Association of DDT with spontaneous abortion: a case-control study

Safe long-term therapy of Cushing's syndrome over 37 years with mitotane

While suggested, surgery is not always possible as a first-line treatment of Cushing's Disease (CD). In such cases, patients require medical therapy in order to prevent complications resulting from hypercortisolism. Although there has been a wide expansion in pharmacological options in recent years, mitotane was the agent of choice for treating hypercortisolism decades ago. Due to the introduction of other therapies, long-term experience with mitotane remains limited. Here, we report the case of a woman with CD who was treated with mitotane for 37 years. During the treatment period, biochemical and clinical disease control was achieved and the patient had two uncomplicated pregnancies. Drug-related side effects remained moderate and could be controlled by several dose adjustments. Our case highlights the ability of mitotane to allow an effective control of hypercortisolism and to represent a safe treatment option in special situations where CD requires an alternative therapeutic approach. Furthermore, we provide a literature review of the long-term use of mitotane and reported cases of pregnancy in the context of mitotane therapy.

Apparent Khat chewers exposure to DDT in Ethiopia and its potential toxic effects: A scoping review

Dichlorodiphenyltrichloroethane (DDT) is an insecticide, a member of dirty dozen persistent organic pollutants, used widely in the world until it was banned in the 1970s.The banning of DDT was strengthened by the Stockholm Convention in 2001. DDT is allowed only for malaria control in Ethiopia. However, farmers are misusing DDT and applying it to Khat (Catha edulis) farming. So, this review analyzes available data in the literature on the current trend, application, occurrence, fate and effects of DDT and its metabolites, dichlorodiphenyldichloroethane (DDD), dichlorodiphenyldichloroethylene (DDE), in the chewable parts of Khat. Generally, the concentration level of DDT, DDD, and DDE, designated as DDTs, is detected in different farmlands of Ethiopia. Some of the DDTs concentrations detected are very high (141.2-973 μg/kg (Gelemso), 194.4-999 μg/kg (Aseno) and 6253-8413.3 μg/kg (Gurage), and these concentrations may indicate increasing recent unmonitored application of DDT on Khat leaves. Some of the detected concentrations of DDT in the literature were above the maximum residue limit (MRL) set by FAO/WHO (100 μg/kg) and the European Commission 10 μg/kg in vegetables and 50 μg/kg in cereals. DDT exposure of Khat chewers linked to the concentration of DDT on Khat leaves and the amount of Khat consumed. DDT might pose health risks to chewers due to chronic toxicity, bioaccumulation, persistent and endocrine disruption properties.

Investigation of the Relationship between Spontaneous Abortion, Serum Pesticides, and Polychlorinated Biphenyl Levels

Occupational and environmental chemical exposure have been associated with adverse reproductive consequences. This study investigates the relationship between spontaneous abortion and blood pesticide and polychlorinated biphenyl (PCB) levels. A survey was conducted, and blood samples were collected from 200 patients, consisting of 100 cases with spontaneous abortion and 100 cases with normal deliveries. A total of 150 different pesticides, including organophosphates, organochlorines, carbamates, and pyrethroids, were screened in the collected blood samples and analyzed quantitatively using Tandem mass spectrometry-specifically in combination with liquid chromatography and gas chromatography-tandem mass spectrometry methods. Eight types of PCBs were analyzed with the gas chromatography-tandem mass spectrometry method. The groups were compared based on these analyses. The mean age of the participants was 28.09 ± 4.94 years. In 59% of the spontaneous abortion group, 5.05 ± 1.97 chemicals were detected in different amounts. (p < 0.05). Analysis of the samples identified the presence of β-Hexachlorocyclohexane (β-HCH), delta-hexachlorocyclohexane (δ HCH), Hexachlorobenzene (HCB), Pentachlorobiphenyl-28 (PCB-28), Pentachlorobiphenyl-52 (PCB-52), o,p'-Dichlorodiphenyldichloroethylene (o,p'-DDE), p,p'-Dichlorodiphenyldichloroethylene (p,p'DDE), o,p'-Dichlorodiphenyldichloroethane (o,p'-DDD), p,p'-Dichlorodiphenyldichloroethane (p,p'-DDD), Pentachlorobiphenyl-118 (PCB-118), Pentachlorobiphenyl-101 (PCB-101), Pentachlorobiphenyl-153 (PCB-153), Pentachlorobiphenyl-138 (PCB-138), Pentachlorobiphenyl-202 (PCB-202), Pentachlorobiphenyl-180 (PCB-180) as well as Fibronil, Buprimate, Acetoclor, Acemiprid, Pentimanthalin, and Triflokystrobin. The spontaneous abortion group had significantly higher exposure to PCB-101, PCB-52, PCB-138, and δ-HCH (p < 0.05). Women included in the study had high pesticide and PCB exposure rates. Many of the blood samples contained multiple pesticides with endocrine-disrupting effects. Higher exposure to organochlorine compounds in the serum was identified in the group with spontaneous abortions.

A multi-pollutant assessment of preconception persistent endocrine disrupting chemicals and incident pregnancy loss

BACKGROUND

A few endocrine disrupting chemicals (EDCs) have been associated with pregnancy loss often as reported by women, though there has been no study of EDC mixtures and pregnancy loss in keeping with the nature of human exposure.

OBJECTIVES

To investigate preconception exposure to a mixture of EDCs to identify important drivers and inform multi-pollutant models of EDCs in relation to incident human gonadrophin chorionic (hCG) pregnancy loss.

METHODS

A cohort of 501 couples were recruited from the general population and prospectively followed until a hCG-confirmed pregnancy or 12 months of trying to become pregnant. Pregnant (n = 344; 69%) women were followed daily through seven weeks post-conception then monthly until delivery. Loss was defined as conversion to negative pregnancy test or a clinical diagnosis. Preconception exposure assessment of EDCs included sixty-three serum chemicals and three blood metals. EDCs were measured using isotope dilution gas chromatography-high resolution mass spectrometry or high-performance liquid chromatography-tandem mass spectrometry, and inductively coupled plasma-mass spectrometry, respectively. Using elastic net variable selection to identify important factors from the exposure mixture, EDC levels and covariates were then included in Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of time-to-pregnancy loss in multi-pollutant models.

RESULTS

Incidence of hCG pregnancy loss was 28%. Nine EDCs of the sixty-six chemical mixture were associated with pregnancy loss; HRs were elevated for polychlorinated biphenyl 194, 2-(N-methyl-perfluorooctane sulfonamido) acetate, polybrominated diphenyl ether 28, and cadmium, even in sensitivity models adjusting for male partners' EDC concentrations. In final multivariable multi-pollutant Cox proportional hazard models, female partners'polybrominated diphenyl ether 28 (aHR = 1.16, 95% CI: 1.02, 1.31) and cadmium (aHR = 1.23, 95% CI: 1.07, 1.40) remained associated with hCG pregnancy loss. Female partners' preconception serum polychlorinated biphenyl 194 and 2-(N-methyl-perfluorooctane sulfonamido) acetate concentrations were consistently inversely associated with loss [(aHR = 0.72, 95% CI: 0.56, 0.92) and (aHR = 0.79, 95% CI: 0.65, 0.95), respectively].

CONCLUSION

Assessing exposure to a mixture of 66 persistent EDCs, females' preconception concentrations of polybrominated diphenyl ether 28 and cadmium were positively associated with incident hCG pregnancy loss in a cohort of couples from the general population trying for pregnancy.

Fetoplacental vasculature as a model to study human cardiovascular endocrine disruption

Increasing evidence has associated the exposure of endocrine-disrupting chemicals (EDCs) with the cardiovascular (CV) system. This exposure is particularly problematic in a sensitive window of development, pregnancy. Pregnancy exposome can affect the overall health of the pregnancy by dramatic changes in vascular physiology and endocrine activity, increasing maternal susceptibility. Moreover, fetoplacental vascular function is generally altered, increasing the risk of developing pregnancy complications (including cardiovascular diseases, CVD) and predisposing the foetus to adverse health risks later in life. Thus, our review summarizes the existing literature on exposures to EDCs during pregnancy and adverse maternal health outcomes, focusing on the human placenta, vein, and umbilical artery associated with pregnancy complications. The purpose of this review is to highlight the role of fetoplacental vasculature as a model for the study of human cardiovascular endocrine disruption. Therefore, we emphasize that the placenta, together with the umbilical arteries and veins, allows a better characterization of the pregnant woman's exposome. Consequently, it contributes to the protection of the mother and foetus against CV disorders in life.

Chloroorganic (DDT) and organophosphate (malathion) insecticides impair the motor function of the bovine cervix

Dichlorodiphenyltrichloroethane (DDT) is a representative organochlorine insecticide and a known endocrine disruptor. Malathion is an organophosphate insecticide and a next-generation pesticide. Previously, it was shown that oxytocin (OT) and prostaglandins (PGs) are involved in the mechanism of the adverse effect of DDT on bovine myometrial contractions. However, disruption of myometrial contractions without disruption of cervical activity may not be sufficient to cause preterm delivery. Hence, the aim of this study was to determine the effects of insecticides on the function of the bovine cervix at preovulation period. Bovine cervical cells or strips were treated with DDT or malathion (0.1-100 ng/ml), and neither DDT nor malathion (each at a dose of 100 ng/ml) affected the viability of cervical cells. Malathion (0.1-10 ng/ml) and the high doses of DDT (10 ng/ml) decreased the force of cervical contractions, in contrast to a low dose of DDT (0.1 ng/ml). Both insecticides also decreased the mRNA expression of the OT receptor and the level of the second messenger (inositol triphosphate, IP3). Moreover, DDT decreased the amount of other second messengers (diacylglycerol, DAG), while malathion decreased the amount of gap junction protein (GAP). Only malathion increased PGE2 and decreased PGF2α secretion, while neither insecticide had an effect on both prostaglandins synthesis. Both DDT and malathion impaired cervical contractions, secretory function and cellular signalling. It is also possible that malathion-mediated induction of locally produced PGE2 can be followed by cervical softening. Admittedly it was shown that DDT and malathion can evoke failures in the regulation of motor function of cervix during oestrus cycle, while their harmful effect on gestation can be also not excluded.

Evaluation of work place pesticide concentration and health complaints among women workers in tea plantation, Southern India

BACKGROUND

Women contribute fifty percent of the total work force in tea plantation sector. The continuous use of chemical pesticides in plantation may increase the risk of exposure and can cause detrimental health effects.

OBJECTIVES

To assess the health status of women worker exposed to pesticides in tea plantation and to evaluate the pesticide levels in work environment.

METHODS

A cross sectional study was performed (n = 204) to assess the health complaints among exposed women workers (n = 116) and non-exposed women (n = 88) using a predesigned questionnaire. Work environmental air samples collected using PUF sampler and personal samplers were analyzed for various pesticides.

RESULTS

Musculoskeletal disorder, skin color changes, allergies and asthma were the most commonly reported health complaints. Notably, only 16% of the women used personal protective equipment (PPE) while 68% reported to have experienced tea plantation work up to 6 month of their pregnancy period. Chlorpyrifos methyl (8.3%), carbendazim (6.7%), thiamethoxam (4.2%), ethion (4.2%) and thiophanate methyl (2.1%) were detected in work place air samples.

SIGNIFICANCE

This study is the first to characterize pesticide levels in work place of women workers in India. Women are continuously exposed to pesticides through their work and environmental exposure. Preventive measures are essential to mitigate the adverse health effects of pesticides among women workers.

Organochlorine pesticide residues in Uganda's honey as a bioindicator of environmental contamination and reproductive health implications to consumers

Honey has multifaceted nutritional and medicinal values; however, its quality is hinged on the floral origin of the nectar. Taking advantage of the large areas that they cover; honeybees are often used as bioindicators of environmental contamination. The focus of the present paper was to examine the quality of honey from within the vicinity of an abandoned pesticide store in Masindi District in western Uganda. Surficial soils (<20 cm depths) and honey samples were collected from within the vicinity of the abandoned pesticide store and analysed for organochlorine pesticide (OCP) residues using gas chromatograph coupled to an electron capture detector (GC-ECD). The mean level of ∑DDTs in all the soil samples was 503.6 µg/kg dry weight (d.w). ∑DDTs contributed 92.2% to the ∑OCPs contamination loads in the soil samples, and others (lindane, aldrin, dieldrin, and endosulfans) contributed only 7.8%. Ratio (p, p'-DDE+p, p'-DDD)/p, p'-DDT of 1.54 suggested historical DDT input in the area. In all the honey samples, the mean level of ∑DDTs was 20.9 µg/kg. ∑DDTs contributed 43.3% to ∑OCPs contamination loads in the honey samples, followed by lindane (29.8%), endosulfans (23.6%) and dieldrin (3.2%), with corresponding mean levels of 14.4, 11.4 and 1.55 µg/kg, respectively. Reproductive risk assessment was done based on the hazard quotient (HQ) and hazard index (HI) procedure. In our study, the calculated HIs for adults (102.38), and children (90.33) suggested high potential health risks to the honey consumers. Lindane, endosulfan and p, p'-DDD detected in the honey samples at levels exceeding the acute reference dose (ARfD) are known risk factors for spontaneous abortion, reduced implantation, menstrual cycle shortening, impaired semen quality, and prostate cancer in exposed individuals and experimental animal models.

Breast and prostate glands affected by environmental substances (Review)

Environmental endocrine disruptor chemicals are substances that can alter the homeostasis of the endocrine system in living organisms. They can be released from several products used in daily activities. Once in the organism, they can disrupt the endocrine function by mimicking or blocking naturally occurring hormones due to their similar chemical structure. This endocrine disruption is the most important cause of the well‑known hormone‑associate types of cancer. Additionally, it is decisive to determine the susceptibility of each organ to these compounds. Therefore, the present review aimed to summarize the effect of different environmental substances such as bisphenol A, dichlorodiphenyltrichloroethane and polychlorinated biphenyls in both the mammary and the prostate tissues. These organs were chosen due to their association with the hormonal system and their common features in carcinogenic mechanisms. Outcomes derived from the present review may provide evidence that should be considered in future debates regarding the effects of endocrine disruptors on carcinogenesis.

Environmental exposures to endocrine disrupting chemicals (EDCs) and their role in endometriosis: a systematic literature review

PURPOSE

Endocrine-related diseases and disorders are on the rise globally. Synthetically produced environmental chemicals (endocrine-disrupting chemicals (EDCs)) mimic hormones like oestrogen and alter signalling pathways. Endometriosis is an oestrogen-dependent condition, affecting 10-15% of women of the reproductive age, and has substantial impacts on the quality of life. The aetiology of endometriosis is believed to be multifactorial, ranging from genetic causes to immunologic dysfunction due to environmental exposure to EDCs. Hence, we undertook a systematic review and investigated the epidemiological evidence for an association between EDCs and the development of endometriosis. We also aimed to assess studies on the relationship between body concentration of EDCs and the severity of endometriosis.

METHOD

Following PRISMA guidelines, a structured search of PubMed, Embase and Scopus was conducted (to July 2018). The included studies analysed the association between one or more EDCs and the prevalence of endometriosis. The types of EDCs, association and outcome, participant characteristics and confounding variables were extracted and analysed. Quality assessment was performed using standard criteria.

RESULTS

In total, 29 studies were included. Phthalate esters were positively associated with the prevalence of endometriosis. The majority (71%) of studies revealed a significant association between bisphenol A, organochlorinated environmental pollutants (dioxins, dioxin-like compounds, organochlorinated pesticides, polychlorinated biphenyls) and the prevalence of endometriosis. A positive association between copper, chromium and prevalence of endometriosis was demonstrated in one study only. Cadmium, lead and mercury were not associated with the prevalence of endometriosis. There were conflicting results for the association between nickel and endometriosis. The relationship of EDCs and severity of endometriosis was not established in the studies.

CONCLUSION

We found some evidence to suggest an association between phthalate esters, bisphenol A, organochlorinated environmental pollutants and the prevalence of endometriosis. Disentangling these exposures from various other factors that affect endometriosis is complex, but an important topic for further research.

Endocrine disrupting chemicals: Impacts on human fertility and fecundity during the peri-conception period

It is becoming increasingly difficult to avoid exposure to man-made endocrine disrupting chemicals (EDCs) and environmental toxicants. This escalating yet constant exposure is postulated to partially explain the concurrent decline in human fertility that has occurred over the last 50 years. Controversy however remains as to whether associations exist, with conflicting findings commonly reported for all major EDC classes. The primary aim of this extensive work was to identify and review strong peer-reviewed evidence regarding the effects of environmentally-relevant EDC concentrations on adult male and female fertility during the critical periconception period on reproductive hormone concentrations, gamete and embryo characteristics, as well as the time to pregnancy in the general population. Secondly, to ascertain whether individuals or couples diagnosed as sub-fertile exhibit higher EDC or toxicant concentrations. Lastly, to highlight where little or no data exists that prevents strong associations being identified. From the greater than 1480 known EDCs, substantial evidence supports a negative association between exposure to phthalates, PCBs, PBDEs, pyrethroids, organochloride pesticides and male fertility and fecundity. Only moderate evidence exists for a negative association between BPA, PCBs, organochloride pesticides and female fertility and fecundity. Overall fewer studies were reported in women than men, with knowledge gaps generally evident for both sexes for all the major EDC classes, as well as a paucity of female fertility studies following exposure to parabens, triclosans, dioxins, PFAS, organophosphates and pyrethroids. Generally, sub-fertile individuals or couples exhibit higher EDC concentrations, endorsing a positive association between EDC exposure and sub-fertility. This review also discusses confounding and limiting factors that hamper our understanding of EDC exposures on fertility and fecundity. Finally, it highlights future research areas, as well as government, industry and social awareness strategies required to mitigate the negative effects of EDC and environmental toxicant exposure on human fertility and fecundity.

Association between prenatal exposure to persistent organic pollutants and neurodevelopment in early life: A mother-child cohort (Shanghai, China)

As common environmental pollutants, persistent organic pollutants (POPs) that are widely applied in industry and agriculture have adverse effects on neurodevelopment. However, evidence on the neurotoxicity of POPs in neural development of offspring is limited. This study explored the relationship between prenatal exposure to POPs and neurodevelopment of 18-month-old toddlers in a mother-child cohort in Shanghai, China. In this study, we determined exposure levels of 37 POPs in cord blood serum collected at the time of delivery. The detection rate of pollutants HCB, β-HCH, and p,p'-DDE was higher than 60%, so these will be discussed in the following analysis. From birth to approximately 18 months, we followed up infants to longitudinally explore whether POPs influenced their language, motor, and cognitive development according to a Bayley-Ⅲ assessment . Based on multivariable regression analyses, the β-HCH concentration in cord serum was negatively related to motor development scores in children at 18 months by adjusting for the covariates, but there was no change in language and cognition. Further piecewise linear regression analysis showed that a cord serum β-HCH concentration greater than 0.2 μg/L had a significantly negative correlation with the motor development scores. p,p'-DDE was positively associated with language development at 18 months before and after adjusting for covariates. But prenatal HCB levels were not associated with any of the Bayley-Ⅲ subscales at 18 months. We concluded that prenatal exposure to β-HCH might have adverse effects on infants' motor development. The minimum harmful concentration of β-HCH was estimated at 0.2 μg/L in cord serum. The unexpected positive association between p,p'-DDT and language development could be due to live birth bias.

Effects of DDT, DDE, aldrin and dieldrin on prostaglandin, oxytocin and steroid hormone release from smooth chorion explants of cattle

Chlorooganic xenobiotics (XBs) such as DDT, DDE, aldrin and dieldrin interfere with release of hormones from chorionic villi that are necessary for sustaining the normal course pregnancy: prostaglandins (PGs), oxytocin (OT), progesterone (P₄) and estradiol (E₂). Approximately 20 %-40 % of these hormones originate from the smooth chorion. The aim of current studies was to investigate effects of these XBs on synthesis and release of PGE₂, PGF_2α, OT, P₄ and E₂ from explants of smooth chorion of cattle, obtained during the120-150 and 151-180 day gestational period. Explants were incubated with DDT, DDE, aldrin or dieldrin at concentrations of 1 and 10 ng/mL for 24 h, and concentrations of PGE₂, PGF_2α, OT, P₄ and E₂ in post incubation medium and the relative abundances of COX-2, PTGES, AKR1B1, NP-I/OT, PAM, HSD3B, and CYP19A1 mRNA transcripts in tissue explants were determined. The XBs did not have effects on cell viability in explants (P > 0.05), however, there were effects on prostaglandins, OT and P₄ secretion and relative abundance of mRNA transcript for genes encoding the main enzymes involved in synthesis of these hormones (P < 0.05). The XBs that were evaluated did not have effects on E₂ synthesis and secretion (P > 0.05). In summary, XBs evaluated in the present study had effects on the pattern of prostaglandin secretion, and can increase OT and P₄ release from smooth chorion explants. Because XBs inhibit hormonal action throughout the chorion, there is an increase in risk of abortions or premature births in animals.

Pesticide Risk and Recurrent Pregnancy Loss in Females of Subhumid Region of India

Objective:

The objective of this study is to determine the level of pesticides and their role in cases of recurrent pregnancy loss (RPL).

Materials and Methods:

This was designed as a case–control study. Gas chromatography was used to characterize the pesticide level in 70 cases and 70 controls. Case refers to women with RPL, whereas controls refer to women with full-term delivery.

Results:

A higher level of pesticide, namely beta-hexachlorocyclohexane, malathion, chlorpyrifos, and fenvalerate was found in the case group as compared to control group (P < 0.05).

Conclusions:

The present study suggests that high exposure of pesticide (organochlorine and organophosphates) may increase the risk of RPL in females of the subhumid region of India.

Maternal Plasma Perfluoroalkyl Substances and Miscarriage: A Nested Case-Control Study in the Danish National Birth Cohort

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are widespread persistent organic pollutants and endocrine disruptors. High doses of perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) exposure can cause pregnancy loss and infant deaths in animals, but the associations between PFAS exposures and risk of miscarriage in humans are not well studied.

METHODS

Using a case-control study nested within the Danish National Birth Cohort (DNBC, 1996-2002), we compared 220 pregnancies ending in miscarriage during weeks 12-22 of gestation, with 218 pregnancies resulting in live births. Levels of seven types of PFAS [PFOS, PFOA, perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonate (PFHpS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluorooctanesulfonic acid (PFOSA)] were measured in maternal plasma collected in early gestation (mean gestational week 8). We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for miscarriage and each PFAS as a continuous variable or in quartiles, controlling for maternal age, parity, socio-occupational status, smoking and alcohol intake, gestational week of blood sampling, and maternal history of miscarriage. Stratification by parity and PFAS mixture analyses using weighted quantile sum (WQS) regression were also conducted.

RESULTS

We observed a monotonic increase in odds for miscarriage associated with increasing PFOA and PFHpS levels. The ORs comparing the highest PFOA or PFHpS quartile to the lowest were 2.2 (95% CI: 1.2, 3.9) and 1.8 (95% CI: 1.0, 3.2). The ORs were also elevated for the second or third quartile of PFHxS or PFOS, but no consistent exposure-outcome pattern emerged. An interquartile range (IQR) increment in the WQS index of seven PFAS was associated with 64% higher odds for miscarriage (95% CI: 1.15, 2.34). The associations were stronger in parous women, while findings were inconsistent among nulliparous women.

CONCLUSION

Maternal exposures to higher levels of PFOA, PFHpS, and PFAS mixtures were associated with the risk of miscarriage and particularly among parous women. Larger replication studies among nulliparous women are needed to allay concerns about confounding by reproductive history. https://doi.org/10.1289/EHP6202.

Risk factors for spontaneous abortion from a prevention perspective in rural China: a population-based follow-up study

OBJECTIVES

We conducted this study to investigate the risk factors for spontaneous abortion among rural Chinese women.

METHODS

Risk factors prior to pregnancy associated with spontaneous abortion were identified among 17,248 rural women enrolled in a prospective population-based follow-up study. The risk of spontaneous abortion was estimated with odds ratio (OR) and 95% confidence interval (CI) for several factors. A nonconditional logistic regression analysis was then performed to identify the independently associated factors.

RESULTS

The total sample of this study population consisted of 17,248 pregnant women including 921 of them whose pregnancies resulted in spontaneous abortion and the incidence of spontaneous abortion was 5.04%. After the adjustment of confounding factors, menarche age, serum creatinine, family genetic diseases or maternal congenital defects was associated with an increased risk of spontaneous abortion while folic acid supplementation reduced the risk among rural Chinese women.

CONCLUSIONS

The findings of our study suggest that multiple modifiable factors may increase the risk of spontaneous abortion which may help relevant departments better to guide detailed effectively prevention strategies toward spontaneous abortion to improve the reproductive quality of rural population. Further studies are required to elaborate these risk factors for spontaneous abortion.

Mapping Geospatial Processes Affecting the Environmental Fate of Agricultural Pesticides in Africa

The application of agricultural pesticides in Africa can have negative effects on human health and the environment. The aim of this study was to identify African environments that are vulnerable to the accumulation of pesticides by mapping geospatial processes affecting pesticide fate. The study modelled processes associated with the environmental fate of agricultural pesticides using publicly available geospatial datasets. Key geospatial processes affecting the environmental fate of agricultural pesticides were selected after a review of pesticide fate models and maps for leaching, surface runoff, sedimentation, soil storage and filtering capacity, and volatilization were created. The potential and limitations of these maps are discussed. We then compiled a database of studies that measured pesticide residues in Africa. The database contains 10,076 observations, but only a limited number of observations remained when a standard dataset for one compound was extracted for validation. Despite the need for more in-situ data on pesticide residues and application, this study provides a first spatial overview of key processes affecting pesticide fate that can be used to identify areas potentially vulnerable to pesticide accumulation.

Do chlorinated insecticides (aldrin and DDT) or products of their transformations (dieldrin and DDE) impair signal transfer from regulators (oxytocin and relaxin) of bovine myometrium motility in vitro?

Aldrin, dieldrin, and DDT are chlorinated insecticides that are unintentionally widespread in the environment. It was previously shown that all of the aforementioned compounds increased secretion of ovarian oxytocin (OT), which is a potent uterotonic agent. However, only DDT and its metabolite (DDE) promoted, while aldrin and dieldrin inhibited basal and OT-stimulated myometrial contractions in cows. Therefore, the aim of this study was to determine the effect of these treatments on the reception and further transmission of the OT-signal for myometrial contractions and on the levels of contractile-associated integral proteins (caveolin; CAV) and gap junction proteins (GAPs). Moreover, their effect on reception of signal for the relaxation of myometrium was also studied. Myometrial strips or cells from non-pregnant (8-12 days of oestrous cycle) or late pregnant (5-8 months) cows were incubated with the studied compounds at environmentally relevant dose (10 ng/ml), which was chosen according to the previous studies. DDT and DDE increased the CAV protein level, while dieldrin decreased the GAPs level. None of the studied compounds affected mRNA expression of the OT receptor and expression of the second messengers (DAG, IP3, PKC, MLCK). Oppositely, DDE and dieldrin decreased mRNA expression of the relaxin (RLX) receptor. Changes in the amount of contractile-associated integral proteins may be involved in the molecular mechanism underlying the adverse effects of the studied insecticides on myometrial motility. Admittedly, none of the studied compounds impaired the reception or further intracellular transmission of the OT signal to promote contractions during the oestrous cycle, while they showed potential to impair the transmission the signal between cells as well as to diminish the effects of one of the primary inhibitor (RLX) of myometrial contractions during gestation.

Concentrations of organochlorine pesticides in cord serum of newborns in Wuhan, China

Organochlorine pesticides (OCPs) had been widely used in China before they were banned decades ago due to the concern of the toxicology to human. Previous reports showed that OCPs were still often detectable in human bodies. However, there is limited study concerning the body burden of OCPs in infants and fetus in China. In this study, the prenatal exposure to OCPs was evaluated by measuring OCPs in cord serum. A total of 1046 cord serum samples were collected in Wuhan during 2014 and 2015, and analyzed for the concentrations of hexachlorocyclohexanes (HCHs), dichlorodiphenyltrichloroethanes (DDTs), dichlorodiphenyldichloroethanes (DDDs) and dichlorodiphenyldichloroethylenes (DDEs) by using gas chromatography-tandem mass spectrometry (GC-MS/MS). The median levels of ∑HCHs and ∑DDTs were 10.1 ng/g lipid (with the range from <LOD to 1910 ng/g lipid) and 35.5 ng/g lipid (with the range from 0.18 to 11,100 ng/g lipid), respectively. β-HCH and p,p'-DDE were found to be the major OCPs presenting in the cord serum samples. A minor positive association between the serum levels of α-HCH and β-HCH was observed, and the concentrations of o,p'- and p,p'-DDT isomers were found positively associated. The OCP exposure levels obtained in this study were comparable to those data from other areas in China and much lower than some of highly polluted countries. The prenatal exposure to OCPs would be of concern since fetuses were more vulnerable than adults and the cord serum is an accurate non-invasive matrix for monitoring of prenatal exposure.

Chlorinated insecticides (toxaphene and endrin) affect oxytocin, testosterone, oestradiol and prostaglandin secretion from ovarian and uterine cells as well as myometrial contractions in cow in vitro

We examined the direct effects of toxaphene and endrin, chlorinated insecticides that are widespread in the environment, on myometrial contractions and on the secretion of hormones involved in regulating these contractions. Granulosa, luteal, endometrial and myometrial cells, and myometrial strips from non-pregnant cows were incubated with both insecticides at environmentally relevant doses. Toxaphene inhibited and endrin stimulated the secretion of testosterone and oestradiol from granulosa cells. Toxaphene also inhibited and endrin stimulated the expression of the mRNA encoding the precursor of oxytocin (OT), as well OT secretion in luteal cell cultures. Moreover, endrin increased OT secretion from granulosa cells. Neither insecticide exerted an effect on progesterone secretion from luteal cells. Only toxaphene decreased the secretion of prostaglandins (PGF2 and PGE2) from endometrial cells. Meanwhile, only endrin decreased basal myometrial contractions, which was accompanied by inhibition of PGF2 secretion from the myometrium. Both endrin and toxaphene also decreased the force of the OT-stimulated myometrial contractions, whereas only toxaphene inhibited the stimulatory effect of OT on the force of myometrial contractions. In contrast to endrin, toxaphene decreased synthesis and secretion of one of the primary stimulators of myometrial contractions (OT) and indirectly inhibited OT signal reception in the myometrium by reducing E2 secretion. Both insecticides decreased OT-stimulated myometrial contractions; therefore, they may inhibit further transmission of the OT signal. Moreover, endrin inhibited basal myometrial contractions, potentially resulting from reduced PGF2 secretion from the myometrium. Our data indicate the potential of these insecticides to disturb the course of the oestrous cycle or fertilisation.

Is in utero exposure to maternal socioeconomic disadvantage related to offspring ovarian reserve in adulthood?

BACKGROUND

Because the ovarian follicle pool is established in utero, adverse exposures during this period may be especially impactful on the size and health of the initial follicle endowment, potentially shaping trajectories of ovarian follicle loss and the eventual onset of menopause. Building on a robust literature linking socioeconomic status (SES) and menopausal timing, the current study examined adverse prenatal exposures related to maternal SES, hypothesizing that greater maternal socioeconomic disadvantage would be associated with lower ovarian reserve in the adult offspring.

METHODS

In a healthy, community-based sub-sample (n = 350) of reproductive age participants in the OVA Study (2006-2011), prenatal maternal SES was examined in relation to two biomarkers of ovarian reserve, antimullerian hormone (AMH) and antral follicle count (AFC). Prenatal maternal SES was assessed indirectly using maternal addresses abstracted from participant birth certificates, geocoded, and linked to US Census-derived variables, including neighborhood-level characteristics: education (% of individuals with a HS diploma); poverty (% of families below the poverty line); unemployment (% of individuals > 16 years who are unemployed); and income (median family income).

RESULTS

In separate covariate-adjusted linear regression models (following the backward elimination of main effects with P > .10), greater maternal neighborhood education was related to higher ovarian reserve as marked by higher levels of offspring AMH (beta = .142, P < .001) and AFC (beta = .092, P < .10) with models accounting for 19.6% and 21.5% of the variance in AMH and AFC, respectively. In addition, greater maternal neighborhood poverty was related to lower ovarian reserve as marked by lower offspring AMH (beta = -.144, P < .01), with the model accounting for 19.5% of the variance in AMH.

CONCLUSIONS

Maternal socioeconomic disadvantage measured indirectly at the neighborhood level was associated with lower ovarian reserve among the adult offspring, independently of offspring SES and other potential confounding factors. This suggests SES-related adversity exposures may have a detrimental impact on the size or health of the initial follicle endowment, leading to accelerated follicle loss over time.

The inhibition of myometrial contractions by chlorinated herbicides (atrazine and linuron), and their disruptive effect on the secretory functions of uterine and ovarian cells in cow, in vitro

The effect of atrazine and linuron, the popular and widely used chlorinated herbicides, on both myometrial contractions and secretory functions of bovine uterus and ovaries in vitro, was investigated. The pesticides inhibited (P<0.05) the basal and oxytocin (OT)-stimulated myometrial strips contractions, as well as the effect of OT on secretion of prostaglandins (PGs: PGF2α and PGE2) from endometrium. But only linuron inhibits the effect of OT on myometrial contractions. Neither of herbicides affected PGs secretion from myometrium and PGF2α from endometrium. Only the lowest dose of both tested compounds decreased PGE2 secretion from endometrium. The pesticides increased (P<0.05) the OT secretion from granulosa. However, only linuron stimulated (P<0.05) the OT secretion from the luteal cells, and it increased (P<0.05) the expression of mRNA for the OT precursor. Both compounds stimulated (P<0.05) the secretion of testosterone and atrazine increased (P<0.05) also the secretion of estradiol from the granulosa cells. While atrazine and linuron reduced (P<0.05) the progesterone secretion from the luteal cells. The data show that atrazine and linuron altered the secretory functions of ovarian cells and inhibited the myometrial contractions in vitro.

Association of reproductive disorders and male congenital anomalies with environmental exposure to endocrine active pesticides

There is growing evidence that environmental exposure to pesticides may increase the risk of developing reproductive and developmental disorders. This study determined the prevalence and risk of developing gestational disorders and male congenital genitourinary malformations in areas with distinct exposure to pesticides, many of them with potential endocrine disrupting properties. A population-based case-control study was carried out on pregnant women and male children living in ten health districts of Andalusia classified as areas of high and low environmental exposure to pesticides according to agronomic criteria. The study population included 45,050 cases and 950,620 controls matched for age and health district. Data were collected from computerized hospital records between 1998 and 2005. Prevalence rates and risk of miscarriage, low birth weight, hypospadias, cryptorchidism and micropenis were significantly greater in areas with higher use of pesticides in relation to those with lower use, thus supporting and extending previous information.

Synergistic effect of DDT and its metabolites in lipopolysaccharide-mediated TNF-α production is inhibited by progesterone in peripheral blood mononuclear cells

Increased TNF-α levels have been associated with adverse pregnancy outcomes. Lipopolysaccharide (LPS), 1,1,1-trichloro-2,2-bis-(chlorophenyl)ethane (DDT), 1,1-bis-(chlorophenyl)-2,2-dichloroethene (DDE), and 1,1-dichloro-2,2-bis(chlorophenyl)ethane (DDD) induce TNF-α release in peripheral blood mononuclear cells (PBMC). Conversely, progesterone (P4) inhibits TNF-α secretion. Pregnant women in malaria endemic areas may be co-exposure to these compounds. Thus, this study was to investigate the synergistic effect of LPS and these pesticides in PBMC and to assess P4 influence on this synergy. Cultured PBMC were exposed to each pesticide in the presence of LPS, P4, or their combination. TNF-α was measured by ELISA. All pesticides enhanced TNF-α synthesis in PBMC. Co-exposure with LPS synergizes TNF-α production, which is blocked by progesterone. These results indicate that these organochlorines act synergistically with LPS to induce TNF-α secretion in PBMC. This effect is blocked by P4.

Secretory function of ovarian cells and myometrial contractions in cow are affected by chlorinated insecticides (chlordane, heptachlor, mirex) in vitro

The aim of the study was to investigate the effect of chlordane, heptachlor and mirex, on hormonal regulation of the force of myometrial contractions. Myometrial, endometrial, granulosa and luteal cells as well as strips of myometrium from non-pregnant cows were incubated with three insecticides at environmentally relevant doses (0.1, 1 or 10ng/ml). None of the insecticides affected the viability of studied cells. Chlordane stimulated, while heptachlor and mirex inhibited, secretion of testosterone and estradiol from granulosa cells as well as secretion of progesterone from luteal cells, respectively. Secretion of oxytocin (OT) from granulosa cells was increased after incubation with all studied insecticides. Only mirex stimulated OT secretion from luteal cells, while heptachlor inhibited this effect. None of them affected synthesis of OT in luteal cells and prostaglandins (PGF2 and PGE2) secretion from uterine cells, except PGE2 secretion from endometrial cells was decreased when the cells were incubated with 0.1ng/ml of chlordane. Basal and OT-stimulated myometrial contractions were increased by mirex and decreased by heptachlor. The data show that the insecticides altered secretory function of ovarian cells. Heptachlor and mirex affected also myometrial contractions in vitro, but uterine secretion of prostaglandins were not involved in the mechanism of that adverse effect of insecticides. The data indicate on potential of these insecticides to disturb fertilisation, blastocyst implantation or even the length of gestation.

Concentrations of organochlorine pesticides in umbilical cord blood and related lifestyle and dietary intake factors among pregnant women of the Huaihe River Basin in China

Organochlorine pesticides (OCPs), one of the persistent organic pollutants (POPs) with highly lipophilic properties, long half-lives, and persistence in the environment, are prevalent in the environment even though they have been banned for >30years. We aimed to investigate the current OCP exposure levels in cord blood from healthy pregnant women residing in the Huaihe River Basin, China, and examined the association between OCP levels and dietary habits and lifestyle factors. In this study, we measured the exposure levels of 17 OCPs in the umbilical cord blood from 999 healthy pregnant women; we also administered 1000 self-reported questionnaires regarding the general characteristics and dietary habits of those women. Our results showed that ρ,ρ'-DDE, ρ,ρ'-DDT, aldrin, dieldrin, and methoxychlor, which had higher measured concentrations (2.01±1.89, 4.31±5.68, 7.29±8.74, 5.27±7.65, and 0.98±1.42ng/mL, respectively) and detection frequencies (99.69%, 100.00%, 81.79%, 75.00%, and 74.49%, respectively), were the predominant OCPs in cord blood, and the higher levels of DDTs, aldrin, dieldrin, and methoxychlor were mainly due to recent use. In addition, most of the HCHs in cord blood were derived not only from historical use of technical HCH, but also from the additional use of lindane. In addition, we found that the education level of the pregnant women and monthly household income were positively correlated with OCP levels, particularly ρ,ρ'-DDE, aldrin, and dieldrin. Furthermore, the consumption of red meat (pork, beef, and lamb), fish, and bean products may be an important contributing factor to the increased concentrations of OCPs in cord blood, while the intake of poultry and pickles was negatively correlated with aldrin level. This study is the first to provide adequate data on current OCP exposure levels in cord blood from pregnant women in the Huaihe River Basin.

Short-term incubation of bovine placentome sections as a tool to study xenobiotic mechanism of action

Studies on the effects of various factors, including xenobiotics, on the maternal-fetal connections in the placenta are restricted by the lack of a simple and inexpensive research model. We used placentomes collected at a slaughterhouse to in vitro study the bovine sections contained integral maternal-fetal connections. The placentomes from cows (n=4/experiment, 120-150 days post coitum) were cut using a razor blade into 60-80 mg sections and incubated in either DMEM/Ham's F-12 or M-199 supplemented with FCS (2%, 5% or 10%), amniotic fluid (AF or inactive AF, 10% or 20%) or both. The sections (n=4/supplement) were incubated for 24 or 48 h in a water bath at 37.5°C in an atmosphere of 5% CO2 and 95% O2. The structure and secretory activity of placentome sections were maintained when incubated in DMEM/Ham's F-12 with 2% FCS and 10% AF. M-199 was less acidified than DMEM/Ham's F-12 during incubation, and thus, this medium was better able to maintain the integrity of the placenta and the secretion of estradiol, progesterone and oxytocin for 48 h. Moreover, we detected a decrease in the expression of placenta-specific 1 (PLAC1) mRNA (an indicator of trophoblast proliferation) and an increase in the levels of keratin 8 (KRT8; a marker of normal placental barrier function) and hypoxia induced factor 1α (HIF1α; a marker of hypoxia) mRNA. These results indicate the presence of adaptation and repair mechanisms and confirm the biological activity of the placentome sections. We propose the use of placentome sections as an in vitro model to study maternal-fetal connections in cows.

Influence of environmental contamination on pregnancy outcomes

This study aims to compare pregnancy outcomes in four contaminated areas to those observed in a non-contaminated area of similar socioeconomic status. A cross-sectional study was carried out. A structured and pre-tested questionnaire was administered to population-based samples of 788-920 families in each of the five studied areas. The exposure assessment used was an ecological measure. Using logistic regression, odds of several pregnancies outcomes (pregnancy occurrence, miscarriage, stillbirth, prematurity, low birth weight, congenital malformation, and multiple births) were estimated after adjustment for potential confounders such as socioeconomic, demographic, and substance abuse factors. We adopted a statistical significance level of 5 %. In three of the four exposed areas, pregnancy occurrence was reduced in comparison to the control area (Area 2, odds ratio (OR) = 0.68, 95 % CI = 0.54-0.86; Area 3, OR = 0.76, 95 % CI = 0.60-0.97; Area 4, OR = 0.71, 95 % CI = 0.56-0.90). Also, a significantly increased odds of miscarriage for living in Area 3 (OR = 1.83, 95 % CI = 1.07-3.12) was found. The other pregnancy outcomes were not significantly elevated in the exposed areas. In conclusion, this study shows evidence of reduced pregnancy occurrence and increased miscarriage occurrence in some of the contaminated areas, compared to the control area.

The adverse effects of aldrin and dieldrin on both myometrial contractions and the secretory functions of bovine ovaries and uterus in vitro

Aldrin and dieldrin are chloroorganic insecticides which are recognised as endocrine disruptors. The aim of the study was to investigate their effect on the secretory functions of the uterus and ovary and on myometrial contractions. Myometrial strips and uterine and ovarian cells from nonpregnant cows were incubated with the xenobiotics (0.1, 1 or 10 ng/ml) for 24 or 72 h. Next, their effect on viability of myometrial, endometrial, granulosa and luteal cells, myometrial strip contractions, the synthesis and secretion of prostaglandins (PGs: PGF2α and PGE2) from uterine cells, the secretion of oestradiol (E2), testosterone (T) and oxytocin (OT) from granulosa cells and the secretion of progesterone (P4) and OT from luteal cells were determined. Neither of the xenobiotics (10 ng/ml) affected (P>0.05) the viability of the ovarian and uterine cells, while both (0.1-10 ng/ml) decreased (P<0.05) the basal and OT-stimulated myometrial contractions. In spite of these effects, neither of the insecticides affected (P>0.05) the synthesis and the secretion of PGs from the myometrial cells. Although they also did not impair the secretion of the PGs from the endometrial cells, they abolished (P<0.05) the stimulatory effect of OT (P<0.05) on the secretion of the PGs and stimulated (P<0.05) the secretion of OT from the granulosa and luteal cells. Moreover, aldrin and dieldrin stimulated secretion of E2 and T from the granulosa cells, while only dieldrin increased (P<0.05) the secretion of P4 from luteal cells. The data show that aldrin and dieldrin stimulated the secretory function of the cultured granulosa and luteal cells and inhibited the myometrial contractions of cows in vitro, which may affect on natural parturition.

Concentrations of persistent organic pollutants in California women's serum and residential dust

BACKGROUND

Humans are exposed to persistent organic pollutants (POPs) through various routes, including consumption of contaminated food and accidental ingestion of settled dust.

OBJECTIVES

We aimed to identify key routes of exposure to organochlorine pesticides, polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs) in California women of reproductive age.

METHODS

Blood was collected from 48 mothers participating in the California Childhood Leukemia Study from 2006 to 2007 and analyzed for POPs using gas chromatography-mass spectrometry. Multivariable linear regression models of natural-log transformed serum concentrations were used to identify determinants of exposure from available questionnaire information on dietary habits, reproductive history, and demographic characteristics, as well as vacuum cleaner dust-POP levels.

RESULTS

After adjusting for blood lipid levels, age, body mass index, cumulative lactation, and sampling date, serum concentrations of multiple major PCBs were positively associated with fish consumption, but not dust-PCB levels. After adjusting for blood lipid levels, Hispanic ethnicity, country of origin, and household annual income, serum concentrations of multiple major PBDEs were positively associated with dust-PBDE levels.

CONCLUSIONS

Our findings suggest that the relative contribution of specific exposure routes to total POP intake varies by chemical class, with dust being a relatively important source of PBDEs and diet being a relatively important source of PCBs.

Impairment of uterine smooth muscle contractions and prostaglandin secretion from cattle myometrium and corpus luteum in vitro is influenced by DDT, DDE and HCH

The aim of this study was to investigate the effect of dichlorodiphenyltrichloroethane(DDT), dichlorodiphenyldichloroethylene (DDE) and γ-hexachlorocyclohexane (HCH) (10 ng/ml) on myometrial motility and the secretory function of the myometrium and corpus luteum (CL) collected from cows on days 8-12 of the estrous cycle. All of the xenobiotics increased (P<0.05) myometrial contractility. Moreover, the xenobiotics stimulated the secretion of the following prostaglandins (PGs) from myometrial strips: PGF2α, PGE2 and PGI2. DDT and DDE also increased (P<0.05) the release of PGF2α from CL strips, and HCH had the same effect (P<0.05) on the secretion of PGE2 and PGI2. The studied xenobiotics did not affect (P>0.05) PG synthesis, but DDT and DDE increased the mRNA expression levels of leukemia inhibitor factor (LIF), which can stimulate PG production. In summary, the xenobiotics affected PG secretion from cow myometrium and CL, which may contribute to the mechanism of uterine contraction disturbance.

Differential effect of DDT, DDE, and DDD on COX-2 expression in the human trophoblast derived HTR-8/SVneo cells

The purpose of this study was to investigate the effect of 1,1,1-trichloro-2,2-bis-(chlorophenyl)ethane (DDT), 1,1-bis-(chlorophenyl)-2,2-dichloroethene (DDE), and 1,1-dichloro-2,2-bis(chlorophenyl)ethane (DDD) isomers on COX-2 expression in a human trophoblast-derived cell line. Cultured HTR-8/SVneo trophoblast cells were exposed to DDT isomers and its metabolites for 24 h, and COX-2 mRNA and protein expression were assessed by RT-PCR, Western blotting, and ELISA. Prostaglandin E₂ production was also measured by ELISA. Both COX-2 mRNA and protein were detected under control (unexposed) conditions in the HTR-8/SVneo cell line. COX-2 protein expression and prostaglandin E₂ production but not COX-2 mRNA levels increased only after DDE and DDD isomers exposure. It is concluded that DDE and DDD exposure induce the expression of COX-2 protein, leading to increased prostaglandin E2 production. Interestingly, the regulation of COX-2 by these organochlorines pesticides appears to be at the translational level.

Spontaneous abortion in spouses of greenhouse workers exposed to pesticides

OBJECTIVE

The aim of this study was to explore the association between exposure to specific pesticides (including endocrine disrupters) of greenhouse workers and spontaneous abortion in their spouses.

METHODS

A group of exposed workers was compared with a non-exposed group. The risk of spontaneous abortion was evaluated using a logistic regression model.

RESULTS

A significantly higher rate of spontaneous abortion was observed among spouses of workers exposed to specific compounds (atrazine, benomyl-carbendazim, carbaryl and DDT) in comparison with spouses of the unexposed group. The logistic regression model confirmed the increased risk of spontaneous abortion (OR=11.8; 95% CI 2.3-59.6).

CONCLUSIONS

These findings suggest that occupational exposure to pesticides might have an adverse effect on the partner's reproductive health.

Impact of endocrine-disrupting compounds (EDCs) on female reproductive health

Evidence is accumulating that environmental chemicals (ECs) including endocrine-disrupting compounds (EDCs) can alter female reproductive development, fertility and onset of menopause. While not as clearly defined as in the male, this set of abnormalities may constitute an Ovarian Dysgenesis Syndrome with at least some origins of the syndrome arising during foetal development. ECs/EDCs have been shown to affect trophoblast and placental function, the female hypothalamo-pituitary-gonadal axis, onset of puberty and adult ovarian function. The effects of ECs/EDCs are complex, not least because it is emerging that low-level, 'real-life' mixtures of ECs/EDCs may carry significant biological potency. In addition, there is evidence that ECs/EDCs can alter the epigenome in a sexually dimorphic manner, which may lead to changes in the germ line and perhaps even to transgenerational effects. This review summarises the evidence for EC, including EDC, involvement in female reproductive dysfunction, it highlights potential mechanisms of EC action in the female and emphasises the need for further research into EC effects on female development and reproductive function.

Levels of DDT and its metabolites in placenta, maternal and cord blood and their potential influence on neonatal anthropometric measures

Previous studies of in utero exposure to dichlorodiphenyltrichloroethane (DDT) have shown mixed results for the harmful effects on fetal growth and development. This cross-sectional study was designed to: (1) examine the extent of DDT exposure in 1578 women, aged 28.5±6.0 who delivered between June 2005 and 2006 in the area of Al-Kharj, Saudi Arabia; and (2) assess its influence on neonatal anthropometric measurement of newly born babies. DDT and its metabolites, namely 1,1-dichloro-2,2-bis (p-chlorophenyl) ethylene (p,p'-DDE), 1,1-dichloro-2,2-bis (p-chlorophenyl) ethane (p,p'-DDD) and 1,1,1-trichloro-2,2' bis (p-chlorophenyl) ethane (p,p'-DDT) were measured in cord and maternal serum as well as placenta by Gas Chromatography coupled with an Electron Capture Detector (GC/ECD). p,p'-DDE was detected in 28.3% of cord and 54.4% of maternal serum, reflecting past exposure, whereas the p,p'-DDT was only found in 0.46% cord and 1.2% maternal samples. As expected the p,p'-DDE cord levels (0.197±0.961μg/L) were 2.8 times lower than the maternal levels (0.551±1.778μg/L), and both were significantly correlated (r=0.517) suggesting its transplacental transfer. The picture was different in placental tissues. p,p'-DDE and p,p'-DDT were detected in 84% and 99% of placental tissues, with the highest p,p'-DDT in placental tissues (29.62±158.282µg/kg dry wt.) compare to p,p'-DDE (10.167±18.851μg/kg dry wt.). In general, the presence of DDT metabolites in our participants indicates that these chemicals are still relevant despite the fact that they have been banned or restricted in the study area for many years. Our results support the view for an association between low in utero exposure to DDT and the anthropometric development of the fetus leading to a reduction in its head circumference, crown-heel length, birth weight and birth height. Since the reduction in these measures was independent of gestational age and/or preterm births, our findings suggest a detrimental effect of the DDT exposure on fetal growth. Neonatal anthropometric measures are considered as an important tool to detect newborns at higher risk of morbidity and impairment of growth. Efforts should be made to decrease exposure of women of reproductive age and to examine maternal DDT exposure in relation to long-term impact on health.

DDT and Other Chlorinated Insecticides

The use of organochlorine insecticides such as DDT, lindane and cyclodieneshas declined markedly worldwide over the last decades. Most are now banned or not used. At an acute toxicity level they have been relatively safe in use for humans. However, the greatest concerns are their persistence in people, wildlife and the environment due to their slow metabolism. Although their carcinogenicity for humans has not been supported by strong epidemiological evidence, their potential to be modulators of endocrine and immune function at levels remaining in the environment or associated with residual spraying of DDT continue to be of concern. At present, DDT is still allowed by the United Nations for combating malaria, with continual monitoring and assessment where possible. The toxicological consequences of exposure of animals and people to DDT is discussed as well as some analogues and other insecticides such as lindane, dieldrin and chlordecone that, although little used, continue to persist in surroundings and people. Because of circumstances of world health brought about by climate change or human activities that have yet to develop, there may come a time when the importance of some may re-emerge.

Adverse effects of falciparum and vivax malaria and the safety of antimalarial treatment in early pregnancy: a population-based study

Background

The effects of malaria and its treatment in the first trimester of pregnancy remain an area of concern. We aimed to assess the outcome of malaria-exposed and malaria-unexposed first-trimester pregnancies of women from the Thai–Burmese border and compare outcomes after chloroquine-based, quinine-based, or artemisinin-based treatments.

Methods

We analysed all antenatal records of women in the first trimester of pregnancy attending Shoklo Malaria Research Unit antenatal clinics from May 12, 1986, to Oct 31, 2010. Women without malaria in pregnancy were compared with those who had a single episode of malaria in the first trimester. The association between malaria and miscarriage was estimated using multivariable logistic regression.

Findings

Of 48 426 pregnant women, 17 613 (36%) met the inclusion criteria: 16 668 (95%) had no malaria during the pregnancy and 945 (5%) had a single episode in the first trimester. The odds of miscarriage increased in women with asymptomatic malaria (adjusted odds ratio 2·70, 95% CI 2·04–3·59) and symptomatic malaria (3·99, 3·10–5·13), and were similar for Plasmodium falciparum and Plasmodium vivax. Other risk factors for miscarriage included smoking, maternal age, previous miscarriage, and non-malaria febrile illness. In women with malaria, additional risk factors for miscarriage included severe or hyperparasitaemic malaria (adjusted odds ratio 3·63, 95% CI 1·15–11·46) and parasitaemia (1·49, 1·25–1·78 for each ten-fold increase in parasitaemia). Higher gestational age at the time of infection was protective (adjusted odds ratio 0·86, 95% CI 0·81–0·91). The risk of miscarriage was similar for women treated with chloroquine (92 [26%] of 354), quinine (95 [27%) of 355), or artesunate (20 [31%] of 64; p=0·71). Adverse effects related to antimalarial treatment were not observed.

Interpretation

A single episode of falciparum or vivax malaria in the first trimester of pregnancy can cause miscarriage. No additional toxic effects associated with artesunate treatment occurred in early pregnancy. Prospective studies should now be done to assess the safety and efficacy of artemisinin combination treatments in early pregnancy.

Funding

Wellcome Trust and Bill & Melinda Gates Foundation.

Environmental toxicant exposure during pregnancy

This literature review is meant to serve as a brief reference for acute and chronic poisonings in pregnant women, specifically involving environmental toxicants commonly present in the home or workplace. These scenarios are familiar to primary care providers but cause great confusion for practitioners and anxiety in the pregnant patient. Herein, we review metals and metalloids, organic solvents, disinfectant byproducts, pesticides, plasticizers, and multiple air pollutants. Reviews of specific studies involving these toxicants are provided to assist practitioners in providing information to patients regarding potential sources, mechanism of action, current laboratory and epidemiological studies, and possible treatments. Literature-based associations with specific toxicants and various pregnancy outcomes are also outlined. Finally, a contact list of important federal and state toxicology support services is provided.

TARGET AUDIENCE

Obstetricians & Gynecologists.

LEARNING OBJECTIVES

After completing this CME activity, physicians should be better able to assess both acute and chronic consequences of various environmental toxic exposures in pregnancy; to evaluate possible pregnancy related specific events surrounding environmental pollutants; and to identify common exposure routes and implement therapeutic interventions where appropriate.

Persistent Organochlorine Exposure and Pregnancy Loss: A Prospective Cohort Study

Polychlorinated biphenyls (PCBs) and 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) are suspected reproductive toxicants. We assessed serum concentration of 76 PCB congeners, DDE, and risk of human chorionic gonadotropin confirmed pregnancy loss among 79 women followed for up to 12 menstrual cycles or until pregnancy. 55 women had live births, 14 experienced pregnancy losses, and 10 did not achieve pregnancy. PCBs and DDE were quantified using gas chromatography with electron capture. PCBs were grouped a priori by biologic activity. Cox proportional hazard regression adjusting for age (categorized 24 - 29, 30 - 34) and average standardized alcohol and cigarette intake (continuous) was used to estimate hazard ratios (HR) of pregnancy loss. Estrogenic PCBs (HR = 1.66, 95% CI: 0.68, 4.02), anti-estrogenic PCBs (HR = 0.10, 95% CI: <0.01, 67.07) and DDE (HR = 1.43, 95% CI: 0.45, 4.52) were not statistically significantly associated with pregnancy loss. Our results provide some signal that estrogenic and antiestrogenic PCBs may be differentially associated with pregnancy loss. Further research is needed to elucidate these associations.