151
|
Watkins DJ, Sánchez BN, Téllez-Rojo MM, Lee JM, Mercado-García A, Blank-Goldenberg C, Peterson KE, Meeker JD. Phthalate and bisphenol A exposure during in utero windows of susceptibility in relation to reproductive hormones and pubertal development in girls. ENVIRONMENTAL RESEARCH 2017; 159:143-151. [PMID: 28800472 PMCID: PMC5623649 DOI: 10.1016/j.envres.2017.07.051] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/28/2017] [Accepted: 07/30/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND Over the past several decades, the age of pubertal onset in girls has shifted downward worldwide. As early pubertal onset is associated with increased risky behavior and psychological issues during adolescence and cardiometabolic disease and cancer in adulthood, this is an important public health concern. Exposure to endocrine disrupting chemicals during critical windows of in utero development may play a role in this trend. Our objective was to investigate trimester-specific phthalate and BPA exposure in relation to pubertal development among girls in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort. METHODS We measured maternal urinary phthalate metabolites and BPA in samples collected during the first, second, and third trimesters of pregnancy. To assess reproductive development among their female children, we measured serum testosterone, estradiol, dehydroepiandrosterone sulfate (DHEA-S), inhibin B, and sex hormone-binding globulin (SHBG), and assessed sexual maturation, including Tanner staging for breast and pubic hair development and menarche status, at age 8-13 years (n = 120). We used linear and logistic regression to examine measures of trimester-specific in utero exposure as predictors of peripubertal hormone levels and pubertal onset, respectively. In secondary analyses, we evaluated estimated exposure at the midpoint of the first trimester and rates of change in exposure across pregnancy in relation to outcomes. RESULTS Several phthalate metabolites measured throughout in utero development were associated with higher serum testosterone concentrations, while a number of metabolites measured in the third trimester were associated with higher DHEA-S. For example, an interquartile range (IQR) increase in mean monoethyl phthalate (MEP) levels across pregnancy was associated with 44% higher peripubertal testosterone (95% CI: 13-83%), while an IQR increase in di-2-ethylhexyl phthalate metabolites (ΣDEHP) specifically in the third trimester was associated with 25% higher DHEA-S (95%CI: 4.7-47%). In IQR increase in mean mono-2-ethylhexyl phthalate (MEHP) levels across pregnancy was associated with lower odds of having a Tanner Stage >1 for breast development (OR = 0.32, 95%CI: 0.11-0.95), while MEHP in the third trimester was associated with higher odds of having a Tanner Stage >1 for pubic hair development (OR = 3.76, 95%CI: 1.1-12.8). Results from secondary analyses were consistent with findings from our main analysis. CONCLUSION These findings suggest that female reproductive development may be more vulnerable to the effects of phthalate or BPA exposure during specific critical periods of in utero development. This highlights the need for comprehensive characterizations of in utero exposure and consideration of windows of susceptibility in developmental epidemiological studies. Future research should consider repeated measures of in utero phthalate and BPA exposure within each trimester and across pregnancy.
Collapse
Affiliation(s)
- Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Martha Maria Téllez-Rojo
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, MOR, Mexico
| | - Joyce M Lee
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA; Pediatric Endocrinology, Child Health Evaluation and Research Unit (CHEAR), University of Michigan, Ann Arbor, MI, USA
| | - Adriana Mercado-García
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, MOR, Mexico
| | | | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| |
Collapse
|
152
|
Cassidy-Bushrow AE, Sitarik AR, Havstad S, Park SK, Bielak LF, Austin C, Johnson CC, Arora M. Burden of higher lead exposure in African-Americans starts in utero and persists into childhood. ENVIRONMENT INTERNATIONAL 2017; 108:221-227. [PMID: 28886415 PMCID: PMC5623116 DOI: 10.1016/j.envint.2017.08.021] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 08/07/2017] [Accepted: 08/30/2017] [Indexed: 05/18/2023]
Abstract
BACKGROUND Recent public health lead crises in urban areas emphasize the need to better understand exposure to environmental toxicants, particularly in higher risk groups. Although African-American children have the highest prevalence of elevated blood lead levels in the United States, little is known about when this trajectory of disproportionate burden of lead exposure first emerges. OBJECTIVES Using tooth-matrix biomarkers that directly measure fetal and early childhood metal levels, the primary goal of this study was to determine if there were racial disparities in lead levels during fetal development and early childhood. Manganese, an essential nutrient that modifies the neurotoxic effects of lead, was also measured. METHODS Pregnant women served by the Henry Ford Health System and living in a predefined geographic area in and around Detroit, Michigan, were recruited during the second trimester or later into the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS), a population-based birth cohort. Offspring born between September 2003 and December 2007 were studied in childhood. Child race was parent-reported. Lead and manganese during the second and third trimesters, early postnatal life (birth through age 1year) and early childhood (age 1 through time of tooth shedding, which ranges from 6 to 12years) were measured via high-resolution microspatial mapping of dentin growth rings, a validated biomarker for prenatal and childhood metal exposure. RESULTS African-American children (N=71) had 2.2 times higher lead levels in the second and third trimesters (both p<0.001) and 1.9 times higher lead levels postnatally in the first year of life (p=0.003) compared to white children (N=51). Lead levels in African-American children were also higher during childhood, but this effect was only marginally significant (p=0.066) and was attenuated after covariate adjustment. Additionally, we observed that African-American children had lower tooth‑manganese levels during the third trimester (p=0.063) and postnatally (p=0.043), however these differences were attenuated after covariate adjustment. CONCLUSION The disproportionate burden of lead exposure is vertically transmitted (i.e., mother-to-child) to African-American children before they are born and persists into early childhood. Our results suggest that testing women for lead during pregnancy (or in pre-conception planning), may be needed to identify the risk to their future offspring, particularly for African-American women.
Collapse
Affiliation(s)
- Andrea E Cassidy-Bushrow
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, USA; Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit, MI, USA.
| | - Alexandra R Sitarik
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, USA; Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit, MI, USA
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, USA; Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit, MI, USA
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Lawrence F Bielak
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Christine Austin
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Division of Environmental Health, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Christine Cole Johnson
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, USA; Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit, MI, USA
| | - Manish Arora
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Division of Environmental Health, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| |
Collapse
|
153
|
Messerlian C, Bellinger D, Mínguez-Alarcón L, Romano ME, Ford JB, Williams PL, Calafat AM, Hauser R, Braun JM. Paternal and maternal preconception urinary phthalate metabolite concentrations and child behavior. ENVIRONMENTAL RESEARCH 2017; 158:720-728. [PMID: 28738300 PMCID: PMC5599166 DOI: 10.1016/j.envres.2017.07.032] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/14/2017] [Accepted: 07/16/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND Prenatal phthalate exposure has been associated with behavioral problems and lower performance on measures of cognitive ability in children. However, the potential effect of phthalate exposure during the sensitive preconception period is unknown. OBJECTIVES To estimate the association of maternal and paternal preconception urinary phthalate metabolite concentrations with child behavior and evaluate potential modification by child sex. METHODS We used data from 166 children (111 singletons, 26 pairs of twins, and 1 set of triplets) born to 134 mothers and 100 fathers participating in a prospective preconception cohort study of subfertile couples from the Massachusetts General Hospital Fertility Center. We estimated mean maternal and paternal preconception exposures by averaging individual phthalate metabolite concentrations in multiple urine samples collected before pregnancy. We assessed children's behavior at 2-9 years of age by parent report using the Behavior Assessment System for Children-2 (BASC-2). We estimated the covariate-adjusted association between individual phthalate metabolite concentrations and the sum of di(2-ethylhexyl) phthalate metabolites (∑ DEHP) and behavior scores, and evaluated differences in associations by child sex using linear regression with Generalized Estimating Equations. Models were further adjusted for prenatal phthalate concentrations in sensitivity analyses. RESULTS Each loge-unit increase in maternal and paternal preconception concentrations of ∑DEHP was associated with a 2.0 (95% CI: - 3.2, - 0.7) and 1.8 (95% CI: - 3.1, - 0.4) point decrease in BASC-2 internalizing behavior scores among all children, respectively. We observed sex-specific associations for some phthalate biomarkers: among boys, maternal monoisobutyl phthalate (MiBP) was positively associated with externalizing behaviors, and paternal MiBP and mono-n-butyl phthalate were positively associated with internalizing behaviors. CONCLUSIONS In this cohort, paternal and maternal preconception concentrations of some phthalate biomarkers were associated with specific aspects of child behavior, even after adjustment for prenatal concentrations. While additional research is warranted to confirm these results, our findings suggest that the preconception period of exposure may be a critical window for offspring neurodevelopment.
Collapse
Affiliation(s)
- Carmen Messerlian
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - David Bellinger
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Megan E Romano
- Department of Epidemiology, Geisel School of Medicine, Dartmouth, Lebanon, NH, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health Boston, MA, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health Boston, MA, USA; Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
154
|
Stacy SL, Papandonatos GD, Calafat AM, Chen A, Yolton K, Lanphear BP, Braun JM. Early life bisphenol A exposure and neurobehavior at 8years of age: Identifying windows of heightened vulnerability. ENVIRONMENT INTERNATIONAL 2017; 107:258-265. [PMID: 28764921 PMCID: PMC5567845 DOI: 10.1016/j.envint.2017.07.021] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/02/2017] [Accepted: 07/24/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Early life BPA exposure could affect neurobehavior, but few studies have investigated whether there are developmental periods when the fetus or child is more vulnerable to these potential effects. OBJECTIVES We explored windows of vulnerability to BPA exposure in a multiethnic cohort of 228 mothers and their children from Cincinnati, Ohio. METHODS We measured urinary BPA concentrations at up to two prenatal and six postnatal time points from the 2nd trimester of pregnancy until the child was age 8years. At age 8years, we administered the Behavioral Assessment System for Children-2 (BASC-2), Behavior Rating Inventory of Executive Function, and Wechsler Intelligence Scale for Children-IV. We estimated covariate-adjusted differences in composite scores from each instrument using a multiple informant model designed to identify heightened windows of vulnerability. RESULTS Among all children, there was not strong evidence that the associations between BPA and neurobehavior varied by the timing of exposure (Visit x BPA p-values≥0.16). However, child sex modified the associations of repeated BPA measures with BASC-2 scores (Visit x Sex x BPA p-values=0.02-0.23). For example, each 10-fold increase in prenatal BPA was associated with more externalizing behaviors in girls (β=6.2, 95% CI: 0.8, 11.6), but not boys (β=-0.8, 95% CI: -5.0, 3.4). In contrast, a 10-fold increase in 8-year BPA was associated with more externalizing behaviors in boys (β=3.9, 95% CI: 0.6, 7.2), but not girls (β=0.3, 95% CI: -3.5, 4.1). CONCLUSIONS We found that sex-dependent associations between BPA and child neurobehavior may depend on the timing of BPA exposure.
Collapse
Affiliation(s)
- Shaina L Stacy
- Department of Epidemiology, Brown University, Providence, RI 02912, United States
| | | | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
| | - Aimin Chen
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, United States
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States
| | - Bruce P Lanphear
- Child and Family Research Institute, BC Children's Hospital and the Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia V5A 1S6, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI 02912, United States.
| |
Collapse
|
155
|
Vuong AM, Yolton K, Xie C, Webster GM, Sjödin A, Braun JM, Dietrich KN, Lanphear BP, Chen A. Childhood polybrominated diphenyl ether (PBDE) exposure and neurobehavior in children at 8 years. ENVIRONMENTAL RESEARCH 2017; 158:677-684. [PMID: 28734254 PMCID: PMC5567986 DOI: 10.1016/j.envres.2017.07.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/05/2017] [Accepted: 07/13/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Prenatal polybrominated diphenyl ether (PBDE) exposure has been associated with decrements in IQ and increased attention deficit/hyperactivity disorder related behaviors in children; however, data are limited for the role of postnatal exposures. OBJECTIVES We investigated the association between a series of childhood PBDE concentrations and Full-Scale Intelligence Quotient (FSIQ) and externalizing problems at 8 years. METHODS We used data from 208 children in the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort. Child serum PBDEs were measured at 1, 2, 3, 5, and 8 years; missing serum PBDE concentrations were estimated via multiple imputation. The Wechsler Intelligence Scales for Children-IV and the Behavior Assessment System for Children-2 was used to assess intelligence and externalizing behavior, respectively, in children at 8 years. We used multiple informant models to estimate associations between repeated lipid-adjusted PBDEs and child neurobehavior and to test for windows of susceptibility. RESULTS Postnatal exposure to PBDE congeners (- 28, - 47, - 99, - 100, and - 153) at multiple ages was inversely associated with FSIQ at 8 years. For instance, a 10-fold increase in BDE-153 concentrations at 2, 3, 5, and 8 years were all related to lower FSIQ at age 8 (β for 3 years: - 7.7-points, 95% CI - 12.5, - 2.9; β for 8 years: - 5.6-points, 95% CI - 10.8, - 0.4). Multiple PBDE congeners at 8 years were associated with increased hyperactivity and aggressive behaviors at 8 years. CONCLUSIONS Postnatal PBDE exposure was associated with decrements in FSIQ and increases in hyperactivity and aggressive behaviors.
Collapse
Affiliation(s)
- Ann M Vuong
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kimberly Yolton
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Changchun Xie
- Division of Biostatistics and Bioinformatics, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Glenys M Webster
- BC Children's Hospital Research Institute and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Andreas Sjödin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kim N Dietrich
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Bruce P Lanphear
- BC Children's Hospital Research Institute and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Aimin Chen
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| |
Collapse
|
156
|
Prenatal antimicrobial use and early-childhood body mass index. Int J Obes (Lond) 2017; 42:1-7. [PMID: 28925412 DOI: 10.1038/ijo.2017.205] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 07/27/2017] [Accepted: 08/02/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND/OBJECTIVES Growing evidence suggests that antibiotic use is associated with childhood body mass index (BMI), potentially via mechanisms mediated by gut microbiome alterations. Less is known on the potential role of prenatal antimicrobial use in offspring obesity risk. We examined whether prenatal antibiotic or antifungal use was associated with BMI at the age of 2 years in 527 birth cohort participants. METHODS/SUBJECTS Antimicrobial use was obtained from the prenatal medical record. Height and weight were measured at the age of 2 years. Overweight/obesity was defined as a BMI ⩾85th percentile. RESULTS A total of 303 (57.5%) women used antibiotics and 101 (19.2%) used antifungals during pregnancy. Prenatal antifungal use was not associated with child BMI at the age of 2 years. In the fully adjusted model, prenatal antibiotic use was associated with a 0.20±0.10 (P=0.046) higher mean BMI Z-score at the age of 2 years. Associations between prenatal antibiotic use and childhood BMI varied by trimester of exposure, with first or second-trimester exposure more strongly associated with larger BMI at the age of 2 years for both BMI Z-score (interaction P=0.032) and overweight/obesity (interaction P=0.098) after covariate adjustment. CONCLUSIONS Prenatal antibiotic, but not antifungal, use is associated with larger BMI at the age of 2 years; associations were stronger for antibiotic exposures in earlier trimesters. Future studies examining whether these associations are due to alterations in the maternal and/or infant microbiome are necessary. Children who are overweight at the age of 2 years are at higher risk for being overweight as they age; prenatal antibiotic use is a potentially modifiable exposure that could reduce childhood obesity.
Collapse
|
157
|
Prenatal environmental chemical exposures and longitudinal patterns of child neurobehavior. Neurotoxicology 2017; 62:192-199. [PMID: 28736150 DOI: 10.1016/j.neuro.2017.07.027] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/21/2017] [Accepted: 07/17/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Prenatal chemical exposures may adversely affect neurodevelopment, but few studies have examined the persistence of these associations. We examined whether associations between prenatal bisphenol A (BPA) or polybrominated diphenyl ether (PBDE) exposures persist or resolve as children age. METHODS We followed 346 mother-child pairs (enrolled 2003-2006) from Cincinnati, OH from pregnancy until children were 8 years old. We measured BPA in urine collected at 16 and 26 weeks gestation and PBDE-47 in serum collected at 16 weeks gestation. We administered repeated measures of children's behavior, mental/psychomotor development, and IQ from ages 1-8 years. We determined if associations of BPA or PBDE-47 with child neurobehavior persisted or resolved as children aged using linear mixed models and estimated neurobehavioral measure reproducibility using intraclass correlation coefficients (ICCs). RESULTS Higher BPA in girls and higher PBDE-47 in both boys and girls were associated with more externalizing behaviors; these associations persisted from ages 2-8 years (exposure×age interaction p-values≥0.36). Higher PBDE-47 concentrations were associated with decreases in MDI from ages 1-3 years (PBDE-47x age interaction p-value=0.03) and persistently lower IQ at ages 5 and 8 years (PBDE-47×age interaction p-value=0.56). Mental/psychomotor abilities had fair reproducibility from ages 1-3 years (ICCs∼0.4), cognitive abilities from ages 5 to 8 years had excellent reproducibility (ICCs=0.7-0.8), and parent-reported behaviors from ages 2-8 years had poor to good reproducibility (ICCs=0.38-0.59). CONCLUSIONS Prenatal BPA and PBDE-47 concentrations were persistently associated with more externalizing behaviors. PBDE-47 concentrations were inversely associated with cognitive abilities that strengthened over time.
Collapse
|
158
|
Etzel TM, Calafat AM, Ye X, Chen A, Lanphear BP, Savitz DA, Yolton K, Braun JM. Urinary triclosan concentrations during pregnancy and birth outcomes. ENVIRONMENTAL RESEARCH 2017; 156:505-511. [PMID: 28427038 PMCID: PMC5495558 DOI: 10.1016/j.envres.2017.04.015] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/24/2017] [Accepted: 04/14/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Triclosan is an antimicrobial chemical used in consumer products, and exposure is ubiquitous among pregnant women in the United States. Triclosan may reduce the levels of thyroid hormones that are important for fetal growth and development. OBJECTIVE We investigated the relationship of prenatal triclosan exposure with birth anthropometry and gestational duration. METHODS We used data from 378 mother-child pairs participating in the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort from Cincinnati, OH. We measured triclosan concentrations in maternal urine samples collected at 16 and 26 weeks of pregnancy. We abstracted information on neonatal anthropometry and gestational duration from medical records. We used multivariable linear regression to estimate the covariate-adjusted association between the average of the two urinary triclosan concentrations and gestational age standardized weight z-score, length, head circumference, and gestational age at birth. RESULTS Median urinary triclosan concentrations were 16ng/mL (range: <2.4 to 1501ng/mL). Each 10-fold increase in triclosan was associated with a predicted 0.15 standard deviation decrease (95% CI: -0.30, 0.00) in birth weight z-score, 0.4-cm decrease (95% CI: -0.8, 0.1) in birth length, 0.3-cm decrease (95% CI: -0.5, 0.0) in head circumference, and 0.3-week decrease (95% CI: -0.6, -0.1) in gestational age. Child sex did not modify the associations between triclosan and birth outcomes. CONCLUSIONS In this cohort, maternal urinary triclosan concentrations during pregnancy were inversely associated with infants' birth weight, length, head circumference, and gestational age.
Collapse
Affiliation(s)
- Taylor M Etzel
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xiaoyun Ye
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Aimin Chen
- Department of Environmental Health, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, B.C., Canada
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kimberly Yolton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
159
|
Abstract
Endocrine-disrupting chemicals (EDCs) might increase the risk of childhood diseases by disrupting hormone-mediated processes that are critical for growth and development during gestation, infancy and childhood. The fetus, infant and child might have enhanced sensitivity to environmental stressors such as EDCs due to their rapid development and increased exposure to some EDCs as a consequence of development-specific behaviour, anatomy and physiology. In this Review, I discuss epidemiological studies examining the relationship between early-life exposure to bisphenol A (BPA), phthalates, triclosan and perfluoroalkyl substances (PFAS) with childhood neurobehavioural disorders and obesity. The available epidemiological evidence suggest that prenatal exposure to several of these ubiquitous EDCs is associated with adverse neurobehaviour (BPA and phthalates) and excess adiposity or increased risk of obesity and/or overweight (PFAS). Quantifying the effects of EDC mixtures, improving EDC exposure assessment, reducing bias from confounding, identifying periods of heightened vulnerability and elucidating the presence and nature of sexually dimorphic EDC effects would enable stronger inferences to be made from epidemiological studies than currently possible. Ultimately, improved estimates of the causal effects of EDC exposures on child health could help identify susceptible subpopulations and lead to public health interventions to reduce these exposures.
Collapse
Affiliation(s)
- Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, RI 02912
| |
Collapse
|
160
|
Vuong AM, Braun JM, Yolton K, Xie C, Webster GM, Sjödin A, Dietrich KN, Lanphear BP, Chen A. Prenatal and postnatal polybrominated diphenyl ether exposure and visual spatial abilities in children. ENVIRONMENTAL RESEARCH 2017; 153:83-92. [PMID: 27915227 PMCID: PMC5222735 DOI: 10.1016/j.envres.2016.11.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/23/2016] [Accepted: 11/24/2016] [Indexed: 05/22/2023]
Abstract
Polybrominated diphenyl ethers (PBDEs) are associated with impaired visual spatial abilities in toxicological studies, but no epidemiologic study has investigated PBDEs and visual spatial abilities in children. The Health Outcomes and Measures of the Environment Study, a prospective birth cohort (2003-2006, Cincinnati, OH), was used to examine prenatal and childhood PBDEs and visual spatial abilities in 199 children. PBDEs were measured at 16±3 weeks gestation and at 1, 2, 3, 5, and 8 years using gas chromatography/isotope dilution high-resolution mass spectrometry. We used the Virtual Morris Water Maze to measure visual spatial abilities at 8 years. In covariate-adjusted models, 10-fold increases in BDE-47, -99, and -100 at 5 years were associated with shorter completion times by 5.2s (95% Confidence Interval [CI] -9.3, -1.1), 4.5s (95% CI -8.1, -0.9), and 4.7s (95% CI -9.0, -0.3), respectively. However, children with higher BDE-153 at 3 years had longer completion times (β=5.4s, 95% CI -0.3, 11.1). Prenatal PBDEs were associated with improved visual spatial memory retention, with children spending a higher percentage of their search path in the correct quadrant. Child sex modified some associations between PBDEs and visual spatial learning. Longer path lengths were observed among males with increased BDE-47 at 2 and 3 years, while females had shorter paths. In conclusion, prenatal and postnatal BDE-28, -47, -99, and -100 at 5 and 8 years were associated with improved visual spatial abilities, whereas a pattern of impairments in visual spatial learning was noted with early childhood BDE-153 concentrations.
Collapse
Affiliation(s)
- Ann M Vuong
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kimberly Yolton
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Changchun Xie
- Division of Biostatistics and Bioinformatics, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Glenys M Webster
- BC Children's Hospital Research Institute, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Andreas Sjödin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kim N Dietrich
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Bruce P Lanphear
- BC Children's Hospital Research Institute, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Aimin Chen
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| |
Collapse
|
161
|
Cheng L, Zhang B, Zheng T, Hu J, Zhou A, Bassig BA, Xia W, Savitz DA, Buka S, Xiong C, Braun JM, Zhang Y, Zhou Y, Pan X, Wu C, Wang Y, Qian Z, Yang A, Romano ME, Shi K, Xu S, Li Y. Critical Windows of Prenatal Exposure to Cadmium and Size at Birth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E58. [PMID: 28075368 PMCID: PMC5295309 DOI: 10.3390/ijerph14010058] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 12/09/2016] [Accepted: 12/14/2016] [Indexed: 12/14/2022]
Abstract
Prenatal cadmium (Cd) exposure has been associated with adverse birth outcomes, but the findings of previous studies are inconsistent. We measured Cd concentrations in urine samples at or near 13, 24, and 35 gestational weeks from 282 women in Wuhan, China. We used generalized estimating equation models to assess the associations between maternal creatinine adjusted urinary Cd concentrations at each trimester and birth size. A significant inverse association was observed between higher maternal Cd levels measured during the 1st trimester and birth size in girls. For each log unit increase in Cd (µg/g creatinine) levels from the 1st trimester, there was a decrease in birth weight by 116.99 g (95% confidence interval (CI): -208.87, -25.11 g). The Cd levels from the 1st and 2nd trimesters were also borderline significantly associated with ponderal index in girls. Joint estimation of trimester-specific effects suggested that associations with Cd levels for ponderal index (pint = 0.02) were significantly different across trimesters, and differences for effects across trimesters for birth weight were marginally significant (pint = 0.08) in girls. No significant associations were observed between Cd levels from any trimester and birth size in boys. Maternal Cd exposure during earlier periods of pregnancy may have a larger impact on delayed fetal growth.
Collapse
Affiliation(s)
- Lu Cheng
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
| | - Bin Zhang
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan 430000, Hubei, China.
| | - Tongzhang Zheng
- Department of Epidemiology, Brown University, Providence, RI 02912, USA.
| | - Jie Hu
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
| | - Aifen Zhou
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan 430000, Hubei, China.
| | - Bryan A Bassig
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06520, USA.
| | - Wei Xia
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
| | - David A Savitz
- Department of Epidemiology, Brown University, Providence, RI 02912, USA.
| | - Stephen Buka
- Department of Epidemiology, Brown University, Providence, RI 02912, USA.
| | - Chao Xiong
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan 430000, Hubei, China.
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI 02912, USA.
| | - Yaqi Zhang
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan 430000, Hubei, China.
| | - Yanqiu Zhou
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
| | - Xinyun Pan
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
| | - Chuansha Wu
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
| | - Youjie Wang
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
| | - Zhengmin Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63103, USA.
| | - Aimin Yang
- College of Earth and Environmental Science, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Megan E Romano
- Department of Epidemiology, Brown University, Providence, RI 02912, USA.
| | - Kunchong Shi
- Department of Epidemiology, Brown University, Providence, RI 02912, USA.
| | - Shunqing Xu
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
| | - Yuanyuan Li
- Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
- Department of Epidemiology, Brown University, Providence, RI 02912, USA.
| |
Collapse
|
162
|
Wang M, Liao X, Laden F, Spiegelman D. Quantifying risk over the life course - latency, age-related susceptibility, and other time-varying exposure metrics. Stat Med 2016; 35:2283-95. [PMID: 26750582 DOI: 10.1002/sim.6864] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 11/25/2015] [Accepted: 12/09/2015] [Indexed: 01/08/2023]
Abstract
Identification of the latency period and age-related susceptibility, if any, is an important aspect of assessing risks of environmental, nutritional, and occupational exposures. We consider estimation and inference for latency and age-related susceptibility in relative risk and excess risk models. We focus on likelihood-based methods for point and interval estimation of the latency period and age-related windows of susceptibility coupled with several commonly considered exposure metrics. The method is illustrated in a study of the timing of the effects of constituents of air pollution on mortality in the Nurses' Health Study. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Molin Wang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,Channing Division of Network Medicine, Department of Medicine, Brigham and WomenŠs Hospital and Harvard Medical School, Boston, MA, U.S.A
| | - Xiaomei Liao
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,Channing Division of Network Medicine, Department of Medicine, Brigham and WomenŠs Hospital and Harvard Medical School, Boston, MA, U.S.A
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,Channing Division of Network Medicine, Department of Medicine, Brigham and WomenŠs Hospital and Harvard Medical School, Boston, MA, U.S.A.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A
| | - Donna Spiegelman
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.,Channing Division of Network Medicine, Department of Medicine, Brigham and WomenŠs Hospital and Harvard Medical School, Boston, MA, U.S.A.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A
| |
Collapse
|
163
|
Chen YH, Ferguson KK, Meeker JD, McElrath TF, Mukherjee B. Statistical methods for modeling repeated measures of maternal environmental exposure biomarkers during pregnancy in association with preterm birth. Environ Health 2015; 14:9. [PMID: 25619201 PMCID: PMC4417225 DOI: 10.1186/1476-069x-14-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 01/16/2015] [Indexed: 05/18/2023]
Abstract
BACKGROUND It is of critical importance to evaluate the role of environmental chemical exposures in premature birth. While a number of studies investigate this relationship, most utilize single exposure measurements during pregnancy in association with the outcome. The studies with repeated measures of exposure during pregnancy employ primarily cross-sectional analyses that may not be fully leveraging the power and additional information that the data provide. METHODS We examine 9 statistical methods that may be utilized to estimate the relationship between a longitudinal exposure and a binary, non-time-varying outcome. To exemplify these methods we utilized data from a nested case-control study examining repeated measures of urinary phthalate metabolites during pregnancy in association with preterm birth. RESULTS The methods summarized may be useful for: 1) Examining sensitive windows of exposure in association with an outcome; 2) Summarizing repeated measures to estimate the relationship between average exposure and an outcome; 3) Identifying acute exposures that may be relevant to the outcome; and 4) Understanding the contribution of temporal patterns in exposure levels to the outcome of interest. In the study of phthalates, changes in urinary metabolites over pregnancy did not appear to contribute significantly to preterm birth, making summary of average exposure across gestation optimal given the current design. CONCLUSIONS The methods exemplified may be of great use in future epidemiologic research projects intended to: 1) Elucidate the complex relationships between environmental chemical exposures and preterm birth; 2) Investigate biological mechanisms in prematurity using repeated measures of maternal factors throughout pregnancy; and 3) More generally, address the relationship between a longitudinal predictor and a binary, non-time-varying outcome.
Collapse
Affiliation(s)
- Yin-Hsiu Chen
- />Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI USA
| | - Kelly K Ferguson
- />Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI USA
| | - John D Meeker
- />Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI USA
| | - Thomas F McElrath
- />Division of Maternal-Fetal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Bhramar Mukherjee
- />Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI USA
| |
Collapse
|
164
|
Wei P, Tang H, Li D. Functional logistic regression approach to detecting gene by longitudinal environmental exposure interaction in a case-control study. Genet Epidemiol 2014; 38:638-51. [PMID: 25219575 DOI: 10.1002/gepi.21852] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 05/29/2014] [Accepted: 07/29/2014] [Indexed: 12/26/2022]
Abstract
Most complex human diseases are likely the consequence of the joint actions of genetic and environmental factors. Identification of gene-environment (G × E) interactions not only contributes to a better understanding of the disease mechanisms, but also improves disease risk prediction and targeted intervention. In contrast to the large number of genetic susceptibility loci discovered by genome-wide association studies, there have been very few successes in identifying G × E interactions, which may be partly due to limited statistical power and inaccurately measured exposures. Although existing statistical methods only consider interactions between genes and static environmental exposures, many environmental/lifestyle factors, such as air pollution and diet, change over time, and cannot be accurately captured at one measurement time point or by simply categorizing into static exposure categories. There is a dearth of statistical methods for detecting gene by time-varying environmental exposure interactions. Here, we propose a powerful functional logistic regression (FLR) approach to model the time-varying effect of longitudinal environmental exposure and its interaction with genetic factors on disease risk. Capitalizing on the powerful functional data analysis framework, our proposed FLR model is capable of accommodating longitudinal exposures measured at irregular time points and contaminated by measurement errors, commonly encountered in observational studies. We use extensive simulations to show that the proposed method can control the Type I error and is more powerful than alternative ad hoc methods. We demonstrate the utility of this new method using data from a case-control study of pancreatic cancer to identify the windows of vulnerability of lifetime body mass index on the risk of pancreatic cancer as well as genes that may modify this association.
Collapse
Affiliation(s)
- Peng Wei
- Division of Biostatistics and Human Genetics Center, The University of Texas School of Public Health, Houston, Texas, United States of America
| | | | | |
Collapse
|
165
|
Ferguson KK, McElrath TF, Ko YA, Mukherjee B, Meeker JD. Variability in urinary phthalate metabolite levels across pregnancy and sensitive windows of exposure for the risk of preterm birth. ENVIRONMENT INTERNATIONAL 2014; 70:118-24. [PMID: 24934852 PMCID: PMC4104181 DOI: 10.1016/j.envint.2014.05.016] [Citation(s) in RCA: 181] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/23/2014] [Accepted: 05/27/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Preterm birth is a significant public health problem, affecting over 1 in 10 live births and contributing largely to infant mortality and morbidity. Everyday exposure to environmental chemicals such as phthalates could contribute to prematurity, and may be modifiable. In the present study we examine variability in phthalate exposure across gestation and identify windows of susceptibility for the relationship with preterm birth. METHODS Women were recruited early in pregnancy as part of a prospective, longitudinal birth cohort at the Brigham and Women's Hospital in Boston, Massachusetts. Urine samples were collected at up to 4 time points during gestation for phthalate measurement, and birth outcomes were recorded at delivery. From this population we selected all 130 cases of preterm birth, defined as delivery before 37 weeks of completed gestation, as well as 352 random controls. RESULTS Urinary phthalate metabolite levels were moderately variable over pregnancy, but levels measured at multiple time points were associated with increased odds of preterm birth. Adjusted odds ratios (aOR) for spontaneous preterm birth were strongest in association with phthalate metabolite concentrations measured at the beginning of the third trimester (aOR for summed di-2-ethylhexyl phthalate metabolites [∑DEHP]=1.33, 95% confidence interval [CI]=1.02, 1.73). Odds ratios for placental preterm birth, defined as delivery with presentation of preeclampsia or intrauterine growth restriction, were slightly elevated in the first trimester for DEHP metabolites (aOR for ∑DEHP=1.33, 95% CI=0.99, 1.78). CONCLUSIONS Pregnant women with exposure to phthalates both early and late in pregnancy are at an increased risk of delivering preterm, but mechanisms may differ based on etiology.
Collapse
Affiliation(s)
- Kelly K Ferguson
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Thomas F McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Yi-An Ko
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.
| |
Collapse
|
166
|
Smarr MM, Vadillo-Ortega F, Castillo-Castrejon M, O'Neill MS. The use of ultrasound measurements in environmental epidemiological studies of air pollution and fetal growth. Curr Opin Pediatr 2013. [PMID: 23399571 DOI: 10.1097/mop.0b013e32835ele74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
PURPOSE OF REVIEW Recently, several international research groups have suggested that studies about environmental contaminants and adverse pregnancy outcomes should be designed to elucidate potential underlying biological mechanisms. The purpose of this review is to examine the epidemiological studies addressing maternal exposure to air pollutants and fetal growth during gestation as assessed by ultrasound measurements. RECENT FINDINGS The six studies published to date found that exposure to certain ambient air pollutants during pregnancy is negatively associated with the growth rates and average attained size of fetal parameters belonging to the growth profile. Fetal parameters may respond to maternal air pollution exposures uniquely, and this response may vary by pollutant and timing of gestational exposure. Current literature suggests that mean changes in head circumference, abdominal circumference, femur length, and biparietal diameter are negatively associated with early-pregnancy exposures to ambient and vehicle-related air pollution. SUMMARY The use of more longitudinal studies, employing ultrasound measures to assess fetal outcomes, may assist with the better understanding of mechanisms responsible for air pollution-related pregnancy outcomes.
Collapse
Affiliation(s)
- Melissa M Smarr
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029, USA.
| | | | | | | |
Collapse
|
167
|
Abstract
PURPOSE OF REVIEW Recently, several international research groups have suggested that studies about environmental contaminants and adverse pregnancy outcomes should be designed to elucidate potential underlying biological mechanisms. The purpose of this review is to examine the epidemiological studies addressing maternal exposure to air pollutants and fetal growth during gestation as assessed by ultrasound measurements. RECENT FINDINGS The six studies published to date found that exposure to certain ambient air pollutants during pregnancy is negatively associated with the growth rates and average attained size of fetal parameters belonging to the growth profile. Fetal parameters may respond to maternal air pollution exposures uniquely, and this response may vary by pollutant and timing of gestational exposure. Current literature suggests that mean changes in head circumference, abdominal circumference, femur length, and biparietal diameter are negatively associated with early-pregnancy exposures to ambient and vehicle-related air pollution. SUMMARY The use of more longitudinal studies, employing ultrasound measures to assess fetal outcomes, may assist with the better understanding of mechanisms responsible for air pollution-related pregnancy outcomes.
Collapse
|
168
|
Afeiche M, Peterson KE, Sánchez BN, Schnaas L, Cantonwine D, Ettinger AS, Solano-González M, Hernández-Avila M, Hu H, Téllez-Rojo MM. Windows of lead exposure sensitivity, attained height, and body mass index at 48 months. J Pediatr 2012; 160:1044-9. [PMID: 22284921 PMCID: PMC3360798 DOI: 10.1016/j.jpeds.2011.12.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 11/07/2011] [Accepted: 12/12/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine longitudinal associations of prenatal, infancy, and early childhood lead exposure during sensitive periods with height and body mass index (BMI). STUDY DESIGN A total of 773 participants were recruited between 1994 and 2005 in Mexico City. Lead exposure history categories were constructed for the prenatal period (maternal patellar lead concentration) and for infancy and childhood (mean child blood lead concentration at birth to 24 months and 30-48 months, respectively). Linear regression models were used to study lead exposure history with height and BMI at 48 months. RESULTS Mean height at age 48 months was significantly lower in children with a blood lead level exceeding the median during infancy (-0.84 cm; 95% CI, -1.42 to -0.25) than in children with a level below the median. Prenatal lead exposure was not associated with height at 48 months. Results for attained BMI generally trended in the same direction as for height. CONCLUSION Our findings suggest an effect of lead exposure early in life on height attainment at 48 months, with the exposure window of greatest sensitivity in infancy.
Collapse
Affiliation(s)
- Myriam Afeiche
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | - Karen E Peterson
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts,Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Lourdes Schnaas
- Division of Research on Public Health, National Institute of Perinatology, Mexico City, México
| | - David Cantonwine
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Adrienne S Ettinger
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut,Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts,Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maritsa Solano-González
- Division of Statistics, Center for Surveys and Evaluation Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | | | - Howard Hu
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Martha M Téllez-Rojo
- Division of Statistics, Center for Surveys and Evaluation Research, National Institute of Public Health, Cuernavaca, Morelos, México
| |
Collapse
|