Association of in utero organochlorine pesticide exposure and fetal growth and length of gestation in an agricultural population

Correlation between pesticide use in agriculture and adverse birth outcomes in Brazil: an ecological study

This ecological study analyzed the association between pesticide use and prematurity, low weight and congenital abnormality at birth, infant death by congenital abnormality, and fetal death in Brazil in 2001. Simple linear regression analysis has determined a positive association between pesticide use and prematurity, low birth weight, and congenital abnormality. The association between pesticide use and low birth weight (p = 0.045) and, congenital abnormality (p = 0.004) and infant death rate by congenital abnormality (p = 0.039) remained after the adjustment made by the proportion of pregnant women with a low number of prenatal care visits.

Reducing exposure to environmental toxicants before birth: moving from risk perception to risk reduction

In this study, we considered approaches to reducing maternal exposure to hazardous environmental toxicants, focusing on risk communication to pregnant women and providers, but also considering identification of environmental toxicants in the community and reduction of environmental toxicants. We addressed the following questions: (1) What do pregnant women and their providers know about environmental toxicants and perinatal health? and (2) What policy strategies are needed (should be considered) to move forward in risk reduction in this area? We reviewed the literature on knowledge of pregnant women and providers regarding these issues. While there is limited research on what pregnant women and their providers know about environmental toxicants and perinatal health, there is evidence of reproductive and perinatal toxicity. This article describes a wide range of policy strategies that could be implemented to address environmental toxicants in the context of perinatal health. Effective leadership in this area will likely require collaboration of both environmental health and maternal and child health leaders and organizations.

Maternal exposure to floricultural work during pregnancy, PON1 Q192R polymorphisms and the risk of low birth weight

BACKGROUND

Although there is evidence from animal studies of impaired reproductive function by exposure to organophosphates (OP), the effects on birth weight have not been sufficiently evaluated in epidemiological studies. Paraoxonase (PON1) detoxifies organophosphates by cleavage of active oxons. Some PON1 gene polymorphisms could reduce the enzyme activity and increase susceptibility to OP toxicity.

OBJECTIVE

To assess the association between maternal exposure to floriculture during pregnancy and the risk of low birth weight (<2500 g) in their offspring, as well as to evaluate the interaction between this exposure and maternal genotype for PON1 Q192R polymorphisms.

MATERIALS AND METHODS

A cross sectional study was carried out in two Mexican states (States of Mexico and Morelos) with high frequencies of greenhouse activity. We interviewed and collected blood samples from 264 females (floriculturists or partners of floricultural workers) who became pregnant during the 10 years prior to the interview. The questionnaire measured socioeconomic characteristics, tobacco and alcohol consumption, diseases and occupational and reproductive history. We also applied a food frequency questionnaire. Information was obtained pertaining to 467 pregnancies. DNA was extracted from white cells, and PON1 genotype was determined by Restriction Fragment Length Polymorphism for Q192R polymorphisms. Results were analyzed with generalized estimating equations models.

RESULTS

After adjusting for potential confounders, we detected a statistically significant interaction between maternal exposure to flower growing work during pregnancy and PON1 Q192R polymorphisms on risk of low birth weight. The risk of having a baby with LBW is nearly six times higher if a mother is a floriculture worker during pregnancy and has PON1 192RR genotype (OR 5.93, 95% CI 1.28, 27.5).

CONCLUSION

These results suggest that the interaction between maternal floriculture work during pregnancy and 192RR PON1 genotype increases the probability of having children with LBW.

The Pine River statement: human health consequences of DDT use

OBJECTIVES

Dichlorodiphenyltrichloroethane (DDT) was used worldwide until the 1970s, when concerns about its toxic effects, its environmental persistence, and its concentration in the food supply led to use restrictions and prohibitions. In 2001, more than 100 countries signed the Stockholm Convention on Persistent Organic Pollutants (POPs), committing to eliminate the use of 12 POPs of greatest concern. However, DDT use was allowed for disease vector control. In 2006, the World Health Organization and the U.S. Agency for International Development endorsed indoor DDT spraying to control malaria. To better inform current policy, we reviewed epidemiologic studies published from 2003 to 2008 that investigated the human health consequences of DDT and/or DDE (dichlorodiphenyldichloroethylene) exposure.

DATA SOURCES AND EXTRACTION

We conducted a PubMed search in October 2008 and retrieved 494 studies.

DATA SYNTHESIS

Use restrictions have been successful in lowering human exposure to DDT, but blood concentrations of DDT and DDE are high in countries where DDT is currently being used or was more recently restricted. The recent literature shows a growing body of evidence that exposure to DDT and its breakdown product DDE may be associated with adverse health outcomes such as breast cancer, diabetes, decreased semen quality, spontaneous abortion, and impaired neurodevelopment in children.

CONCLUSIONS

Although we provide evidence to suggest that DDT and DDE may pose a risk to human health, we also highlight the lack of knowledge about human exposure and health effects in communities where DDT is currently being sprayed for malaria control. We recommend research to address this gap and to develop safe and effective alternatives to DDT.

Levels of hexachlorobenzene (HCB) in breast milk in relation to birth weight in a Norwegian cohort

BACKGROUND

Hexachlorobenzene (HCB) is a ubiquitous environmental contaminant that, even at low doses, causes destruction of ovarian primordial germ cells in experimental studies. However, its potential for reproductive toxicity in humans exposed to background levels has not been fully evaluated. Here we examined the association between maternal levels of HCB and their infants' birth weight.

METHODS

HCB was measured in milk samples from a subset of women in the Norwegian Human Milk Study (HUMIS), 2003-2006; 300 subjects were randomly chosen from the cohort and 26 from all small for gestational age (SGA) children. Additional information was obtained through questionnaires and the Medical Birth Registry.

RESULTS

Overall, HCB was associated with birth weight (adjusted b = -90 g per 8 microg/kg milk fat, 95% CI-275 to 8) and with SGA (odds ratio 1.8, 95% CI 0.9-3.7 per 8 microg/kg milk fat (difference between the 10th and the 90th percentile)). After stratification, however, the association was present only among smokers. For birth weight for past or current smokers: b = -282, CI -467 to -98; for never smokers: b = 0.5, CI -149 to 150, p-value for interaction: 0.01. Similar results were observed for head circumference, crown-heel length, and SGA.

CONCLUSIONS

We saw a moderate association between HCB and markers of impaired fetal growth among past and current smokers. This finding may be non-causal and due to underlying genetic variants tied to both growth and breakdown of HCB or to confounding by unmeasured toxicants that coexist in exposure sources. It may, however, also result from HCB exposure.

Lymphoma and lung cancer in offspring born to pregnant mice dosed with dibenzo[a,l]pyrene: the importance of in utero vs. lactational exposure

The fetus and neonate cannot be viewed as "little adults"; they are highly sensitive to toxicity from environmental chemicals. This phenomenon contributes to the fetal basis of adult disease. One example is transplacental carcinogenesis. Animal models demonstrate that environmental chemicals, to which pregnant women are daily exposed, can increase susceptibility of the offspring to cancer. It is uncertain to what degree in utero vs. lactational exposure contributes to cancer, especially for hydrophobic chemicals such as polyhalogenated biphenyls, ethers, dioxins, furans, etc., which can partition into breast milk. We developed a pregnant mouse model in which exposure to the polycyclic aromatic hydrocarbon (PAH), dibenzo[a,l]pyrene (DBP), during late gestation, produces an aggressive T-cell lymphoma in offspring between 3 and 6 months of age. Survivors exhibit multiple lung and liver (males) tumors. Here, we adopt a cross-foster design with litters born to dams treated with DBP exchanged with those born to dams treated with vehicle. Exposure to DBP in utero (about 2 days) produced significantly greater mortality than residual DBP exposure only through breast milk (3 weeks of lactation). As previously observed pups in all groups with an ahr(b-1/d) ("responsive") genotype were more susceptible to lymphoma mortality than ahr(d/d) ("non-responsive") siblings. At termination of the study at 10 months, mice exposed in utero also had greater lung tumor multiplicity than mice exposed only during lactation. Our results demonstrate that short exposure to DBP during late gestation presents a greater risk to offspring than exposure to this very hydrophobic PAH following 3 weeks of nursing.

Prenatal phenol and phthalate exposures and birth outcomes

BACKGROUND

Many phthalates and phenols are hormonally active and are suspected to alter the course of development.

OBJECTIVE

We investigated prenatal exposures to phthalate and phenol metabolites and their associations with body size measures of the infants at birth.

METHODS

We measured 5 phenol and 10 phthalate urinary metabolites in a multiethnic cohort of 404 women in New York City during their third trimester of pregnancy and recorded size of infants at birth.

RESULTS

Median urinary concentrations were > 10 microg/L for 2 of 5 phenols and 6 of 10 phthalate monoester metabolites. Concentrations of low-molecular-weight phthalate monoesters (low-MWP) were approximately 5-fold greater than those of high-molecular-weight metabolites. Low-MWP metabolites had a positive association with gestational age [0.97 day gestational age per ln-biomarker; 95% confidence interval (CI), 0.07-1.9 days, multivariate adjusted] and with head circumference. Higher prenatal exposures to 2,5-dichlorophenol (2,5-DCP) predicted lower birth weight in boys (-210 g average birth weight difference between the third tertile and first tertile of 2,5-DCP; 95% CI, 71-348 g). Higher maternal benzophenone-3 (BP3) concentrations were associated with a similar decrease in birth weight among girls but with greater birth weight in boys.

CONCLUSIONS

We observed a range of phthalate and phenol exposures during pregnancy in our population, but few were associated with birth size. The association of 2,5-DCP and BP3 with reduced or increased birth weight could be important in very early or small-size births. In addition, positive associations of urinary metabolites with some outcomes may be attributable partly to unresolved confounding with maternal anthropometric factors.

Fetal growth indicators and perfluorinated chemicals: a study in the Danish National Birth Cohort

Perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS) are widespread persistent organic pollutants that have been associated with reduced birth weight at doses expected in many pregnant populations. The authors randomly selected 1,400 pregnant women and their newborns from the Danish National Birth Cohort (1996-2002) to investigate whether these compounds reduce organ growth. PFOS and PFOA were measured in maternal blood samples taken early in pregnancy. Placental weight, birth length, and head and abdominal circumferences were measured shortly after birth by trained midwives or nurses. Maternal PFOA levels in early pregnancy were associated with smaller abdominal circumference and birth length. For each ng/ml increase in PFOA, birth length decreased by 0.069 cm (95% confidence interval: 0.024, 0.113) and abdominal circumference decreased by 0.059 cm (95% confidence interval: 0.012, 0.106). An inverse association was also observed between PFOA and placental weight and head circumference, and a positive association was observed with newborn ponderal index, but none of these associations was statistically significant. Maternal PFOS levels were not associated with any of the five fetal growth indicators. These findings suggest that fetal exposure to PFOA but not PFOS during organ development may affect the growth of organs and the skeleton.

DDT reintroduction for malaria control: the cost-benefit debate for public health

DDT is a persistent insecticide that was widely used in the world from the 1940s until the 70s, when it was banned in the United States and other countries. Most of its toxic effects are not observed in the acute forms, but particularly after chronic exposure. These long-term issues include reproductive effects, varying according to the time of life in which the individuals were exposed. The aims of the current study were to review the principal toxicological effects of DDT on reproduction, stratifying by physiological periods of exposure, and based on the magnitude of these effects, to discuss the cost-benefit relationship of reintroducing DDT with the specifically defined vector control criteria.

Epidemiologic evidence of relationships between reproductive and child health outcomes and environmental chemical contaminants

This review summarizes the level of epidemiologic evidence for relationships between prenatal and/or early life exposure to environmental chemical contaminants and fetal, child, and adult health. Discussion focuses on fetal loss, intrauterine growth restriction, preterm birth, birth defects, respiratory and other childhood diseases, neuropsychological deficits, premature or delayed sexual maturation, and certain adult cancers linked to fetal or childhood exposures. Environmental exposures considered here include chemical toxicants in air, water, soil/house dust and foods (including human breast milk), and consumer products. Reports reviewed here included original epidemiologic studies (with at least basic descriptions of methods and results), literature reviews, expert group reports, meta-analyses, and pooled analyses. Levels of evidence for causal relationships were categorized as sufficient, limited, or inadequate according to predefined criteria. There was sufficient epidemiological evidence for causal relationships between several adverse pregnancy or child health outcomes and prenatal or childhood exposure to environmental chemical contaminants. These included prenatal high-level methylmercury (CH(3)Hg) exposure (delayed developmental milestones and cognitive, motor, auditory, and visual deficits), high-level prenatal exposure to polychlorinated biphenyls (PCBs), polychlorinated dibenzofurans (PCDFs), and related toxicants (neonatal tooth abnormalities, cognitive and motor deficits), maternal active smoking (delayed conception, preterm birth, fetal growth deficit [FGD] and sudden infant death syndrome [SIDS]) and prenatal environmental tobacco smoke (ETS) exposure (preterm birth), low-level childhood lead exposure (cognitive deficits and renal tubular damage), high-level childhood CH(3)Hg exposure (visual deficits), high-level childhood exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (chloracne), childhood ETS exposure (SIDS, new-onset asthma, increased asthma severity, lung and middle ear infections, and adult breast and lung cancer), childhood exposure to biomass smoke (lung infections), and childhood exposure to outdoor air pollutants (increased asthma severity). Evidence for some proven relationships came from investigation of relatively small numbers of children with high-dose prenatal or early childhood exposures, e.g., CH(3)Hg poisoning episodes in Japan and Iraq. In contrast, consensus on a causal relationship between incident asthma and ETS exposure came only recently after many studies and prolonged debate. There were many relationships supported by limited epidemiologic evidence, ranging from several studies with fairly consistent findings and evidence of dose-response relationships to those where 20 or more studies provided inconsistent or otherwise less than convincing evidence of an association. The latter included childhood cancer and parental or childhood exposures to pesticides. In most cases, relationships supported by inadequate epidemiologic evidence reflect scarcity of evidence as opposed to strong evidence of no effect. This summary points to three main needs: (1) Where relationships between child health and environmental exposures are supported by sufficient evidence of causal relationships, there is a need for (a) policies and programs to minimize population exposures and (b) population-based biomonitoring to track exposure levels, i.e., through ongoing or periodic surveys with measurements of contaminant levels in blood, urine and other samples. (2) For relationships supported by limited evidence, there is a need for targeted research and policy options ranging from ongoing evaluation of evidence to proactive actions. (3) There is a great need for population-based, multidisciplinary and collaborative research on the many relationships supported by inadequate evidence, as these represent major knowledge gaps. Expert groups faced with evaluating epidemiologic evidence of potential causal relationships repeatedly encounter problems in summarizing the available data. A major driver for undertaking such summaries is the need to compensate for the limited sample sizes of individual epidemiologic studies. Sample size limitations are major obstacles to exploration of prenatal, paternal, and childhood exposures during specific time windows, exposure intensity, exposure-exposure or exposure-gene interactions, and relatively rare health outcomes such as childhood cancer. Such research needs call for investments in research infrastructure, including human resources and methods development (standardized protocols, biomarker research, validated exposure metrics, reference analytic laboratories). These are needed to generate research findings that can be compared and subjected to pooled analyses aimed at knowledge synthesis.

Environmental contaminants and pregnancy outcomes

OBJECTIVE

To review selected environmental, occupational, and other important risk factors for the following adverse pregnancy outcomes: low birth weight (LBW), intrauterine growth retardation (IUGR), and preterm delivery (PTD).

DESIGN

The evidence is explored in greater detail for environmental tobacco smoke, drinking water disinfection byproducts, and organochlorine (DDT) and organophosphate pesticides, partly using a weight of evidence approach.

MAIN OUTCOME MEASURE(S)

Low birth weight and IUGR are surrogate measures of fetal growth that are determined at delivery. Low birth weight is defined as <2,500 grams, and occurs in about 7% of US births. Intrauterine growth retardation is commonly defined as birth weight less than the tenth percentile for gestational week, using a standard population. Preterm delivery is birth at <37 weeks gestational age, and occurs in approximately 12% of US births.

RESULT(S)

Numerous factors are associated with these endpoints that may be important to consider in studies of environmental exposures, such as young or old maternal age, race/ethnicity, multiple births, low socioeconomic status, inadequate prenatal care, low maternal weight gain, and infections and premature rupture of the membranes. Environmental contaminants found associated with increased risk of one or more of the endpoints include: tobacco smoke, carbon monoxide, air pollutants, heavy metals, pesticides, chlorination byproducts, and solvents.

CONCLUSION(S)

Future research directions include measurement of exposure biomarkers during critical windows and consideration of genetic polymorphisms.

Organochlorine pesticides by LC-MS

Contamination of water resources by organochlorine pesticides (OCPs) continues to receive widespread attention because of the increasing concern regarding their high persistence and bioaccumulation. These organic pollutants are not amenable by liquid chromatography (LC) coupled to atmospheric pressure ionization-mass spectrometry, which represents the method of choice for the characterization of pesticide residues in water. Gas chromatography-mass spectrometry provides excellent response for OCPs, but it falls short when complex, multiresidue analyses are required. As recently demonstrated, an efficient EI-based LC-MS interface can generate very good spectra for an extremely wide range of small-medium molecular weight molecules of different polarity and can represent a valid tool in solving the analytical challenge of analyzing OCPs by LC-MS. Based on this assumption, we present a new approach for the determination of 12 OCPs in water samples. The method requires a solid-phase extraction preconcentration step followed by nanoscale liquid chromatography coupled to a direct-electron ionization direct interface (Direct-EI). Direct-EI is a miniaturized interface for efficiently coupling a liquid chromatograph with an EI mass spectrometer. The capability to acquire high-quality EI spectra in a wide range of concentrations, and to operate in selected ion monitoring mode during analyses, allowed a precise quantification of the OCPs. Without sample injection enrichment, limits of detection of the method span from 0.044 to 0.33 microg/L, corresponding to an instrumental detection limit of 120-850 pg. In addition, a careful evaluation of the matrix effect showed that the response of the Direct-EI interface was never affected by sample interferences. From our knowledge, the proposed method represents the first application of LC-MS in the analysis of organochlorine pesticides.

Factors predicting organochlorine pesticide levels in pregnant Latina women living in a United States agricultural area

Organochlorine (OC) pesticide use was restricted starting in the 1970s in developed countries and the 1980s and 1990s in developing countries. Current exposure to OC pesticides - dichlorodiphenyltrichloroethane (DDT), lindane (99% pure gamma-hexachlorocyclohexane (gamma-HCH)), hexachlorobenzene (HCB) - occurs on a limited basis. We measured para, para' (p,p')-DDE, p,p'-DDT, ortho, para' (o,p')-DDT, HCB, beta (beta)-HCH (the most persistent isomer of technical-grade HCH) and gamma-HCH in serum from 426 low-income pregnant Latina women living in an agricultural community in California. Detection frequencies were 94% to 100%. Median levels (ng/g lipid) of p,p'-DDE (1,052), p,p'-DDT (13), beta-HCH (37) and HCB (65) were significantly higher than United States population levels. Multivariate analyses of p,p'-DDE, p,p'-DDT, o,p'-DDT, beta-HCH and HCB indicate that time spent living outside the United States and birthplace in an area of Mexico with recent use of OC pesticides were significant predictors of exposure. Time spent living in the United States was associated with increased serum levels of p,p'-DDE and beta-HCH, but the increase for each year lived in the United States was lower than for each year lived outside the United States. There was no difference between the increase of HCB levels over time spent in or outside the United States, suggesting current and thus preventable exposure routes. However, we observed no associations between serum levels of any OC compound and current intake of saturated fat or agricultural take-home exposure risk factors. Lactation history and recent weight gain were negatively associated with serum levels of some, but not all OC compounds studied. Smoking history was borderline associated with elevated HCB levels. We observed no significant associations with body mass index. Although the weight of evidence from this study indicates that most exposure occurred before moving to the United States, the results for HCB indicate the possibility of ongoing exposure in this country.

Factors predicting organochlorine pesticide levels in pregnant Latina women living in a United States agricultural area

Organochlorine (OC) pesticide use was restricted starting in the 1970s in developed countries and the 1980s and 1990s in developing countries. Current exposure to OC pesticides - dichlorodiphenyltrichloroethane (DDT), lindane (99% pure gamma-hexachlorocyclohexane (gamma-HCH)), hexachlorobenzene (HCB) - occurs on a limited basis. We measured para, para' (p,p')-DDE, p,p'-DDT, ortho, para' (o,p')-DDT, HCB, beta (beta)-HCH (the most persistent isomer of technical-grade HCH) and gamma-HCH in serum from 426 low-income pregnant Latina women living in an agricultural community in California. Detection frequencies were 94% to 100%. Median levels (ng/g lipid) of p,p'-DDE (1,052), p,p'-DDT (13), beta-HCH (37) and HCB (65) were significantly higher than United States population levels. Multivariate analyses of p,p'-DDE, p,p'-DDT, o,p'-DDT, beta-HCH and HCB indicate that time spent living outside the United States and birthplace in an area of Mexico with recent use of OC pesticides were significant predictors of exposure. Time spent living in the United States was associated with increased serum levels of p,p'-DDE and beta-HCH, but the increase for each year lived in the United States was lower than for each year lived outside the United States. There was no difference between the increase of HCB levels over time spent in or outside the United States, suggesting current and thus preventable exposure routes. However, we observed no associations between serum levels of any OC compound and current intake of saturated fat or agricultural take-home exposure risk factors. Lactation history and recent weight gain were negatively associated with serum levels of some, but not all OC compounds studied. Smoking history was borderline associated with elevated HCB levels. We observed no significant associations with body mass index. Although the weight of evidence from this study indicates that most exposure occurred before moving to the United States, the results for HCB indicate the possibility of ongoing exposure in this country.

Organophosphate pesticide exposure and neurodevelopment in young Mexican-American children

BACKGROUND

Organophosphate (OP) pesticides are widely used in agriculture and homes. Animal studies suggest that even moderate doses are neurodevelopmental toxicants, but there are few studies in humans.

OBJECTIVES

We investigated the relationship of prenatal and child OP urinary metabolite levels with children's neurodevelopment.

METHODS

Participating children were from a longitudinal birth cohort of primarily Latino farm-worker families in California. We measured six nonspecific dialkylphosphate (DAP) metabolites in maternal and child urine as well as metabolites specific to malathion (MDA) and chlorpyrifos (TCPy) in maternal urine. We examined their association with children's performance at 6 (n = 396), 12 (n = 395), and 24 (n = 372) months of age on the Bayley Scales of Infant Development [Mental Development (MDI) and Psychomotor Development (PDI) Indices] and mother's report on the Child Behavior Checklist (CBCL) (n = 356).

RESULTS

Generally, pregnancy DAP levels were negatively associated with MDI, but child measures were positively associated. At 24 months of age, these associations reached statistical significance [per 10-fold increase in prenatal DAPs: beta = -3.5 points; 95% confidence interval (CI), -6.6 to -0.5; child DAPs: beta = 2.4 points; 95% CI, 0.5 to 4.2]. Neither prenatal nor child DAPs were associated with PDI or CBCL attention problems, but both prenatal and postnatal DAPs were associated with risk of pervasive developmental disorder [per 10-fold increase in prenatal DAPs: odds ratio (OR) = 2.3, p = 0.05; child DAPs OR = 1.7, p = 0.04]. MDA and TCPy were not associated with any outcome.

CONCLUSIONS

We report adverse associations of prenatal DAPs with mental development and pervasive developmental problems at 24 months of age. Results should be interpreted with caution given the observed positive relationship with postnatal DAPs.

In utero exposure to DDT and performance on the Brazelton neonatal behavioral assessment scale

We investigated whether decrements in neonatal neurodevelopment, as determined by the Brazelton neonatal behavioral assessment scale (BNBAS), were associated with in utero exposure to dichlorodiphenyltrichloroethane (DDT): p,p'-dichlorodiphenyl trichloroethane (p,p'-DDT), o,p'-dichlorodiphenyl trichloroethane (o,p'-DDT) and p,p'-DDT's primary breakdown product p,p'-dichlorodiphenyl dichloroethylene (p,p'-DDE) (heretofore collectively referred to as DDT/DDE). Our subjects were a birth cohort of 303 infants whose mothers were low-income Latinas living in the Salinas Valley, an agricultural community in California. We assessed neonates < or =2 months old using the seven BNBAS clusters (habituation, orientation, motor performance, range of state, regulation of state, autonomic stability, and reflex) and examined performance in relationship to DDT/DDE measures in maternal serum samples collected during pregnancy. We did not find any detrimental associations between in utero DDT/DDE levels and neonatal performance on the BNBAS. In this same cohort, we previously demonstrated that exposures to DDT/DDE were related to decrements in neurodevelopment at 6-24 months of age. The failure to observe effects on the BNBAS in these same children may be due to limited sensitivity of a single BNBAS assessment or a delay in the manifestations of neurodevelopmental effects of DDT/DDE until after the neonatal period.

Prenatal pesticide and PCB exposures and birth outcomes

Evidence is inconsistent or poorly understood for links between polychlorinated biphenyls (PCBs), 1,1'-dichloro-2,2'-bis(4-chlorophenyl)ethylene (DDE), and organophosphate (OP) pesticides and adverse pregnancy outcomes, although they are known developmental toxicants. We measured biomarkers of maternal exposure to DDE, PCB, and OP metabolites in the third trimester of pregnancy among 404 mothers in a multiethnic cohort in New York City. We also determined maternal paraoxonase (PON1), butyrylcholinesterase (BuChe), and PON1Q192R gene variant. Higher multivariate-adjusted DDE levels (but not PCB) were associated with lower birth weight (-98 g/log10 DDE, p = 0.096) and head circumference (-0.54 cm/log10 DDE, p = 0.030). DDE and PCB levels were not related to birth length, Ponderal index, or gestational age. Birth length was shorter for mothers with PON192RR slow genotype compared with PON192QQ (p = 0.026), and head circumference was inversely associated with maternal PON1 activity (p = 0.004). With slow-activity PON1 or PON192, urinary diethylphosphates (SigmaDEPs) were associated with lower birth weight and dimethylphosphates (SigmaDMPs) with shorter birth length. No associations were found between birth outcomes and BuChe. In summary, we found suggestive relationships between prenatal environmental biomarkers and birth outcomes in this population. Maternal susceptibility factors including PON1 and maternal weight contributed to the observed effects.

Maternal fish consumption, mercury levels, and risk of preterm delivery

BACKGROUND

Pregnant women receive mixed messages about fish consumption in pregnancy because unsaturated fatty acids and protein in fish are thought to be beneficial, but contaminants such as methylmercury may pose a hazard.

METHODS

In the Pregnancy Outcomes and Community Health (POUCH) study, women were enrolled in the 15th to 27th week of pregnancy from 52 prenatal clinics in five Michigan communities. At enrollment, information was gathered on amount and category of fish consumed during the current pregnancy, and a hair sample was obtained. A segment of hair closest to the scalp, approximating exposure during pregnancy, was assessed for total mercury levels (70-90% methylmercury) in 1,024 POUCH cohort women.

RESULTS

Mercury levels ranged from 0.01 to 2.50 pg/g (mean = 0.29 microg/g; median = 0.23 microg/g). Total fish consumption and consumption of canned fish, bought fish, and sport-caught fish were positively associated with mercury levels in hair. The greatest fish source for mercury exposure appeared to be canned fish. Compared with women delivering at term, women who delivered before 35 weeks' gestation were more likely to have hair mercury levels at or above the 90th percentile (> or = 0.55 microg/g), even after adjusting for maternal characteristics and fish consumption (adjusted odds ratio = 3.0; 95% confidence interval, 1.3-6.7).

CONCLUSION

This is the first large, community-based study to examine risk of very preterm birth in relation to mercury levels among women with low to moderate exposure. Additional studies are needed to see whether these findings will be replicated in other settings.

In utero exposure to dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenyldichloroethylene (DDE) and neurodevelopment among young Mexican American children

OBJECTIVE

We investigated the relationship between prenatal exposure to dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenyldichloroethylene (DDE) and neurodevelopment of Mexican farm-workers' children in California.

METHODS

Participants from the Center for the Health Assessment of Mothers and Children of Salinas study, a birth cohort study, included 360 singletons with maternal serum measures of p,p'-DDT, o,p'-DDT, and p,p'-DDE. Psychomotor development and mental development were assessed with the Bayley Scales of Infant Development at 6, 12, and 24 months.

RESULTS

We found a approximately 2-point decrease in Psychomotor Developmental Index scores with each 10-fold increase in p,p'-DDT levels at 6 and 12 months (but not 24 months) and p,p'-DDE levels at 6 months only. We found no association with mental development at 6 months but a 2- to 3-point decrease in Mental Developmental Index scores for p,p'-DDT and o,p'-DDT at 12 and 24 months, corresponding to 7- to 10-point decreases across the exposure range. Even when mothers had substantial exposure, breastfeeding was usually associated positively with Bayley scale scores.

CONCLUSIONS

Prenatal exposure to DDT, and to a lesser extent DDE, was associated with neurodevelopmental delays during early childhood, although breastfeeding was found to be beneficial even among women with high levels of exposure. Countries considering the use of DDT should weigh its benefit in eradicating malaria against the negative associations found in this first report on DDT and human neurodevelopment.