰĒúąÖćøïøĉ ē õÙĒÙúđàĊ ÷ öǰ
Ăíĉ ï ć÷ĕéš üŠ ć ǰĀćÖĀâĉ Ü êĆĚ Ü ÙøøõŤ öĊ Ö ćøýċ Ö þćĔî
øąéĆïêęĞćÝąöĊÙüćöÿĆöóĆîíŤÖĆïøąéĆïÿćøêąÖĆęüĔî
đúČ Ă éìĊę đóĉę ö ×ċĚ î ǰđîČę Ă Üéš ü ÷×ćéÙüćöøĎš đÖĊę ÷ üÖĆ ï
óùêĉÖøøöÿč×õćóǰöĊóùêĉÖøøöÖćøÿĎïïčĀøĊęǰ×ćéÖćø
øĆïøĎšđøČęĂÜĂĆîêøć÷ĒúąÖćøðŜĂÜÖĆîêîđĂÜÝćÖÿćø
êąÖĆęü ÿŠÜñúêŠĂÿč×üĉì÷ćÿŠüîïčÙÙúàċęÜđðŨîðŦÝÝĆ÷ìĊę
ÿĞćÙĆâ êŠ ĂÖćøøĆï ÿĆöñĆÿÿćøêąÖĆę üđךćÿĎŠøŠćÜÖć÷,5
îĂÖÝćÖîĊĚĀâĉÜêĆĚÜÙøøõŤìĊęöĊÖćøýċÖþćêęĞćöĆÖÝąĂ÷ĎŠ
ĔîÿõćóĒüéúšĂöìĊęĕöŠéĊǰöĊåćîą÷ćÖÝîĒúąĂćýĆ÷Ă÷ĎŠ
ĔîßčößîĒĂĂĆé öĊìĊęóĆÖĂćýĆ÷Ă÷ĎŠĔÖúšëîîìĊęüčŠîüć÷ǰ
ĀøČĂöĊÖćøðøąÖĂïĂćßĊóìĊęđÿĊę÷ÜêŠĂÖćøøĆïÿĆöñĆÿ
ÿćøêąÖĆęüǰđߊîǰđðŨîĒøÜÜćîĔîđĀöČĂÜêąÖĆęüǰĒøÜÜćî
ĔîÖćøÙĆ é Ē÷Ö×÷ąĂĉ đúĘ Ö ìøĂîĉ Ö ÿŤ Ā øČ Ă ÖćøìĞ ć
öćéĂüîǰàċę Ü ĂćßĊ ó éĆ Ü ÖúŠ ć üÿŠ ü îĔĀ⊠öĊ ø ć÷ĕéš
ÙŠĂîךćÜîšĂ÷ đöČęĂöĊøć÷ĕéšîšĂ÷ÝċÜĕöŠÿćöćøëÝĆéĀć
Öćøïøĉ ē õÙĂćĀćøđÿøĉ ö ĂČę î ėǰìĊę öĊ ð øąē÷ßîŤ êŠ Ă
ǰÿĉîÙšćĂčðēõÙïøĉēõÙìĊę
Öćøÿąÿö×ĂÜÿćøêąÖĆęüĔîÖøąéĎÖĕéš1
ðŦÝÝĆ÷éšćîÿĉęÜĒüéúšĂöǰÖćøðîđðŚŪĂîÿćø
êąÖĆę ü Ĕîÿĉę Ü Ēüéúš Ă öđðŨ î ĂĊ Ö ðŦ Ý ÝĆ ÷ Āîċę Ü ìĊę ÿĞ ć ÙĆ âǰ
ĀćÖĀâĉÜêĆĚÜÙøøõŤĂ÷ĎŠĔîÿĉęÜĒüéúšĂöìĊęöĊÖćøðîđðŚŪĂî
ÖĘĂćÝÝąìĞćĔĀšĕéšøĆïÿĆöñĆÿÿćøêąÖĆęüđךćÿĎŠøŠćÜÖć÷
ēé÷ÿćöćøëÝĞ ć Ēî ÖĒĀ úŠ Ü Öćøð î đðŚŪ Ă îĔî
ÿĉęÜĒüéúšĂöĕéš  ĒĀúŠÜ ĕéšĒÖŠǰéĉî îĚĞć ĂćÖćý Ēúą
ÿĉîÙšćĂčðēõÙïøĉēõÙǰ1) ÖćøðîđðŚŪĂîÿćøêąÖĆęüĔîéĉî
ÿćöćøëóïĕéš ĔîóČĚ î ìĊę ìĞ ć ÖćøđÖþêøđîČę Ă ÜÝćÖ
đÖþêøÖøĂćÝĔßšÿćøđÙöĊÖĞćÝĆéýĆêøĎóČßìĊęöĊÖćøñÿö
ÿćøêąÖĆę ü ǰàċę Ü îĂÖđĀîČ Ă ÝćÖÝąìĞ ć ĔĀš đÖĉ é Öćø
ðîđðŚŪĂîĔîéĉîĒúšüǰñúĉêñúìćÜÖćøđÖþêøÖĘĂćÝöĊ
ÖćøðîđðŚŪĂîÿćøêąÖĆęüĕéšđߊîÖĆîǰĀøČĂÖćøĂ÷ĎŠĔÖúš
ÖĆïóČĚ îēøÜÜćîĂčêÿćĀÖøøöǰđߊîǰēøÜÜćîøĊĕàđÙĉú
ĒïêđêĂøĊę 2) ÖćøðîđðŚŪĂîÿćøêąÖĆęüĔîîĚĞćöĆÖđÖĉé×ċĚî
êćöĒĀúŠÜîĚĞćíøøößćêĉǰđߊîǰĒöŠîĚĞćǰìąđúÿćï ĀøČĂ
ĂćÝđÖĉéÝćÖÖćøðúŠĂ÷îĚćĞ đÿĊ÷ÝćÖēøÜÜćîĂčêÿćĀÖøøö
úÜÿĎŠĒĀúŠÜîĚĞćíøøößćêĉ ) ÖćøðîđðŚŪĂîÿćøêąÖĆęü
ĔîĂćÖćý ÿŠüîĔĀ⊠đðŨ î òčśîúąĂĂÜÝćÖÿĊìćïš ćîǰ
ĒúąÙüĆîÝćÖēøÜÜćîĂčêÿćĀÖøøöǰøüöëċÜÖćøÿĎééö
ÙüĆîïčĀøĊęöČĂÿĂÜǰĒúąǰ

 Volume 48 No.3 September - December 2021

 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal

öĊ Ö ćøîĞ ć ÿćøêąÖĆę ü öćĔßš đðŨ î ÿŠ ü îðøąÖĂï×ĂÜ ÙČĂ Öćøđóĉęö×ċĚî×ĂÜðøĉöćèđúČĂéĔîøąïïĕĀúđüĊ÷î

ñúĉêõĆèæŤêŠćÜėǰĕéšĒÖŠǰĂć÷ĕúîŤđîĂøŤǰúĉðÿêĉÖǰïøĆßĂĂî
ñúĉêõĆèæŤđðúĊę÷îÿĊñöǰđóČęĂđóĉęöðøąÿĉìíĉõćó×ĂÜÿĊ
ĔĀšöĊÙüćöìîìćîĒúąđóĉęöÖćø÷ċéđÖćąÖĆïóČĚîñĉüĕéš
îćî÷ĉęÜ×ċĚîǰēé÷ÿćøêąÖĆęüìĊęĔÿŠĔîñúĉêõĆèæŤđĀúŠćîĆĚî
ÿćöćøëéĎ é àċ ö đך ć ÿĎŠ Ö øąĒÿđúČ Ă éĒúąñŠ ć îìćÜ
ñĉüĀîĆÜĕéš2
ÖćøøĆïÿĆöñĆÿÿćøêąÖĆęü×ĂÜìćøÖ
ÝćÖöćøéć
öćøéćìĊę öĊ ø ąéĆ ï ÿćøêąÖĆę ü ÿĎ Ü ÿćöćøë
ÿŠÜñŠćîÿćøêąÖĆęüĕð÷ĆÜìćøÖĔîÙøøõŤĕéšǰđîČęĂÜÝćÖ
øąĀüŠćÜêĆĚÜÙøøõŤÝąöĊÖćøđÙúČęĂî÷šć÷×ĂÜĒÙúđàĊ÷ö
ÝćÖöćøéćÿĎŠìćøÖĔîÙøøõŤìĞćĔĀšöĊÖćøđÙúČęĂî÷šć÷
×ĂÜÿćøêąÖĆęüĕðóøšĂöėǰÖĆïĒÙúđàĊ÷öéšü÷ǰÝċÜđðŨî
ÿćđĀêčĔĀšìćøÖĔîÙøøõŤöĊøąéĆïÿćøêąÖĆęüĔîđúČĂéÿĎÜ
ēé÷ĀâĉÜêĆĚÜÙøøõŤÝąöĊÖćøđðúĊę÷îĒðúÜìćÜÿøĊøüĉì÷ć
ÝċÜÿŠÜñúêŠĂÖćøđöĒìïĂúĉàċö×ĂÜĒÙúđàĊ÷öǰìĞćĔĀš
ÿćøêąÖĆę ü ìĊę ëĎ Ö ÖĆ Ö đÖĘ ï ĔîÖøąéĎ Ö ëĎ Ö ðúéðúŠ Ă ÷
ĂĂÖöćéš ü ÷ēé÷ÖøąïüîÖćøđöĒìïĂúĉ àċ ö ×ĂÜ
ĒÙúđàĊ÷öĔîĀâĉÜêĆĚÜÙøøõŤöĊǰǰøą÷ąìĊęÿĞćÙĆâēé÷öĊ
øć÷úąđĂĊ÷é éĆÜîĊĚ
øą÷ąĒøÖ Öćøđóĉęö×ċĚî×ĂÜðøĉöćèđúČĂé
ĔîøąïïĕĀúđüĊ ÷ î×ĂÜĀâĉ Ü êĆĚ Ü ÙøøõŤ đðŨ î ñúĔĀš
ĒÙúđàĊ÷öĔîđúČĂéđóĉęö×ċĚîđîČęĂÜÝćÖÖćøđóĉęöÖćøéĎéàċö
ĒÙúđàĊ ÷ öĔîúĞ ć ĕÿš Ē úąúéÖćø×Ć ï ëŠ ć ÷ĒÙúđàĊ ÷ ö
×ĂÜĕêǰîĂÖÝćÖîĊĚ÷ĆÜđðŨîĕðĕéšüŠćÖćøñúĉêđĂÿēêøđÝî
ìĊęúéúÜĔîÖćøêĆĚÜÙøøõŤÿŠÜñúĔĀšđóĉęöÖćøÿúć÷×ĂÜ
ÖøąéĎÖđĀöČĂîÖĆïìĊęóïõćüąÖøąéĎÖóøčîĔîüĆ÷Āöé
ðøąÝĞćđéČĂîǰÿĆââćèăĂøŤēöîÿĞćÙĆâìĊęÙüïÙčöÖćø
đðúĊę ÷ îĒðúÜđĀúŠ ć îĊĚ ÙČ Ă ăĂøŤ ēöîóćøćĕíøĂ÷éŤ
Ēúąǰ, 25-dihydroxyvitamin D àċęÜìĆĚÜÿĂÜĂ÷ŠćÜîĊĚ
Ýąđóĉęö×ċĚîĔîÖćøĕĀúđüĊ÷îǰ ĒñîõćóìĊęǰ

ESTROGEN PREGNANCY PTH

(placenta)

BLOOD VOLUME 1,25-(OH)2VITAMIN D

BONE TOTAL CALCIUM intestinal Ca** absorption

CALCITONIN Ca**excretion KIDNEY

ĒñîõćóìĊęǰ Calcium metabolism in early pregnancy éĆéĒðúÜÝćÖǰSilbergeld

øą÷ąìĊęÿĂÜ đÖĉé×ċĚîĔîÖćøêĆĚÜÙøøõŤêĂîðúć÷ǰ ĕêøöćÿìĊęÿćö
ǰĔîߊüÜđüúćîĊĚÖøąïüîÖćøÿøšćÜÖøąéĎÖ
×ĂÜìćøÖĔîÙøøõŤÖúć÷đðŨîðŦÝÝĆ÷ñúĆÖéĆîĔîÖćøđðúĊę÷îĒðúÜÖćøđñćñúćâĒÙúđàĊ÷ö×ĂÜöćøéćǰĒÙúđàĊ÷ö
ÝąëĎÖÿŠÜĕð÷ĆÜìćøÖĔîÙøøõŤĒúąÖćøđñćñúćâĒÙúđàĊ÷ö×ĂÜöćøéćÝąëĎÖÙüïÙčöēé÷üĉêćöĉîéĊ ăĂøŤēöî
óćøćĕíøĂ÷éŤ ĒúąēðøĒúÙêĉîǰēé÷ÿĆðéćĀŤìĊęǰǰ×ĂÜÖćøêĆĚÜÙøøõŤÝąöĊÖćøëŠć÷ēĂîĒÙúđàĊ÷öÝćÖöćøéć
ÿĎŠ ì ćøÖðøąöćèǰǰöĉ ú úĉ Ö øĆ ö êŠ Ă üĆ î Ýîëċ Ü ǰǰöĉ ú úĉ Ö øĆ ö êŠ Ă üĆ î ĔîÿĆ ð éćĀŤ ìĊę ǰǰ×ĂÜÖćøêĆĚ Ü ÙøøõŤ 
(ĒñîõćóìĊęǰ

š‹’š‹‹šŠ¤|Ÿ•ƒÊ¬q‚™‚¬i™ŠšŠ€™šl‰ 

 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal
Fetal Ca** requirement
1,25-(OH)2VITAMIN D
BONE PTH maternal blood [Ca**]
PROLACTIN
ĒñîõćóìĊęǰ Calcium metabolism in late pregnancy éĆéĒðúÜÝćÖǰSilbergeld
ÖćøđðúĊę ÷ îĒðúÜ×ĂÜĒÙúđàĊ ÷ öìĆĚ Ü ǰǰ
øą÷ąÿĂéÙúš Ă ÜÖĆ ï ðøĉ ö ćèêąÖĆę ü ĔîøŠ ć ÜÖć÷Ĕî
Āâĉ Ü êĆĚ Ü ÙøøõŤ Ē êŠ ú ąĕêøöćÿǰÖćøýċ Ö þć×ĂÜǰHu
ĒúąÙèą15 ìĊęìĞ ćÖćøêøüÝüĆé øąéĆï ÿćøêąÖĆęüĔî
đúČĂéĔîĀâĉÜêĆĚÜÙøøõŤǰóïøąéĆïÿćøêąÖĆęüĔîĒêŠúą
ĕêøöćÿĂ÷ĎŠìĊęǰ, ,  μg/dL êćöúĞćéĆïǰ
ÿĂéÙúšĂÜÖĆïÖćøýċÖþć×ĂÜǰLiu ĒúąÙèą ìĊęóï
øąéĆïÿćøêąÖĆęü×ĂÜĀâĉÜêĆĚÜÙøøõŤĔîĕêøöćÿĒøÖ
ÿĎÜÖüŠćĕêøöćÿĂČęîėǰ  ± ,  ± ,
 ± ǰμg/dL êćöúĞćéĆï
ǰĒúąÝąđóĉęööćÖ ìćøÖĂć÷čǰ1 đéČĂî19
ìĊęÿčéĀúĆÜÙúĂéǰ  ± ǰμg/dL) ēé÷ìĆĚÜÿĂÜ
ÖćøýċÖþćÿîĆïÿîčîÖćøýċÖþć×ĂÜǰHertz-Picciotto
ĒúąÙèą ìĊęóïüŠć øąéĆïÿćøêąÖĆęüĔîđúČĂéøąĀüŠćÜ
ÖćøêĆĚÜÙøøõŤÝąöĊúĆÖþèąđðŨîǰU-shaped curve
îĂÖÝćÖîĊĚđéĘÖ÷ĆÜÿćöćøëÿĆöñĆÿÿćøêąÖĆęü
ÝćÖöćøéćñŠ ć îîĚĞ ć îö×ĂÜöćøéćĕéš đߊ î ÖĆ î ǰöĊ
Öćøýċ Ö þć óïüŠ ć öćøéćìĊę öĊ ø ąéĆ ï ÿćøêąÖĆę ü Ĕî
đúČĂéđÞúĊę÷Ă÷ĎŠìĊęǰǰwHE-ǰÝąöĊÙŠćđÞúĊę÷øąéĆï
ÿćøêąÖĆę ü ĔîîĚĞ ćîöđìŠ ćÖĆ ï ǰǰμg/100 ml àċę Ü
óïüŠć ÙŠ ćÿĆ ö ðøąÿĉ ì íĉĝÿ ĀÿĆ ö óĆ î íŤ×ĂÜêĆü ĒðøìĆĚ Ü
ÿĂÜîĊĚđìŠćÖĆïǰǰđöČęĂìéÿĂïÙŠćđÞúĊę÷×ĂÜêąÖĆęü
ìĊę ó ïĔîîĚĞ ćîöÖĆ ï ìćøÖìĊę öĊîĚĞ ćĀîĆ ÖǰǰÖĉēúÖøĆöǰ
ǰĀćÖöĊÙŠćêęĞćÖüŠćǰǰg/L
ìćøÖÝąĕéšøĆïÿćøêąÖĆęüđךćÿĎŠøŠćÜÖć÷ǰǰμg/kg
êŠ Ă üĆ î  ĒúąöĊ Ö ćøýċ Ö þćÙüćöÿĆ ö óĆ î íŤ ø ąĀüŠ ć Ü
 Volume 48 No.3 September - December 2021
intestinal Ca** absorption
êąÖĆęüĔîîĚĞćîööćøéćĒúąøąéĆïÿćøêąÖĆęüĔîđúČĂé
×ĂÜöćøéćǰÝĞ ć îüîǰ255 ÙĎŠ ǰĀúĆ Ü ÙúĂéǰ1 đéČ Ă îǰ
óïüŠć êąÖĆęüĔîîĚĞćîöĂ÷ĎŠìĊęǰ - ǰμg/L øąéĆï
ÿćøêąÖĆęüĔîđúČĂé×ĂÜöćøéćĂ÷ĎŠìĊęǰ - ǰwHE-
øąéĆïÿćøêąÖĆęüĔîđúČĂé×ĂÜìćøÖĂ÷ĎŠìĊęǰ - ǰ
μg/dL àċęÜóïÙüćöÿĆöóĆîíŤĕðĔîìćÜïüÖ×ĂÜøąéĆï
ÿćøêąÖĆęü ĔîđúČĂ é×ĂÜìćøÖÖĆï êąÖĆęü ĔîîĚĞ ć îö
ĒúąđúČĂé×ĂÜöćøéćǰēé÷ðøĉöćèêąÖĆęüĔîîĚĞćîööĊ
ÙüćöÿĆ ö óĆ î íŤ ÖĆ ï êąÖĆę ü ĔîđúČ Ă éǰǰwHE-ǰĔî
ñúÖøąìï×ĂÜÿćøêąÖĆęü
êŠĂÿč×õćóĀâĉÜêĆĚÜÙøøõŤ
êąÖĆę ü ÿŠ Ü ñúđÿĊ ÷ êŠ Ă øąïï×ĂÜøŠ ć ÜÖć÷
Āúć÷øąïïǰēé÷ñŠćîÖćøđóĉęö×ċĚî×ĂÜǰOxidative
stress đðŨîĀúĆÖǰđöČęĂêąÖĆęüđðúĊę÷îĒðúÜÖúĕÖÖćø
ìĞ ć Üćî×ĂÜøąïïêŠ ć Üė ĔîøŠć ÜÖć÷Ýċ Üđóĉę ö Ùüćö
đÿĊę ÷ ÜêŠ Ă ĂĆ î êøć÷ìĊę Ý ąđÖĉ é ×ċĚ î ĔîøąĀüŠ ć ÜÖćø
êĆĚÜÙøøõŤǰēé÷öĊøć÷úąđĂĊ÷ééĆÜîĊĚ
. ēúĀĉêÝćÜǰ Anemia)
ēúĀĉêÝćÜøąĀüŠćÜÖćøêĆĚÜÙøøõŤêøüÝüĆé
ĕéšÝćÖøąéĆïăĊēöēÖúïĉîǰ Hb
ëČĂüŠćöĊõćüąēúĀĉêÝćÜ ñúÖøąìï×ĂÜēúĀĉêÝćÜ
êŠĂĀâĉÜêĆĚÜÙøøõŤÝąđóĉęöĂĆêøćÖćøêć÷ðøĉÖĞćđîĉé àċęÜ

ÿĆöóĆîíŤÖĆïÙüćöđÿĊę÷Ü×ĂÜÖćøÙúĂéÖŠĂîÖĞćĀîé
ǰđðŨî
ĒúąÖćøđÝøĉâđêĉïēê×ĂÜìćøÖǰÖćøđÖĉéēúĀĉêÝćÜ
ÝćÖÿćøêąÖĆęüđÖĉéĕéšÝćÖĀúć÷ÿćđĀêč 1) ÖćøÿøšćÜǰ
Heme úéúÜǰđóøćąêąÖĆęüÝąĕðÝĆïÖĆïđĂîĕàöŤìĊę
ÿĞćÙĆâĔîÖćøÿøšćÜǰHeme ÙČĂ Delta-Aminolevulinic
Acid Dehydratase (ALA-D
ǰĒúąǰFerrochelatase ÖüŠ ć ìĊę đÙøČę Ă ÜöČ Ă ÝąêøüÝóï, SBP đÞúĊę ÷ đìŠ ć ÖĆ ïǰ
đðŨ î ñúĔĀš ǰPorphyrin ĔîđúČ Ă éđóĉę ö ×ċĚ î ǰ
ǰÖćø ǰmmHg21 àċę Ü ÿĂéÙúš Ă ÜÖĆ ï Öćøýċ Ö þć×ĂÜǰ
×îÿŠÜ×ĂÜđĀúĘÖ đךćÿĎŠ ĕöēêÙĂîđéøĊ÷ĔîđöĘ é đúČ Ăé
ĒéÜëĎÖ×Ćé ×üćÜìĞ ćĔĀš ÖćøÿøšćÜăĊēöēÖúïĉî úéúÜ
ĒúąđÖĉé ÖćøÙĆęÜ ×ĂÜǰProtoporphyrin ĔîđúČĂé

Öćø÷Ćï÷ĆĚÜÖćøìĞćÜćî×ĂÜđĂîĕàöŤǰNa-K-ATPase
×ĂÜđöĘéđúČĂéĒéÜǰđðŨîñúĔĀšđöĘéđúČĂéĒéÜđðøćą
ĒêÖÜŠć÷×ċĚîĒúąĂć÷čÿĆĚîúÜǰĒúąǰ
ǰÖćø÷Ćï÷ĆĚÜÖćø ÖćøĀćÙüćöÿĆöóĆ îíŤ×ĂÜøąéĆï ÿćøêąÖĆęüÖĆïÖćø
ÿøšćÜ Globin ìĞćĔĀšÖćøñúĉêđöĘéđúČĂéĒéÜúéúÜ20
. ÙüćöéĆ î ēúĀĉ ê ÿĎ Ü ×è ąêĆĚ Ü ÙøøõŤǰ
(Gestational Hypertension: GH)
ÙüćöéĆ î ēúĀĉ ê ÿĎ Ü×èąêĆĚ ÜÙøøõŤ ǰÙČ Ăǰ
õćüąìĊęöĊǰSystolic Blood Pressure (SBP) œ 
ǰìĆĚÜîĊĚÖćøđÖĉéõćüą
mmHg ĀøČ Ă ǰDiastolic Blood Pressure (DBP)
œ 90 mmHg ìĊę ê øüÝóïĔîߊ ü ÜĂć÷č Ù øøõŤ ǰǰ
ÿĆðéćĀŤ×ċĚîĕðǰēé÷ĕöŠóïõćüąǰProteinuria øŠüöéšü÷
ÙüćöéĆîēúĀĉêÿĎÜđðŨîĂĆîêøć÷êŠĂöćøéćĒúąìćøÖ
ĔîÙøøõŤǰĂĆîêøć÷êŠĂöćøéćǰìĞćĔĀšđúČĂéĕĀúđüĊ÷î
ĔîøŠćÜÖć÷ÿŠüîêŠćÜėǰĕéšĕöŠéĊǰìĞćĔĀšĂüĆ÷üąìĞćÜćî
úšöđĀúüǰĒúąĂćÝìĞćĔĀšđÿšîđúČĂéĔîÿöĂÜĒêÖđÖĉé
ĀĆüĔÝüć÷đóøćąĀĆüĔÝìĞćÜćîĀîĆÖđÖĉîĕðǰñúđÿĊ÷ìĊę
ÝąđÖĉéÖĆïìćøÖǰìĞćĔĀšÖćøđðúĊę÷îëŠć÷ĂćĀćøĒúą
×ĂÜđÿĊ ÷ øąĀüŠ ć ÜöéúĎ Ö ÖĆ ï øÖĕöŠ éĊ ǰ ìĞ ć ĔĀš Ö ćø
đÝøĉâđêĉïēê×ĂÜìćøÖñĉéðÖêĉǰēĂÖćÿđÖĉéÖćø×ćé
ĂĂÖàĉđÝîĔîÙøøõŤöĊÜŠć÷×ċĚîǰĂćÝìĞćĔĀšìćøÖêć÷Ĕî
ÙøøõŤ êąÖĆę üđðŨ îðŦ ÝÝĆ÷Āîċę ÜìĊę đóĉę öēĂÖćÿÖćøđÖĉ é
ÙüćöéĆîēúĀĉêÿĎÜ×èąêĆĚÜÙøøõŤǰöĊÖćøýċÖþćđÖĊę÷üÖĆï
ÿćøêąÖĆęüĒúąõćüąÙüćöéĆîēúĀĉêÿĎÜĔîĀîĎìéúĂÜǰ
ēé÷ĒïŠÜđðŨî ÿĂÜÖúčŠö ǰÙČ ĂǰÖúčŠö ìĊęĕéšøĆïÿćøêąÖĆę üǰ
(Lead acetate) ðøĉöćèǰǰppm (ÖúčŠöìéúĂÜ
ĕêøöćÿìĊęǰ1 ×ĂÜÖćøĒìšÜìĆĚÜĀöéǰÖćøýċÖþć×ĂÜǰ
š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal
ĒúąÖúčŠöìĊęĕöŠĕéšøĆïÿćøêąÖĆęüǰ ÖúčŠöÙüïÙčö
øą÷ąđüúćǰǰüĆîǰĀúĆÜđÿøĘÝÿĉĚîÖćøìéúĂÜǰóïüŠćǰ
ÖúčŠöìéúĂÜöĊøąéĆïÿćøêąÖĆęüĔîđúČĂéđÞúĊę÷đìŠćÖĆï
ǰμg/dL, SBP đÞúĊę÷đìŠćÖĆïǰǰmmHg Ĕî×èą
ìĊęÖúčŠöÙüïÙčöðøĉöćèøąéĆïÿćøêąÖĆęüĔîđúČĂéêęĞć
Fiorim ĒúąÙèą22 ìĊęóïüŠć ÖćøĕéšøĆïÿćøêąÖĆęüĔî
øąéĆïêęĞćǰ ðøąöćèǰǰμg/dL) ĀøČĂÿĆöñĆÿđóĊ÷ÜÙøĆĚÜ
đéĊ ÷üĔîÙüćöđך öך îÿĎ Üǰ ðøąöćèǰǰμg/dL) ÖĘ
ÿćöćøëđóĉęöǰSBP ĔîÿĆêüŤìéúĂÜĔĀšÿĎÜ×ċĚîĕéšǰÿŠüî
ÖćøýċÖþćĔîöîčþ÷Ťēé÷ǰYazbeck ĒúąÙèą ìĞć
đÖĉéÙüćöéĆîēúĀĉêÿĎÜĔîĀâĉÜêĆĚÜÙøøõŤǰÝĞćîüîǰǰ
ÙîǰìĊęĕéšøĆï ÖćøüĉîĉÝÞĆ÷ üŠćöĊÙ üćöéĆî ēúĀĉê ÿĎÜĔî
ĕêøöćÿìĊęǰǰĒúąǰǰñúÖćøýċÖþć óïüŠć ǰøąéĆï
ÿćøêąÖĆęü öĊÙ üćöÿĆö óĆî íŤÖĆï ÙüćöéĆ î ēúĀĉ ê ÿĎ Üǰ
ǰ± ǰμg/dL, p = 
ÙüćöéĆ îēúĀĉ êÿĎ ÜÝćÖÿćøêąÖĆę üđÖĉ é×ċĚ îéš ü÷ðŦ Ý ÝĆ ÷
Āúć÷ðøąÖćøǰđߊ î ǰÖćøđðúĊę ÷ îĒðúÜǰCalcium
homeostasis Öćøđóĉę ö ÖćøìĞ ć Üćî×ĂÜǰRenin-
Angiotensin system Ö ć ø ú é ÿ ć ø ǰAntioxidant
reserves ĀøČĂÖćøđóĉęö×ċĚî×ĂÜÿćøĂîčöĎúĂĉÿøąĔî
øŠćÜÖć÷ǰ(Reactive Oxygen Species: ROS) àċę Ü
ÿŠÜñúĔĀšđÖĉéõćüąđÙøĊ÷éĂĂÖàĉđéßĆęî (Oxidative
stress) îĂÖÝćÖîĊĚÖćøÿĎâđÿĊ÷ĀîšćìĊę×ĂÜđàúúŤđ÷ČęĂïč
ñîĆÜĀúĂéđúČĂé ÖćøéĎéàċöĕîêøĉÖĂĂÖĕàéŤúéúÜǰ
ĒúąÖćøđóĉęöøąéĆï×ĂÜǰEndothelin ìĞćÙüćöđÿĊ÷Āć÷
êŠĂìŠĂĕê21
3. ÖćøĒìš ÜìĊę đÖĉ é×ċĚ îđĂÜǰ Spontaneous
abortion)
ÖćøĒìš ÜìĊę đÖĉé ×ċĚ î đĂÜǰĀöć÷ëċ ÜǰÖćø
ÿĎ â đÿĊ ÷ ÖćøêĆĚ ÜÙøøõŤ ÖŠ ĂîÿĆ ð éćĀŤ ìĊę ǰ20 ×ĂÜÖćø
êĆĚÜÙøøõŤǰÿŠ üîĔĀ⊠öćÖÖüŠćøšĂ÷úąǰ ÝąóïĔî
š‹’š‹‹šŠ¤|Ÿ•ƒÊ¬q‚™‚¬i™ŠšŠ€™šl‰ 
 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal
Borja-Aburto ĒúąÙèą đóČęĂðøąđöĉîÙüćöđÿĊę÷Ü
×ĂÜÖćøĒìšÜìĊęđÖĉé×ċĚîđĂÜÝćÖÖćøĕéšøĆïÿĆöñĆÿÿćø
êąÖĆęüøąéĆïêęĞćĀøČĂðćîÖúćÜǰñúÖćøýċÖþć óïüŠćǰ
Āâĉ Ü êĆĚ Ü ÙøøõŤ ìĊę đÖĉ é ÖćøĒìš Ü öĊ ø ąéĆ ï ÿćøêąÖĆę ü
ĔîđúČ ĂéđÞúĊę ÷ đìŠ ć ÖĆ ï ǰǰwHE-ǰÿĎ ÜÖüŠ ć Āâĉ Ü
êĆĚÜÙøøõŤìĊęđðŨîÖúčŠöÙüïÙčöìĊęöĊøąéĆïÿćøêąÖĆęüĔî
đúČĂéđÞúĊę÷đìŠćÖĆïǰǰwHE-ǰĂ÷ŠćÜöĊîĆ÷ÿĞćÙĆâ
ìćÜÿëĉêĉǰĒúą÷ĆÜóïüŠć ìčÖėǰ5 μg/dL ÝąìĞćĔĀšöĊ
ēĂÖćÿĒìšÜđóĉęööćÖ×ċĚîǰ đìŠćǰ 95%$*ǰǰ - 
ÿöïĎøèŤ ǰîĞćĕðÿĎŠÖćøđÝøĉâđêĉïēêìĊęßšćǰđÖĉéñúđÿĊ÷
ēé÷øĎðĒïï ÖćøøĆïÿĆöñĆÿÿćøêąÖĆęü×ĂÜÿćöĊĒúą
õøø÷ćìĊęöĊÙüćöÿĆöóĆ îíŤêŠĂÖćøĒìš ÜöĊǰ øĎðĒïïǰ
ÙČĂǰ1) ÿćøêąÖĆęüĔîÿćöĊëĎÖÿŠÜñŠćîìćÜîĚĞćĂÿčÝĉĕð
ÿĎŠĒöŠǰ2) ÿćøêąÖĆęüÝćÖđÿČĚĂñšć ĂčðÖøèŤìĞćÜćî öČĂ
×ĂÜÿćöĊ ĄúĄǰđðŨ î ĒĀúŠ Ü ÖćøÿĆ ö ñĆ ÿ ÿćøêąÖĆę ü
ÿĞćĀøĆïõøø÷ć Ēúąǰ
ǰÿćøêąÖĆęüĔîêĆüÿćöĊìĞćĔĀš Jelliffe-Pawlowski ĒúąÙèą ĔîĀâĉÜêĆĚÜÙøøõŤ
đÖĉ é ÖćøđðúĊę ÷ îĒðúÜ×ĂÜĂÿč Ýĉ ǰēé÷ÙĎŠ øĆÖ ìĊę ÿ ćöĊ öĊ
øąéĆ ï ÿćøêąÖĆę ü ĔîđúČ Ă éöćÖÖüŠ ć ǰǰwHE-ǰöĊ
ÙüćöÿĆöóĆîíŤÖĆïÖćøĒìšÜ Ă÷ŠćÜöĊîĆ÷ÿĞćÙĆâìćÜÿëĉêĉ
(, 95%CI =  - 
ǰÿŠüîøąéĆïÿćøêąÖĆęüĔî ÖćøđÖĉéõćüąìćøÖêĆüđúĘÖǰ(Small-for-Gestational-
õøø÷ćĒöšđóĊ÷Üǰ5 - 9 μg/dL ÖĘĂćÝđóĉęöÙüćöđÿĊę÷Ü
ÖćøĒìšÜđðŨîÿĂÜđìŠć25
ñúÖøąìï×ĂÜÿćøêąÖĆęü
êŠĂÿč×õćóìćøÖĒøÖđÖĉé
ñúÖøąìïêŠĂÿč×õćó×ĂÜìćøÖĒøÖđÖĉéöĊ
éĆÜîĊĚ
. ÖćøÙúĂéÖŠ Ă îÖĞ ć Āîéǰ Preterm
labor)
ÖćøÙúĂéÖŠĂîÖĞćĀîéđðŨîõćüąÖćø
ÙúĂéÖŠĂîĂć÷čÙøøõŤÙøïǰǰÿĆðéćĀŤǰàċęÜÖćøìĞćÜćî
×ĂÜĂüĆ÷üąĒìïìčÖÿŠüî×ĂÜìćøÖ÷ĆÜĕöŠéĊđìŠćìćøÖ
ÙøïÖĞ ć ĀîéǰÿŠ Ü ñúĔĀš đÖĉ é ÖćøđðúĊę ÷ îĒðúÜìĊę
ñĉéðÖêĉĒúąÿŠÜñúêŠĂøąïïøŠćÜÖć÷ǰđߊîǰðĂéǰóï
ðŦâĀćđøČęĂÜÖćø×ćéÿćøúéĒøÜêċÜñĉüǰìĞćĔĀšëčÜúö
ĒôïǰìćøÖÝąöĊĂćÖćøĀć÷ĔÝĀĂïĒúąĂćÝêšĂÜĔßš
 Volume 48 No.3 September - December 2021
đÙøČęĂÜߊü÷Āć÷ĔÝǰĀĆüĔÝǰĂćÝöĊðŦâ ĀćđÿšîđúČĂéìĊę
đßČęĂöêŠĂøąĀüŠćÜđÿšîđúČĂéĒéÜĔĀâŠìĊęĂĂÖÝćÖĀĆüĔÝ
đóČęĂĕðđúĊĚ÷ÜøŠćÜÖć÷ÖĆïđÿšîđúČĂéìĊęĕðÿĎŠðĂé÷ĆÜđðŗéĂ÷ĎŠ
(PDA) ìĞćĔĀšöĊđúČĂéñŠćîĕðÿĎŠðĂéöćÖđðŨîñúìĞćĔĀš
ìćøÖĀć÷ĔÝĀĂïǰĒúąđÖĉ é õćüąĀĆ ü ĔÝúš ö đĀúüǰ
Ēúą÷ĆÜöĊÙüćöđÿĊę÷ÜêŠĂÖćøđÖĉéõćüąìčóēõßîćÖćø
đîČęĂÜÝćÖöĊÖćøÿąÿö×ĂÜÿćøĂćĀćøĔîøŠćÜÖć÷îšĂ÷
öĊ Ö ćøóĆ ç îć×ĂÜøąïïìćÜđéĉ î ĂćĀćøìĊę ÷Ć Ü ĕöŠ
êŠĂóĆçîćÖćøĒúąÿč×õćóøą÷ą÷ćü ÿćøêąÖĆęü
×Ćé×üćÜÖćøÿĆ ÜđÙøćąĀŤ Ù ĂúúćđÝîĒúąǰPraline
hydroxylation àċęÜĂćÝöĊñúÖøąìïìĊęđðŨ îĂĆîêøć÷
êŠ ĂēÙøÜÿøš ćÜǰChorioamniotic membrane Ēúą
ìĞćĔĀšđÖĉéõćüąîĚĞćđéĉîÖŠĂîÖĞćĀîé ÖćøýċÖþć×ĂÜ
ĒúąìćøÖǰÝĞćîüîǰǰÙĎŠǰóïüŠćǰĀâĉÜêĆĚÜÙøøõŤìĊęöĊ
øąéĆï ÿćøêąÖĆę üĔîđúČĂéöćÖÖüŠćĀøČĂđìŠ ćÖĆï ǰ10
μg/dL ÝąöĊĒîüēîšöÖćøÙúĂéÖŠĂîÖĞćĀîéǰøüöëċÜ
Age: SGA) ēé÷óïÙüćöÿĆö óĆ îíŤ×ĂÜÖćøđóĉę ö×ċĚ î
×ĂÜøąéĆïÿćøêąÖĆęüìĊęöćÖÖüŠćǰ μg/dL Ýąúé
-ǰ×ĂÜüĆîÖćøêĆĚÜÙøøõŤǰđöČęĂđìĊ÷ïÖĆïñĎšĀâĉÜìĊęöĊ
øąéĆïÿćøêąÖĆęüêęĞćÖüŠćǰîĂÖÝćÖîĊĚñĎšĀâĉÜìĊęöĊøąéĆï
ÿćøêąÖĆęüöćÖÖüŠćǰ μg/dL öĊÙüćöđÿĊę÷Üđóĉęö×ċĚîǰ
ǰđìŠćǰÿĞćĀøĆïÖćøÙúĂéÖŠĂîÖĞćĀîéǰĒúąöĊÙüćö
đÿĊę÷Üđóĉęö×ċĚîǰǰđìŠćǰÿĞćĀøĆïÖćøöĊìćøÖǰSGA ēé÷
ÙŠćøąéĆïÿćøêąÖĆęüĔîđúČĂéöćÖÖüŠćǰ μg/dL Ĕî
ĕêøöćÿìĊęÿĂÜđÖĊę÷üךĂÜÖĆï ÖćøúéúÜ×ĂÜÝĞćîüî
üĆ î ìĊę êĆĚ ÜÙøøõŤ ìĆĚ Ü Āöéǰ úéúÜǰ-ǰüĆ î êŠ ĂĀîŠ ü ÷
đóĉę ö ×ċĚ î öćÖÖüŠ ć ǰ μg/dL) àċę Ü ÿĂéÙúš Ă ÜÖĆ ï
ÖćøýċÖþć×ĂÜǰTaylor, Golding & Emond óïüŠć
øąéĆïÿćøêąÖĆęüĔîđúČĂéöćÖÖüŠćǰ μg/dL Ýąđóĉęö
ÙüćöđÿĊę÷ÜêŠĂÖćøÙúĂéÖŠĂîÖĞćĀîé10

. îĚĞ ć ĀîĆ Ö ĒøÖđÖĉ é îš Ă ÷ǰ Low birth
weight)
ìćøÖÙøïÖĞ ćĀîéĂć÷č ÙøøõŤ øąĀüŠ ćÜǰ
 - ǰÿĆðéćĀŤǰÿŠüîĔĀâŠöĆÖÝąöĊîĚĞćĀîĆÖĒøÖđÖĉé
öćÖÖüŠćĀøČĂđìŠćÖĆïǰ
ǰÖøĆöǰìćøÖĒøÖđÖĉéìĊęöĊ
îĚĞćĀîĆÖîšĂ÷ÖüŠćǰ
ǰÖøĆöǰöĆÖöĊðŦâĀćÖćøđÝĘïðśü÷ ëċ Ü ÖćøđÝøĉâ đêĉ ï ēê×ĂÜÿöĂÜìćÜĂš Ăöĕéš ǰöĆ Ö Ĕßš
ĒúąÖćøêć÷ÝćÖÖćøêĉéđßČĚĂÿĎÜǰēé÷öĊÙüćöÿĆöóĆîíŤ
ÖĆïõĎöĉÙčšöÖĆîêęĞćǰóĆç îćÖćøúŠćßšćǰĒúąđöČęĂēê×ċĚî
ÝąöĊÙüćöđÿĊę÷ÜĔîÖćøđÖĉéēøÙđøČĚĂøĆÜǰđߊîǰÙüćöéĆî
ēúĀĉ ê ÿĎ Ü ǰđïćĀüćî 29 éš ü ÷Ùč è ÿöïĆ êĉ ì ćÜđÙöĊ ìĊę
Ùúšć÷ÖĆîøąĀüŠćÜÿćøêąÖĆęüÖĆïĒÙúđàĊ÷öÝċÜìĞćĔĀš
ÿćøêąÖĆę ü ÿćöćøëđך ć ĕðĒìîìĊę Ē ÙúđàĊ ÷ öĒúą
÷Ćï÷ĆĚÜÖćøĀúĆęÜǰOsteocalcin ĔîđàúúŤÿøšćÜÖøąéĎÖǰ
ÿŠÜñúĔĀšúéÖćøđÝøĉâđêĉïēê×ĂÜÖøąéĎÖǰÿćøêąÖĆęü
÷Ć Ü đðúĊę ÷ îĒðúÜǰHypothalamic-pituitary axis
function ìĞćĔĀšÖćøĀúĆęÜăĂøŤēöîìĊęÝĞćđðŨîêŠĂÖćø
đÝøĉâđêĉïēêîšĂ÷úÜ öĊÖćøýċÖþć óïüŠć øąéĆïÿćø
êąÖĆęüìĊęǰ μg/dL Ēúąǰ μg/dL ÝąìĞćĔĀšîĚĞćĀîĆÖ
×ĂÜìćøÖĒøÖđÖĉ é úéúÜǰǰÖøĆ ö ǰĒúąǰǰÖøĆ ö
êćöúĞćéĆï ÿĂéÙúšĂÜÖĆïÖćøýċÖþć×ĂÜǰZhang
ĒúąÙèą ìĊ ęý ċÖ þćÙüćöÿĆö óĆî íŤ× ĂÜîĚĞ ć ĀîĆÖ
ìćøÖÙúĂéÖŠ Ă îÖĞ ć ĀîéÖĆ ï øąéĆ ï ÿćøêąÖĆę ü Ĕî
ðŦÿÿćüą×ĂÜöćøéćǰóïüŠćǰøąéĆïÿćøêąÖĆęüöĊÙüćö
ÿĆöóĆîíŤÖĆïîĚĞćĀîĆÖìćøÖÙúĂéÖŠĂîÖĞćĀîé Ă÷ŠćÜöĊ
îĆ÷ÿĞćÙĆâìćÜÿëĉêĉǰOR = ǰ CI =  -

ǰÙüćößĆéđÝî×ĂÜÙüćöÿĆöóĆîíŤ÷ęĉÜđóĉę ööćÖ
÷ĉęÜ×ċĚîĔîÖúčŠöìćøÖđóýĀâĉ ÜǰOR = ǰ CI =
 - 
ǰöćÖÖüŠ ć ìćøÖđóýßć÷ǰOR = ǰ ×ĂÜÿöĂÜ
(95%CI =  - 
ǰđîČęĂÜÝćÖÿćøêąÖĆęüöĊÙüćö đéĘÖìĊęöĊøąéĆïÿćøêąÖĆęüĔîđúČĂéĒöšÝą
ÿćöćøëĔîÖćøúéÖćøìĞćÜćî×ĂÜđĂÿēêøđÝîǰàċęÜöĊ
Āîš ćìĊę ÿĞ ćÙĆ âĔîÖćøÖøąêčš îĔĀš đÖĉ éÖćøóĆ ç îćĒúą
ÙüïÙčöÖøąïüîÖćøìćÜÿøĊøüĉì÷ć àċęÜìćøÖĔîÙøøõŤ
ÝąĕéšøĆïñŠćîìćÜöćøéćǰÖćøĂĂÖùìíĉĝ×ĂÜđĂÿēêøđÝî
ǰêęĞćǰöĊðŦâĀćĔîđøČęĂÜ
îĆĚîÝąĂĂÖùìíĉĝñŠćîÖćøÖøąêčšîêĆüøĆï×ĂÜđĂÿēêøđÝî
(Estrogen Receptors: ERs) àċęÜÝąëĎÖóïĔîđóýĀâĉÜ
š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal
öćÖÖüŠćđóýßć÷ǰÝċÜĂćÝđðŨ î ÿćđĀêčĔĀš ó ïìćøÖ
îĚĞćĀîĆÖîšĂ÷ĔîđóýĀâĉÜöćÖÖüŠćđóýßć÷
3. úé×îćéđÿšîøĂïýĊøþąǰ Low head
circumference)
×îćé×ĂÜøĂïýĊøþąÿćöćøëïŠÜïĂÖ
ðøąđöĉîĔîđéĘÖĂć÷čîšĂ÷ÖüŠćǰǰðŘǰēé÷đéĘÖßć÷ÝąöĊ
đÿšîøĂïýĊøþąēêÖüŠćđéĘÖĀâĉÜđúĘÖîšĂ÷ǰàċęÜđéĘÖĒøÖ
đÖĉéÝąöĊđÿšîøĂïýĊøþą÷ćüðøąöćèǰǰđàîêĉđöêø
Öćøýċ Öþć×ĂÜǰRothenberg ĒúąÙèą óïÙüćö
ÿĆö óĆ î íŤđßĉ Üúï×ĂÜøąéĆ ï ÿćøêąÖĆęü ĔîöćøéćêŠ Ă
đÿšîøĂïýĊøþąìćøÖǰēé÷øąéĆïÿćøêąÖĆęüĔîđúČĂé
×ĂÜöćøéćߊ ü Üǰǰ-  μg/dL ìĊę Ă ć÷č Ù øøõŤ ǰǰ
ÿĆðéćĀŤÝąìĞćĔĀš×îćé×ĂÜøĂïýĊøþąìćøÖúéúÜǰ
 đàîêĉđöêø (95%CI =  - ) êĂîìćøÖ
Ăć÷čǰǰđéČĂîǰñúÖćøýċÖþćéĆÜÖúŠćü÷ĆÜÿĂéÙúšĂÜ
ÖĆïÖćøýċÖþć×ĂÜǰSchell ĒúąÙèą ìĊęýċÖþćĔî
Āâĉ Ü êĆĚ Ü ÙøøõŤ Ē úąìćøÖǰÝĞ ć îüîǰǰÙĎŠ ǰóïüŠ ćǰ
øąéĆï ÿćøêąÖĆęü Ĕîöćøéćߊü ÜĕêøöćÿìĊęÿ ĂÜìĊęöĊ
ÙŠćöćÖÖüŠćǰ μg/dL Ýąúé×îćéøĂïýĊøþą×ĂÜ
ìćøÖĀúĆÜÙúĂéìĊęǰǰĒúąǰǰđéČĂî
ñúÖøąìï×ĂÜÿćøêąÖĆęü
êŠĂÿč×õćó×ĂÜđéĘÖ
ÿćøêąÖĆęüöĊñúÖøąìïêŠĂÿč×õćó×ĂÜđéĘÖ
éĆÜîĊĚ
. ñúÖøąìïêŠ Ă ÖøąïüîÖćøìĞ ć Üćî
êęĞćÖüŠćøąéĆïǰǰμg/dL ÿćöćøëÖŠĂĔĀšđÖĉéÙüćö
ñĉéðÖêĉêŠĂøŠćÜÖć÷ĕéšǰēé÷đÞóćąêŠĂÖøąïüîÖćø
ìĞćÜćî×ĂÜÿöĂÜǰ Cognitive function) ìĞćĔĀšöĊøąéĆï
Intelligence Quotient (IQ
ÖćøđøĊ÷îøĎšǰóĆçîćÖćøúŠćßšćǰ×ćéÿöćíĉǰĒúąĂćÝÝąöĊ
ðŦ â ĀćđøČęĂÜóùêĉ ÖøøöÖćøđך ćÿĆ ÜÙöđöČę Ăđך ćÿĎŠ üĆ ÷
š‹’š‹‹šŠ¤|Ÿ•ƒÊ¬q‚™‚¬i™ŠšŠ€™šl‰ 
 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal
ñĎšĔĀ⊠ öĊÖćøýċÖþćĔîĀîĎìéúĂÜìĊęêĆĚÜÙøøõŤēé÷
ǰĔîđéĘÖĂć÷čǰǰðŘ
ĔĀšéČęöîĚĞćìĊęñÿöêąÖĆęüĂąàĉđêìǰǰóïüŠćǰúĎÖĀîĎ
ìĊę Ù úĂéĂĂÖöćĕéš øĆ ï ñúÖøąìïêŠ Ă ÖćøóĆ ç îć
ǰÝąđêĊĚ ÷ ÖüŠ ćđéĘ ÖìĊę öĊ øąéĆ ï ÿćøêąÖĆę ü Ĕî
øąïïðøąÿćìĔîøą÷ą÷ćü øüöëċ ÜÖćøýċ Ö þćǰ
Cognitive deficits ĔîđéĘ Ö ǰēé÷Ĕßš đÙøČęĂ ÜöČ ĂÖćø
ðøąđöĉîǰBayley Mental Development Index
ǰĒúą÷ĆÜóïüŠć ÖćøÿĆöñĆÿÿćøÿćøêąÖĆęü
(MDI
ǰÖĆïÖćøêøüÝüĆéøąéĆïÿćøêąÖĆęüÖŠĂîÙúĂé ÖŠĂîÙúĂéĕöŠöĊÙüćöÿĆöóĆîíŤÖĆïǰBMI ĔîđéĘÖìčÖė
ĔîđúČĂéÝćÖÿć÷ÿąéČĂ×ĂÜđéĘÖǰóïüŠćǰÙŠćöĆí÷åćî
×ĂÜøąéĆï ÿćøêąÖĆę üĔîđúČĂ éÝćÖÿć÷ÿąéČ ĂĂ÷ĎŠ ìĊęǰ
ǰμg/dL Ă÷ĎŠĔîߊüÜǰǰëċÜǰǰμg/dL ēé÷
Cognitive function ÝąöĊÙüćöÿĆöóĆîíŤÖĆïøąéĆï
ÿćøêąÖĆęüÖŠĂîÙúĂéēé÷đÞóćąĔîđéĘÖñĎšßć÷ìĊęĂć÷čǰ
ǰđéČĂî ĒêŠÖĘöĊÖćøýċÖþćìĊęóïüŠćǰÖćøĕéšøĆïÿćø
êąÖĆę üÖŠ ĂîÙúĂéĔîđéĘ Ö ĕöŠ öĊÙ üćöÿĆö óĆ î íŤÖĆ ï ǰIQ
×ĂÜđéĘ Ö êĂîĂć÷č ǰ ǰĀøČ Ă ǰǰðŘ ǰ ĒêŠ ÖĘ ÷Ć Ü ðøćÖä
ĀúĆÖåćîïćÜĂ÷ŠćÜìĊęßĊĚĔĀšđĀĘîüŠćđéĘÖñĎšßć÷öĊÙüćö
ĂŠĂîĕĀüöćÖÖüŠćđéĘ ÖñĎš Āâĉ ÜìĊę Ý ąĕéš øĆï ÿćøêąÖĆę ü
ÖŠĂîÙúĂé Ēúą÷ĆÜöĊÖćøýċÖþćëċÜÖćøÿĆöñĆÿÿćø
êąÖĆęüÖĆïÖćøđÖĉéēøÙÿöćíĉÿĆĚîĔîđéĘÖĂć÷č ǰ- ǰðŘ
ēé÷öĊ øĎðĒïïÖćøýċ ÖþćđðŨ îǰCase-control study
óïüŠćǰÖćøýċÖþćøąéĆïÿćøêąÖĆęüĔîđúČĂéÖĆïÖćøđÖĉé
ēøÙÿöćíĉÿĆĚ î öĊÙüćöÿĆö óĆ îíŤÖĆîĂ÷ŠćÜöĊ îĆ ÷ÿĞćÙĆ â
ìćÜÿëĉêĉǰēé÷đÞóćąĔîđéĘ ÖìĊę øĆï ÿĆö ñĆÿ ÿćøêąÖĆę ü
öćÖÖüŠćǰǰμg/dL ÝąđóĉęöēĂÖćÿđÿĊę÷ÜêŠĂÖćøđðŨî
ēøÙÿöćíĉÿĆĚî ĒêŠĂ÷ŠćÜĕøÖĘêćöÖćøýċÖþćéĆÜÖúŠćü
ĕöŠÿćöćøëĂíĉïć÷úċÖúÜĕðëċÜøąéĆïÖúĕÖ×ĂÜÖćøđÖĉé
ēøÙÿöćíĉ ÿĆĚ î ÖĆ ï ÖćøÿĆ ö ñĆ ÿ ÿćøêąÖĆę ü ĕéš ǰàċę Ü ēøÙ
ÿöćíĉÿĆĚîđðŨîēøÙÝĉêđüßđéĘÖìĊęóïïŠĂ÷ìĊęÿčéǰēé÷öĊ
ĂĆêøćÙüćößčÖđÞúĊę÷ìĆęüēúÖđìŠćÖĆïøšĂ÷úąǰǰĒúą
Ĕîðøąđìýĕì÷öĊÙüćößčÖđìŠćÖĆïøšĂ÷úąǰǰĒ÷ÖđðŨî
đóýßć÷øšĂ÷úąǰǰĒúąđóýĀâĉÜøšĂ÷úąǰ
. ñúÖøąìïêŠ ĂÖćøđÝøĉâ đêĉ ï ēê×ĂÜ
øŠćÜÖć÷
öĊÖćøýċÖþćëċÜøąéĆïÿćøêąÖĆęüĔîđúČĂé
ǰĒúą 
ǰÖúčŠöđéĘÖðÖêĉìĊęöćøĆïïøĉÖćøìĊęÙúĉîĉÖ
ìĊę ÿŠ ÜñúêŠ ĂÖćøđÝøĉâ đêĉ ï ēêǰéš ćîÿŠü îÿĎ ÜÖĆ ï éĆ ß îĊ
 Volume 48 No.3 September - December 2021
öüúÖć÷ǰBody Mass Index (BMI
óïüŠćǰđéĘÖìĊęöĊÿćøêąÖĆęüĔîđúČĂéÿĎÜöćÖÖüŠćÙŠćÖúćÜ
(Median
đúČ ĂéêęĞ ć ÖüŠ ć ÙŠ ć ÖúćÜ Ă÷Š ć ÜöĊ îĆ ÷ ÿĞ ć ÙĆ â ìćÜÿëĉ êĉ
ĔîߊüÜ×ĂÜüĆ÷ìćøÖ (- cm, 95%CI = -ǰ
ëċÜǰ-
ߊüÜüĆ÷ îĂÖÝćÖîĊĚ÷ĆÜöĊÖćøýċÖþćøąéĆïÿćøêąÖĆęü
ĔîđúČĂé×ĂÜđéĘÖĂć÷čǰǰ- ǰðŘǰìĊęöĊøąéĆïÿćøêąÖĆęü
đÞúĊę÷ǰǰμg/dL óïÙüćöÿĆöóĆîíŤđßĉÜúïÖĆïÿŠüîÿĎÜ
ĒúąîĚĞ ćĀîĆÖǰàċęÜĂćÝìĞćĔĀšđÖĉéēøÙÖøąéĎÖóøčî Ĕî
ñĎšĔĀâŠĕéšĔîĂîćÙê Ēúą÷ĆÜöĊÖćøýċÖþćĔîìĞćîĂÜ
đéĊ÷üÖĆîìĊęóïÙüćöÿĆöóĆîíŤìćÜúïøąĀüŠćÜøąéĆï
ÿćøêąÖĆęüĔîđúČĂéÖĆïÿŠüîÿĎÜ×ĂÜđéĘÖ
ĒîüìćÜĔîÖćøêĉéêćöđòŜćøąüĆÜ
ÖćøÿĆöñĆÿÿćøêąÖĆęüĔîĀâĉÜêĆĚÜÙøøõŤ
ĒúąđéĘÖ
ðøąđìýĕì÷ĕéšöĊĒîüìćÜÖćøêĉéêćöđòŜć
øąüĆ Ü ÖćøÿĆ ö ñĆ ÿ ÿćøêąÖĆę ü ĔîÖúčŠ ö đéĘ Ö đúĘ Ö Ăć÷č
0 - 15 ðŘǰìĆĚÜđßĉÜøčÖĒúąđßĉÜøĆï ÖćøéĞćđîĉîÜćîđßĉÜøčÖ
Ĕîßč ö ßîóČĚ î ìĊę đÿĊę ÷ Üǰđøĉę ö ÝćÖÖćøøąïč Ē ĀúŠ Ü Öćø
ðîđðŚŪ Ă î×ĂÜÿćøêąÖĆę ü Ĕîÿĉę Ü Ēüéúš Ă öǰĀćÖöĊ
ðøĉöćèÿćøêąÖĆęüĔîÿĉęÜĒüéúšĂöđÖĉîÙŠćöćêøåćîÖĘ
ÝąéĞćđîĉîÖćøêøüÝüĆéøąéĆïÿćøêąÖĆęüĔîđúČĂéđéĘÖ
êŠĂĕð ÿŠüîÖćøéĞćđîĉî ÜćîđßĉÜøĆïđðŨîĒîüìćÜĔî
ÿëćîó÷ćïćúđóČęĂđòŜćøąüĆÜĒúąðŜĂÜÖĆîÖćøÿĆöñĆÿ
ÿćøêąÖĆęüĔîÖúčŠöđéĘÖđúĘÖǰēé÷đéĘ ÖìĊęøĆïïøĉÖćøĔî
ÿëćîó÷ćïćúĒïŠÜđðŨî ǰÖúčŠöǰĕéšĒÖŠǰ1) ÖúčŠöñĎšðśü÷
đéĘ ÖìĊę öĊ ĂćÖćøÿÜÿĆ ÷ēøÙóĉ þ êąÖĆęüìĊę øĆï ïøĉÖćøǰèǰ
ÿëćîó÷ćïćúǰ2) ÖúčŠöđéĘÖìĊęöĊÙüćöđÿĊę÷ÜÿĎÜöćÝćÖ
ÖćøéĞćđîĉîÜćîđßĉÜøčÖǰ öĊñúÖćøðøąđöĉîÙüćöđÿĊę÷Ü
Ēúšü
ÿč×õćóđéĘÖéĊÙčèõćó (Well Child Clinic: WCC)

đéĘÖÝąĕéšøĆïÖćøàĆÖðøąüĆêĉêćöĒïïôĂøŤöǰPbC01
ĀćÖöĊÙüćöđÿĊę÷ÜÿĎÜÖĘÝąéĞćđîĉîÖćøêøüÝøŠćÜÖć÷
ĒúąĀćÖóïüŠćđðŨ î ēøÙóĉ þêąÖĆęüÖĘÝąéĞ ćđîĉ îÖćø
øĆÖþćó÷ćïćúêŠĂĕð
ĒîüìćÜÖćøêĉ é êćöđòŜ ć øąüĆ Ü ĔîĀâĉ Ü
êĆĚÜÙøøõŤǰðŦÝÝčïĆîĕéšöĊÖćøéĞćđîĉîÖćøĔîÖúčŠöđÿĊę÷ÜìĊę
ðøąÖĂïĂćßĊóÿĆ öñĆÿÿćøêąÖĆęüēé÷ÖćøêøüÝüĆé
øąéĆïÿćøêąÖĆęüĔîđúČĂé ĒêŠđîČęĂÜÝćÖðŦÝÝčïĆîĀâĉÜ
êĆĚÜÙøøõŤÿćöćøëøĆïÿĆöñĆÿÿćøêąÖĆęüĕéšÝćÖĒĀúŠÜ
ĂČęîėǰîĂÖđĀîČ ĂÝćÖÖćøðøąÖĂïßĊó ìĊę đÖĊę÷üךĂÜ
ÖĆïÿćøêąÖĆęü đߊîǰÝćÖúĉðÿêĉÖǰÝćÖñúĉêõĆèæŤ÷šĂö
ÿĊñö ìĞćĔĀšÖćøđòŜćøąüĆÜĂĆîêøć÷ÿćøêąÖĆęüĔîĀâĉÜ
êĆĚ Ü ÙøøõŤ ÷Ć Ü ĕöŠ Ù øĂïÙúč ö öćÖóĂ Ýċ Ü ÙüøöĊ Ö ćø
éĞćđîĉ îÖćøÙĆéÖøĂÜ êĉ éêćöǰđòŜćøąüĆÜÖćøÿĆöñĆ ÿ
ÿćøêąÖĆęüĔîÖúčŠöĀâĉÜêĆĚÜÙøøõŤĕêøöćÿìĊęǰ1 ìčÖÙîǰ
đóČęĂðŜĂÜÖĆîñúÖøąìïìĊęÝąđÖĉé×ċĚîÖĆïêĆü×ĂÜĀâĉÜ
êĆĚÜÙøøõŤđĂÜĒúąøąïïðøąÿćììĊęÖĞćúĆÜóĆçîć×ĂÜ
ìćøÖ àċęÜðøąÖĂïéšü÷ǰǰ×ĆĚîêĂîĀúĆÖǰ×ĆĚîĒøÖ ÙČĂ
ÖćøĔßš Ē ïïÙĆ é ÖøĂÜđóČę Ă øąïč Ù üćöđÿĊę ÷ ÜÖćøøĆ ï
ÿĆöñĆÿÿćøêąÖĆęüǰēé÷ĂćÝÝąðøą÷čÖêŤĔߚךĂÙĞćëćö
êćöĒîüìćÜ×ĂÜýĎ î ÷Ť Ù üïÙč ö ĒúąðŜ Ă ÜÖĆ î ēøÙǰ
ðøąđìýÿĀøĆåĂđöøĉÖć àċęÜךĂÙĞćëćöđÖĊę÷üךĂÜÖĆï
ÖćøĂćýĆ÷Ă÷ĎŠĔîïšćîìĊęÿøšćÜ×ċĚîÖŠĂîðŘǰÙý ǰ
ĀøČĂïšćîìĊęÖĞćúĆÜàŠĂöĒàöǰÖćøöĊóĊęîšĂÜĀøČĂâćêĉìĊę
ÖĞćúĆÜøĆïøĆÖþćēøÙóĉþêąÖĆęüĀøČĂöĊøąéĆïÿćøêąÖĆęü
ĔîđúČ Ă éđÖĉ î ǰǰμg/dL ÖćøĂćýĆ ÷ øŠ ü öÖĆ ï ñĎš ìĊę
ÿĆöñĆÿÖĆïÿćøêąÖĆęüĔîÖćøìĞćÜćîĀøČĂÜćîĂéĉđøÖǰ
ĒúąÖćøĂćýĆ÷Ă÷ĎŠĔÖúšÖĆïēøÜÜćîĂčêÿćĀÖøøöìĊęöĊ
ÖćøĔßš ÿ ćøêąÖĆę üǰĀćÖêĂïüŠć Ĕߊ ĀøČĂĕöŠ ì øćïĔî
ÙĞ ć ëćöך Ă Ĕéך Ă Āîċę Ü ÖĘ Ý ąîĞ ć ĕðÿĎŠ ×ĆĚ î êĂîÖćø
êøüÝüĆ é øąéĆ ï ÿćøêąÖĆę üĔîđúČ Ă éǰĂ÷Š ć ÜĕøÖĘ ê ćö
úĆ Ö þ è ą×ĂÜך Ă ÙĞ ć ëćöĀøČ Ă ðŦ ÝÝĆ ÷ ìĊę Ĕßš ÷Ć Ü öĊ
ÙüćöÝĞ ć đóćąĒúąÙüćöÙøĂïÙúč ö ĕöŠ đóĊ ÷ ÜóĂ
ÿĞ ć ĀøĆ ï Āâĉ Ü êĆĚ Ü ÙøøõŤ ǰ ĔîĂîćÙêÝċ Ü êš Ă ÜöĊ Ö ćø
óĆ ç îćĒïïêøüÝÙĆ é ÖøĂÜÿćøêąÖĆę ü ĔĀš öĊ Ù üćö
š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal
ÙøĂïÙúčöĒúąÿĂéÙúšĂÜÖĆïïøĉïìĔîðøąđìýĕì÷
ĀúĆÜÝćÖÙĆéÖøĂÜĒúšüóïÙüćöđÿĊę÷ÜĔĀšéĞćđîĉîÖćøÿĎŠ
×ĆĚî êĂîìĊęǰǰÙČ Ă ÖćøêøüÝüĆéøąéĆï ÿćøêąÖĆę üĔî
đúČĂ éđóČę Ăøąïč ð øĉö ćèÿćøêąÖĆę üĔîøŠćÜÖć÷ǰēé÷
ĀâĉÜêĆĚÜÙøøõŤìęĊöĊøąéĆïÿćøêąÖĆęüĔîđúČĂéöćÖÖüŠć
5 μg/dL ÙüøÝąĕéšøĆïÙĞćĒîąîĞćÖćøðäĉïĆêĉêîđóČęĂ
úéðøĉ ö ćèøąéĆ ï ÿćøêąÖĆę ü ĔîđúČ Ă éĒúąöĊ Ö ćø
êĉéêćöñúøąéĆ ïÿćøêąÖĆęüĔîđúČĂéìčÖėǰ1 đéČĂîǰ
øüöëċ Ü ĀîŠ ü ÷ÜćîìĊę đ ÖĊę ÷ üך Ă ÜÙüøéĞ ć đîĉ î Öćø
êøüÝüĆé øąéĆï ÿćøêąÖĆę üĔîÿĉęÜĒüéúšĂöĔîßčö ßî
đóČęĂúéēĂÖćÿĔîÖćøÿĆöñĆÿÿćøêąÖĆüę ĔîĂîćÙê
ïìÿøčð
ÖćøÿĆ ö ñĆ ÿ ÿćøêąÖĆę ü ĔîĀâĉ Ü êĆĚ Ü ÙøøõŤ
ÿŠÜñúÖøąìïìĊęøčî ĒøÜìĆĚ ÜêŠ ĂêĆüĀâĉ ÜêĆĚÜÙøøõŤđĂÜ
ĒúąìćøÖǰēé÷êąÖĆę ü ĔîĀâĉ Ü êĆĚ Ü ÙøøõŤ ÿ ćöćøë
ÿŠÜñŠćîøÖĕð÷ĆÜìćøÖĔîÙøøõŤĕéšǰÝćÖÖćøìïìüî
üøøèÖøøö óïüŠćǰøąéĆïÿćøêąÖĆęüêĆĚÜĒêŠǰǰμg/dL
ÝąđøĉęöÿŠÜñúÖøąìïêŠĂÿč×õćóǰēé÷ĔîöćøéćìĞćĔĀš
đÖĉéēúĀĉêÝćÜǰÙüćöéĆîēúĀĉêÿĎÜ×èąêĆĚÜÙøøõŤǰĒúą
ÖćøĒìšÜìĊęđÖĉé×ċĚîđĂÜǰÿŠüîñúÖøąìïêŠĂìćøÖìĞćĔĀš
đÖĉ éÖćøÙúĂéÖŠ ĂîÖĞ ćĀîéǰöĊ îĚĞ ćĀîĆ ÖĒøÖđÖĉ éîš Ă÷
ĒúąöĊđÿšîøĂïýĊøþąîšĂ÷ÖüŠćðÖêĉǰĒúąĔîđéĘÖÿŠÜ
ñúÖøąìïêŠ Ă ÖøąïüîÖćøìĞ ć Üćî×ĂÜÿöĂÜǰöĊ
ðŦ â ĀćĔîđøČęĂÜÖćøđøĊ÷ îøĎšǰóĆ ç îćÖćøúŠ ćßš ćǰ×ćé
ÿöćíĉǰĒúąÿŠÜñúêŠĂÖćøđÝøĉâ đêĉïēê×ĂÜøŠćÜÖć÷ǰ
ĒöšüŠćðŦÝÝčïĆîÝąöĊÖćøýċÖþćëċÜñúÖøąìïÝćÖÿćø
êąÖĆęüêŠĂÿč×õćóÝĞćîüîöćÖǰĒêŠÿëćîÖćøèŤøąéĆï
ÿćøêąÖĆę ü ĔîđúČ ĂéĔîðøąđìýĕì÷ēé÷đÞóćąĔî
Āâĉ ÜêĆĚ Ü ÙøøõŤ ìĊę đðŨ î ðŦ ÝÝĆ ÷ ĀúĆ ÖêŠ ĂÖćøÿŠ ÜêŠ Ăÿćø
êąÖĆęüĕð÷ĆÜìćøÖ÷ĆÜ×ćéÖćøđòŜćøąüĆÜêĉéêćöĂ÷ŠćÜ
êŠĂđîČęĂÜǰøüöëċÜÖćøÝĆéÖćøךĂöĎúĂ÷ŠćÜđðŨîøąïïǰ
êąÖĆęüÝċÜĂćÝÝąđðŨîõĆ÷đÜĊ÷ïìĊęàŠĂîĂ÷ĎŠǰèǰðŦÝÝčïĆîîĊĚ
ēé÷ĂćÝÝąÿĆ Ü đÖêĕéš Ý ćÖÖćøđÖĉ é ēøÙĔîđéĘ Ö ìĊę öĊ
ÙüćöÿĆöóĆîíŤÖĆïÖćøÿĆöñĆÿÿćøêąÖĆęüöćÖ×ċĚîǰđߊîǰ
š‹’š‹‹šŠ¤|Ÿ•ƒÊ¬q‚™‚¬i™ŠšŠ€™šl‰ 
 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal

ÙüćöéĆîēúĀĉêÿĎÜǰēøÙÿöćíĉÿĆĚîǰĀøČĂĒöšÖøąìĆęÜÖćø êøüÝÙĆ é ÖøĂÜÿćøêąÖĆę ü ĔîĀâĉ Ü êĆĚ Ü ÙøøõŤ đðŨ î

óïøąéĆï IQ ìĊęêęĞćúÜĔîđéĘÖĕì÷ǰÝċÜÙüøöĊÖćøêĉéêćö ðøąđéĘî ìĊę îŠ ćÿîĔÝéĞ ćđîĉ î ÖćøĂ÷Š ćÜêŠ ĂđîČę ĂÜđóČę Ă
đòŜćøąüĆÜÖćøÿĆöñĆÿÿćøêąÖĆęüĔîĀâĉÜêĆĚÜÙøøõŤêĆĚÜĒêŠ ðŜĂÜÖĆîñúÖøąìïìĊęÝąđÖĉé×ċĚîøüöëċÜÜïðøąöćè
ĕêøöćÿìĊęǰ1 ×ĂÜÖćøêĆĚÜÙøøõŤǰÖćøóĆçîćđÙøČęĂÜöČĂ ÝĞćîüîöćÖìĊęĂćÝÝąêšĂÜĔßšĔîÖćøøĆÖþćĔîĂîćÙê
đĂÖÿćøĂšćÜĂĉÜ
 :JNUIJBOHǰ4 ǰ8BFZBOHǰ% ǰ,VSBFJBEǰ4ǰ4DSFFOJOHǰGPSǰelevated blood lead levels and related
risk factors among Thai children residing in a fishing DPNNVOJUZǰ5PYJDT  

 Silver MK, Li X, Liu Y, Li M, Mai X, Kaciroti / ǰFUǰBMǰ-PX-level prenatal lead exposure
and infant sensory functionǰ&OWJSPOǰ)FBMUIǰ 

 4JOEIVǰ,/ ǰ#POEVǰ+% ǰ(BOFTBOǰ4, ǰ4ZFEǰ$ ǰ,BOHǰ( ǰ.PIBOǰ73ǰ#MPPEǰlead levels in
mother-JOGBOUǰ1BJSTǰ*OEJBOǰ+ǰ1FEJBUS  
-
 Yao H-y, Huang X-Iǰ5IFǰCMPPEǰMFBEǰMFWFMǰBOEǰQSFHOBOUǰPVUDPNFǰJOǰQSFHOBOUǰXPNFOǰ
with non-occupational lead exposVSFǰ;IPOHIVBǰ'Vǰ$IBOǰ,Fǰ;Bǰ;IJ  
-
 Vigeh M, Saito H, Sawada S-*ǰ-FBEǰexposure in female workers who are pregnant or
of childbearing BHFǰ*OEVTUrial health (2):255-
 %JTIB ǰ4IBSNBǰ4 ǰ(PZBMǰ. ǰ,VNBSǰ1, ǰ(IPTIǰ3 ǰ4IBSNBǰ1ǰ"TTPDJBUJPOǰPGǰSBJTFEǰCMPPEǰ
lead levels in pregnant women with preeclampsia: a TUVEZǰBUǰUFSUJBSZǰDFOUSFǰTaiwan J
Obstet Gynecol  
-
 Hamadneh J, Hamadneh S, Massadeh A, Kassab M, Al-#BZZBSJǰ/ ǰ,IBEFSǰ: ǰFUǰBMǰ#MPPEǰ
lead level and correlation with pregnancy-associated BOFNJBǰ".+ǰ 
-
 Hassanian-.PHIBEEBNǰ ) ǰ ;BNBOJǰ / ǰ )BNJEJǰ ' ǰ 'BSOBHIJǰ ' ǰ (BDILBSǰ -ǰ #MPPEǰ MFBEǰ
levels in pregnant women referring to midwifery clinic in a referral center in TeISBOǰ+ǰ
3FTǰ.FEǰ4DJǰ
 3JNCBVEǰ% ǰ3FTUSFQPǰ. ǰ-PVJTPOǰ" ǰ#PVLIBSJǰ3 ǰ"SEJMMPOǰ7 ǰ$BSMFTǰ( ǰFUǰBMǰ#MPPEǰMFBEǰ
levels and risk factors for lead exposure among pregnant women in western French
(VJBOBǰUIFǰSPMFǰPGǰNBOJPDǰDPOTVNQUJPOǰJ Toxicol Environ Health A  
-
 5BZMPSǰ$. ǰ(PMEJOHǰ+ ǰ&NPOEǰ".ǰ"EWFSTFǰFGGFDUTǰPGǰNBUFSOBMǰMFBEǰMFWFMTǰPOǰCJSUIǰPVUDPNFTǰ
in the ALSPAC study: a prospFDUJWFǰCJSUIǰDPIPSUǰTUVEZǰ#+0(  
-
 TBZMPSǰ$. ǰ(PMEJOHǰ+ ǰ)JCCFMOǰ+ ǰ&NPOEǰ".ǰ&OWJSPONFOUBMǰGBDUPSTǰQSFEJDUJOHǰCMPPEǰMFBEǰ
levels in pregnant women in the 6,ǰUIFǰ"-41"$ǰTUVEZǰ1-P4ǰ0OF  
F-F
 La-Llave-León O, Estrada-Martínez S, Manuel Salas-Pacheco J, Peña-Elósegui R,
Duarte-SuTUBJUBǰ + ǰ $BOEFMBTǰ 3BOHFMǰ +- ǰ FUǰ BMǰ #MPPEǰ MFBEǰ MFWFMTǰ BOEǰ SJTLǰ GBDUPSTǰ JOǰ
QSFHOBOUǰXPNFOǰGSPNǰ%VSBOHP ǰ.FYJDPǰ"SDIǰ&OWJSPOǰ0DDVQǰ)FBMUIǰ 
-

 Volume 48 No.3 September - December 2021

 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal

 4JMCFSHFMEǰ &,ǰ -FBEǰ JOǰ CPOFǰ JNQMJDBUJPOTǰ GPSǰ UPYJDPMPHZǰ EVSJOHǰ QSFHOBODZǰ BOEǰ
lacUBUJPOǰ&OWJSPOǰ)Falth Perspect -
 ,VNBSǰ" ǰ,BVSǰ4ǰ$BMDJVNǰa nutrient in preHOBODZǰ+ǰ0CTUFUǰ(ZOBFDPMǰ*OEJB  
-
 Hu H, Tellez-Rojo MM, Lamadrid-Figueroa H, Hernández-Avila M, Bellinger D, Mercado-
García A, FUǰBMǰFetal lead exposure at each stage of pregnancy as a predictor of infant
NFOUBMǰEFWFMPQNFOUǰ&OWJSPOǰ)FBMUIǰ1FSTQFDUǰ 
-
 Liu K-S, Hao J-H, Shi J, Dai C-F, Guo X-3ǰ#MPPEǰlead levels during pregnancy and its
influencing fBDUPSTǰJOǰ/BOKJOH ǰ$IJOBǰChinese Medical Sciences Journal  
-
 Hertz-Picciotto I, Schramm M, Watt-.PSTFǰ. ǰ$IBOUBMBǰ, ǰ"OEFSTPOǰ+ ǰ0TUFSMPIǰ+ǰ1BUUFSOT
and determinants of blood lead dVSJOHǰQSFHOBODZǰ"Nǰ+ǰ&QJEFNJPM  
-
 Namihira D, Saldivar L, PustilnJLǰ/ ǰ$BSSFµOǰ(+ ǰ4BMJOBTǰ.&ǰ-FBEǰJOǰIVNBOǰCMPPEǰBOEǰNJML
from nursing women living near a smelter in Mexico $JUZǰ+ǰ5PYJDPMǰ&OWJSPOǰ)FBMUI
 
-
 Ettinger AS, Téllez-3PKPǰ.. ǰ"NBSBTJSJXBSEFOBǰ$ ǰ#FMMJOHFSǰ% ǰ1FUFSTPOǰ, ǰ4DIXBSU[ǰ+ ǰFUǰBM
&GGFDUǰPGǰCSFBTUǰNJMLǰMFBEǰPOǰJOGBOUǰCMPPEǰMFBEǰMFWFMTǰBUǰǰNPOUIǰPGǰBHFǰ&OWJSPONFOUBMǰ
Health PFSTQFDUJWFTǰ 
-
 Pongpunlert Wǰ-FBEǰQPJTPOJOHǰ$IVMBǰ.FEǰ+  
- (in Thai)
 Fioresi M, Simões MR, Furieri LB, Broseghini-Filho GB, VFTDPWJǰ.7" ǰ4UFGBOPOǰ* ǰFUǰBMǰ
Chronic lead exposure increases blood pressure and myocardial DPOUSBDUJMJUZǰJOǰSBUTǰ
PLoS One  
F-F
 'JPSJNǰ+ ǰ3JCFJSPǰ +¼OJPSǰ3' ǰ 4JMWFJSBǰ&" ǰ 1BEJMIBǰ"4 ǰ 7FTDPWJǰ.7 ǰ EFǰ+FTVTǰ )$ ǰFUǰ BMǰ
Low-level lead exposure increases systolic arterial pressure and endothelium-derived
vasodilator GBDUPSTǰJOǰSBUǰBPSUBTǰ1-P4ǰ0OF  
F
 Yazbeck C, Thiebaugeorges O, Moreau T, Goua V, Debotte G, Sahuquillo + ǰ FUǰ BMǰ
Maternal blood lead levels and the risk of pregnancy-induced hypertension: the
EDEN cohort TUVEZǰ&OWJSPOǰ)FBMUIǰ1FSTQFDU  
-
 Borja-Aburto VH, Hertz-1JDDJPUUPǰ * ǰ 3PKBTǰ -PQF[ǰ . ǰ 'BSJBTǰ 1 ǰ 3JPTǰ $ ǰ #MBODPǰ +ǰ #MPPEǰ
lead levels measVSFEǰ QSPTQFDUJWFMZǰ BOEǰ SJTLǰ PGǰ TQPOUBOFPVTǰ BCPSUJPOǰ Am J
Epidemiol  
-
 #FMMJOHFSǰ %$ǰ 5FSBUPHFOǰ VQEBUFǰ MFBEǰ BOEǰ QSFHOBODZǰ Birth Defects Res A Clin Mol
5FSBUPMǰ 
-
 Centers for Disease Control and PreventionǰPremature bJSUIǰ<*OUFSOFU>ǰ<DJUFEǰǰ
%FDFNCFSǰ >ǰ Available from: IUUQTXXXDEDHPWSFQSPEVDUJWFIFBMUIGFBUVSFT
premature-CJSUIJOEFYIUNM

š‹’š‹‹šŠ¤|Ÿ•ƒÊ¬q‚™‚¬i™ŠšŠ€™šl‰ 

 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal

 7JTUJDBǰ%5 ǰ"ISFOTǰ'" ǰ&MMJTPOǰ83ǰ5IFǰFGGFDUTǰPGǰMFBEǰVQPOǰDPMMBHFOǰTZOUIFTJTǰBOEǰ

proline IZESPYZMBUJPOǰJOǰUIFǰ4XJTTǰNPVTFǰ5ǰGJCSPCMBTUǰ"SDIJWFT of Biochemistry and
Biophysics  
-
 Jelliffe-1BXMPXTLJǰ-- ǰ.JMFTǰ42 ǰ$PVSUOFZǰ+( ǰ.BUFSOBǰ# ǰ$IBSMUPOǰ7ǰ&GGFDUǰPGǰNBHOJUVEF
and timing of maternal pregnancy blood lead (Pb) levels on birth ouUDPNFTǰ+PVSOBMǰ
of Perinatology  
-
 ,IVOQSBEJUǰ4ǰ-PXǰCJSUIXFJHIU: fFUBMǰPSJHJOTǰPGǰBEVMUǰEJTFBTFǰ$IVMBǰ.FEǰ+ǰ 
-
(in Thai)
 1PUVMBǰ7 ǰ,BZFǰ8ǰ3FQPSUǰGSPNǰUIFǰ$%$: is lead exposure a risk factor for bone loss? J
WomeOTǰ)FBMUIǰ -BSDINU
ǰ 
-
 ;IVǰ . ǰ 'JU[HFSBMEǰ &' ǰ (FMCFSHǰ ,) ǰ -JOǰ 4 ǰ %SVTDIFMǰ $.ǰ .BUFSOBMǰ MPX-level lead
exposure and fetal HSPXUIǰ&OWJSPOǰ)FBMUIǰ1FSTQFDU  
-
 ;IBOHǰ# ǰ9JBǰ8 ǰ-Jǰ: ǰ#BTTJHǰ#" ǰ;IPVǰ" ǰ8BOHǰ: ǰFUǰBMǰ1SFOBUBMǰFYQosure to lead in
relation to risk of preterm low birth weight: a matched case-control TUVEZǰJOǰ$IJOBǰ
Reprod Toxicol -
 8JFCFǰ+1 ǰ#BSSǰ,+ǰ&GGFDUǰPGǰQSFOBUBMǰBOEǰOFPOBUBMǰFYQPTVSFǰUPǰMFBEǰPOǰUIFǰBGGJOJUZǰBOE
OVNCFSǰPGǰFTUSBEJPMǰSFDFQUPSTǰJOǰUIFǰVUFSVTǰ+ǰ5PYJDPMǰ&OWJSPOǰ)FBMUIǰ 
-
 3PUIFOCFSHǰ4+ ǰ4DIOBBTǰ- ǰ1FSSPOJǰ& ǰ)FSO£OEF[ǰ3. ǰ.BSU¯OF[ǰ4 ǰ )FSO£OEF[ǰ$ǰ1SF-
BOEǰ QPTUOBUBMǰ MFBEǰ FGGFDUǰ POǰ IFBEǰ DJSDVNGFSFODFǰ Bǰ DBTFǰ GPSǰ DSJUJDBMǰ QFSJPETǰ
Neurotoxicol Teratol 1999;21(1):1-
 4DIFMMǰ-. ǰ %FOIBNǰ . ǰ 4UBSLǰ "% ǰ 1BSTPOTǰ1+ ǰ 4DIVMUFǰ &&ǰ (SPXUIǰ PGǰ JOGBOUTǰ MFOHUI ǰ
weight, head and arm circumferences in relation to low levels of blood lead
mFBTVSFEǰTFSJBMMZǰ"Nǰ+ǰ)VNǰ#JPM  
-
 Hong SB, Im MH, KJNǰ+8 ǰ1BSLǰ&+ ǰ4IJOǰ.4 ǰ,JNǰ#/ ǰFUǰBMǰ&OWJSPONFOUBMǰlead exposure and
attention deficit/hyperactivity disorder symptom domains in a community sample of
South Korean school-age cIJMESFOǰ&OWJSPOǰ)FBMUIǰ1FSTQFDUǰ 
-
 $IBOEǰ%# ǰ3BKBSBNJǰ(3ǰ-Png-term changes in brain cholinergic system and behavior
in rats following gestational exposure to lead: protective effect of calcium
TVQQMFNFOUǰ*OUFSEJTDJQǰ5PYJDPMǰ 
-
 Jedrychowski W, Perera F, Jankowski J, Mrozek-Budzyn D, Mroz & ǰ'MBLǰ& ǰFUǰBMǰ(FOEFSǰ
specific differences in neurodevelopmental effects of prenatal exposure to very low-
lead levels: the prospective cohort study in three-ZFBSǰ PMETǰ &BSMZǰ )VNǰ %FWǰ
 
-

 Volume 48 No.3 September - December 2021

 š‹’š‹¥†ŠÖš
Royal Thai Navy Medical Journal

 5BZMPSǰ $. ǰ ,PSEBTǰ , ǰ (PMEJOHǰ + ǰ &NPOEǰ ".ǰ &GGFDUTǰ Pf low-level prenatal lead
FYQPTVSFǰPOǰDIJMEǰ*2ǰBUǰǰBOEǰǰZFBSTǰJOǰBǰ6,ǰCJSUIǰDPIPSUǰTUVEZǰ/FVSPtoxicology
-
 Wang H-L, Chen X-T, Yang B, Ma F-L, Wang S, Tang M-- ǰFUǰBMǰ$BTF-control study of
blood lead levels and attention deficit hyperactivJUZǰ EJTPSEFSǰ JOǰ $IJOFTFǰ DIJMESFOǰ
&OWJSPOǰ)FBMUIǰ1FSTQFDUǰ 
-
 7JTBOVZPUIJOǰ5 ǰ1BWBTVUIJQBJTJUǰ$ ǰ8BDIJSBEJMPLǰ1 ǰ"SVOSVBOHǰ1 ǰ#VSBOBTVLTBLVMǰ5ǰ5IFǰ
prevalence of attention deficit/hyperactivity disorder in Thailand Journal of Mental
Health of Thailand  
- JOǰ5IBJ

 "GFJDIFǰ . ǰ 1FUFSTPOǰ ,& ǰ 4£ODIF[ǰ #/ ǰ 4DIOBBTǰ - ǰ $BOUPOXJOFǰ % ǰ &UUJOHFSǰ "4 ǰ FUǰ BMǰ
8JOEPXTǰ PGǰ MFBEǰ FYQPTVSFǰ TFOTJUJWJUZ ǰ BUUBJOFEǰ IFJHIU ǰ BOEǰ CPEZǰ NBTTǰ JOEFYǰ BUǰ ǰ
moOUITǰ5IFǰ+PVSOBMǰPGǰ1FEJBUSJDT  
-
 :BOHǰ) ǰ)VPǰ9 ǰ:FLFFOǰ5" ǰ;IFOHǰ2 ǰ;IFOHǰ. ǰ9Vǰ9ǰ&GGFDUTǰPGǰMFBEǰBOEǰDBENJVNǰ
exposure from electronic waste on child physical HSPXUIǰ&OWJSPOǰ4DJǰ1PMMVUǰ3FTǰ*OUǰ
 
-
 #VSOTǰ+4 ǰ8JMMJBNTǰ1- ǰ-FFǰ.. ǰ3FWJDIǰ# ǰ4FSHFZFWǰ0 ǰ)BVTFSǰ3 ǰ FUǰBMǰ1Fripubertal
blood lead levels and growth among Russian CPZTǰ&OWJSPOǰ*OUǰ-
 Bureau of Occupational and Environmental DiseasesǰGuideline for surveillance and
prevent lead poisoning in children <*OUFSOFU>ǰ<DJUFEǰ2021 March 1>ǰ"WBJMBCMFǰGSPN
hUUQFOWPDDEEDNPQIHPUIVQMPBETNFEJBNBOVBM5QEG JOǰ5IBJ


š‹’š‹‹šŠ¤|Ÿ•ƒÊ¬q‚™‚¬i™ŠšŠ€™šl‰