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Balalian AA, Stingone JA, Kahn LG, Herbstman JB, Graeve RI, Stellman SD, Factor-Litvak P. Perinatal exposure to polychlorinated biphenyls (PCBs) and child neurodevelopment: A comprehensive systematic review of outcomes and methodological approaches. Environ Res 2024; 252:118912. [PMID: 38615789 DOI: 10.1016/j.envres.2024.118912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs), extensively used in various products, prompt ongoing concern despite reduced exposure since the 1970s. This systematic review explores prenatal PCB and hydroxylated metabolites (OH-PCBs) exposure's association with child neurodevelopment. Encompassing cognitive, motor development, behavior, attention, ADHD, and ASD risks, it also evaluates diverse methodological approaches in studies. METHODS PubMed, Embase, PsycINFO, and Web of Science databases were searched through August 23, 2023, by predefined search strings. Peer-reviewed studies published in English were included. The inclusion criteria were: (i) PCBs/OH-PCBs measured directly in maternal and cord blood, placenta or breast milk collected in the perinatal period; (ii) outcomes of cognitive development, motor development, attention, behavior, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) among children≤18 years old. Quality assessment followed the National Heart, Lung, and Blood Institute's tool. RESULTS Overall, 87 studies were included in this review. We found evidence for the association between perinatal PCB exposure and adverse cognitive development and attention issues in middle childhood. There appeared to be no or negligible link between perinatal PCB exposure and early childhood motor development or the risk of ADHD/ASD. There was an indication of a sex-specific association with worse cognition and attention scores among boys. Some individual studies suggested a possible association between prenatal exposure to OH-PCBs and neurodevelopmental outcomes. There was significant heterogeneity between the studies in exposure markers, exposure assessment timing, outcome assessment, and statistical analysis. CONCLUSIONS Significant methodological, clinical and statistical heterogeneity existed in the included studies. Adverse effects on cognitive development and attention were observed in middle childhood. Little or no apparent link on both motor development and risk of ADHD/ASD was observed in early childhood. Inconclusive evidence prevailed regarding other neurodevelopmental aspects due to limited studies. Future research could further explore sex-specific associations and evaluate associations at lower exposure levels post-PCB ban in the US. It should also consider OH-PCB metabolites, co-pollutants, mixtures, and their potential interactions.
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Affiliation(s)
- Arin A Balalian
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Question Driven Design and Analysis Group (QD-DAG), New York, NY, USA.
| | - Jeanette A Stingone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Julie B Herbstman
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Richard I Graeve
- Institute for Medical Sociology, Martin Luther University Halle-Wittenberg, Halle Saale, Germany
| | - Steven D Stellman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Oh J, Buckley JP, Li X, Gachigi KK, Kannan K, Lyu W, Ames JL, Barrett ES, Bastain TM, Breton CV, Buss C, Croen LA, Dunlop AL, Ferrara A, Ghassabian A, Herbstman JB, Hernandez-Castro I, Hertz-Picciotto I, Kahn LG, Karagas MR, Kuiper JR, McEvoy CT, Meeker JD, Morello-Frosch R, Padula AM, Romano ME, Sathyanarayana S, Schantz S, Schmidt RJ, Simhan H, Starling AP, Tylavsky FA, Volk HE, Woodruff TJ, Zhu Y, Bennett DH. Erratum: "Associations of Organophosphate Ester Flame Retardant Exposures during Pregnancy with Gestational Duration and Fetal Growth: The Environmental influences on Child Health Outcomes (ECHO) Program". Environ Health Perspect 2024; 132:49003. [PMID: 38598327 PMCID: PMC11005959 DOI: 10.1289/ehp14968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/12/2024]
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Stevens ER, Mead-Morse EL, Labib K, Kahn LG, Choi S, Sherman SE, Oncken C, Williams NJ, Loney T, Shahawy OE. Prevalence and factors associated with second hand smoke exposure among a sample of pregnant women in Cairo, Egypt. BMC Womens Health 2024; 24:145. [PMID: 38409025 PMCID: PMC10898124 DOI: 10.1186/s12905-023-02821-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/30/2023] [Indexed: 02/28/2024] Open
Abstract
PURPOSE This study estimated the prevalence of and factors associated with secondhand smoke (SHS) exposure, and assessed attitudes and knowledge about SHS among pregnant women in Cairo, Egypt. METHODS Pregnant women in the third trimester were recruited to participate in a survey assessing tobacco smoking and SHS exposure during their current pregnancy. Participants were recruited from three antenatal clinics in Cairo, Egypt, from June 2015 to May 2016. We examined differences in sociodemographic characteristics and SHS exposure, attitudes, and knowledge by smoking/SHS status. We used multivariable ordinary least squares regression to examine the association between husbands' smoking and pregnant women's mean daily hours of SHS exposure, adjusting for women's smoking status, age group, education, and urban (vs. suburban/rural) residence. RESULTS Of two hundred pregnant women aged 16-37 years, about two-thirds (69%) had a husband who smoked tobacco. During their current pregnancy, most women reported being non-smokers (71%), and 38% of non-smokers reported being SHS-exposed. Non-smokers exposed to SHS tended to live in more rural areas and have husbands who smoked in the home. In adjusted analyses, having a husband who smoked was significantly associated with a greater mean number of hours of SHS exposure per day exposed, and this difference was driven by husbands who smoked in the home (p < 0.001). Women in the SHS-exposed group were less likely than other groups to agree that SHS exposure was harmful to their own or their future child's health; however, all groups agreed that SHS was harmful to newborn health. CONCLUSION Among our sample of pregnant women in Cairo, Egypt, there was a high rate of SHS exposure as well as misconceptions about the safety of SHS exposure to a developing fetus. Our findings suggest a need for targeted education and gender-sensitive messaging about SHS exposure, along with improved enforcement of existing tobacco control policies.
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Affiliation(s)
- Elizabeth R Stevens
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Erin L Mead-Morse
- Department of Medicine, UConn Health School of Medicine, Connecticut, USA
| | - Kareem Labib
- Department of Obstetrics and Gynecology, Ain Shams University School of Medicine, Cairo, Egypt
| | - Linda G Kahn
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- Department of Pediatrics, New York University Grossman School of Medicine, New York, USA
| | - Sugy Choi
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Scott E Sherman
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- Public Health Research Center, New York University in Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Cheryl Oncken
- Department of Medicine, UConn Health School of Medicine, Connecticut, USA
| | - Natasha J Williams
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
| | - Omar El Shahawy
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
- Public Health Research Center, New York University in Abu Dhabi, Abu Dhabi, United Arab Emirates.
- School of Global Public Health, New York University, New York, USA.
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Oh J, Buckley JP, Li X, Gachigi KK, Kannan K, Lyu W, Ames JL, Barrett ES, Bastain TM, Breton CV, Buss C, Croen LA, Dunlop AL, Ferrara A, Ghassabian A, Herbstman JB, Hernandez-Castro I, Hertz-Picciotto I, Kahn LG, Karagas MR, Kuiper JR, McEvoy CT, Meeker JD, Morello-Frosch R, Padula AM, Romano ME, Sathyanarayana S, Schantz S, Schmidt RJ, Simhan H, Starling AP, Tylavsky FA, Volk HE, Woodruff TJ, Zhu Y, Bennett DH. Associations of Organophosphate Ester Flame Retardant Exposures during Pregnancy with Gestational Duration and Fetal Growth: The Environmental influences on Child Health Outcomes (ECHO) Program. Environ Health Perspect 2024; 132:17004. [PMID: 38262621 PMCID: PMC10805613 DOI: 10.1289/ehp13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Widespread exposure to organophosphate ester (OPE) flame retardants with potential reproductive toxicity raises concern regarding the impacts of gestational exposure on birth outcomes. Previous studies of prenatal OPE exposure and birth outcomes had limited sample sizes, with inconclusive results. OBJECTIVES We conducted a collaborative analysis of associations between gestational OPE exposures and adverse birth outcomes and tested whether associations were modified by sex. METHODS We included 6,646 pregnant participants from 16 cohorts in the Environmental influences on Child Health Outcomes (ECHO) Program. Nine OPE biomarkers were quantified in maternal urine samples collected primarily during the second and third trimester and modeled as log 2 -transformed continuous, categorized (high/low/nondetect), or dichotomous (detect/nondetect) variables depending on detection frequency. We used covariate-adjusted linear, logistic, and multinomial regression with generalized estimating equations, accounting for cohort-level clustering, to estimate associations of OPE biomarkers with gestational length and birth weight outcomes. Secondarily, we assessed effect modification by sex. RESULTS Three OPE biomarkers [diphenyl phosphate (DPHP), a composite of dibutyl phosphate and di-isobutyl phosphate (DBUP/DIBP), and bis(1,3-dichloro-2-propyl) phosphate] were detected in > 85 % of participants. In adjusted models, DBUP/DIBP [odds ratio (OR) per doubling = 1.07 ; 95% confidence interval (CI): 1.02, 1.12] and bis(butoxyethyl) phosphate (OR for high vs. nondetect = 1.25 ; 95% CI: 1.06, 1.46), but not other OPE biomarkers, were associated with higher odds of preterm birth. We observed effect modification by sex for associations of DPHP and high bis(2-chloroethyl) phosphate with completed gestational weeks and odds of preterm birth, with adverse associations among females. In addition, newborns of mothers with detectable bis(1-chloro-2-propyl) phosphate, bis(2-methylphenyl) phosphate, and dipropyl phosphate had higher birth weight-for-gestational-age z -scores (β for detect vs. nondetect = 0.04 - 0.07 ); other chemicals showed null associations. DISCUSSION In the largest study to date, we find gestational exposures to several OPEs are associated with earlier timing of birth, especially among female neonates, or with greater fetal growth. https://doi.org/10.1289/EHP13182.
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Affiliation(s)
- Jiwon Oh
- Department of Public Health Sciences, University of California Davis (UC-Davis), Davis, California, USA
| | - Jessie P. Buckley
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill (UNC-Chapel Hill), Chapel Hill, North Carolina, USA
| | - Xuan Li
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kennedy K. Gachigi
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kurunthachalam Kannan
- Wadsworth Center, Division of Environmental Health Sciences, New York State Department of Health, Albany, New York, USA
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, New York, USA
| | - Wenjie Lyu
- Department of Pediatrics, New York University (NYU) Grossman School of Medicine, New York, New York, USA
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, New York, USA
| | - Jennifer L. Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Environmental and Occupational Health Sciences Institute, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Claudia Buss
- Department of Medical Psychology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Pediatrics, UC-Irvine School of Medicine, Orange, California, USA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University (NYU) Grossman School of Medicine, New York, New York, USA
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Ixel Hernandez-Castro
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California Davis (UC-Davis), Davis, California, USA
- Medical Investigations of Neurodevelopmental Disorders Institute, UC-Davis, Sacramento, California, USA
| | - Linda G. Kahn
- Department of Pediatrics, New York University (NYU) Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Jordan R. Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cindy T. McEvoy
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, UC-Berkeley, Berkeley, California, USA
| | - Amy M. Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Megan E. Romano
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington and Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, University of California Davis (UC-Davis), Davis, California, USA
- Medical Investigations of Neurodevelopmental Disorders Institute, UC-Davis, Sacramento, California, USA
| | - Hyagriv Simhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Anne P. Starling
- Department of Epidemiology, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
- Center for Lifecourse Epidemiology of Adiposity and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Frances A. Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Heather E. Volk
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Deborah H. Bennett
- Department of Public Health Sciences, University of California Davis (UC-Davis), Davis, California, USA
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Salvi NB, Ghassabian A, Brubaker SG, Liu H, Kahn LG, Trasande L, Mehta-Lee SS. Prenatal phthalate exposure and fetal penile length and width. Pediatr Res 2023:10.1038/s41390-023-02939-x. [PMID: 38057576 DOI: 10.1038/s41390-023-02939-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/08/2023] [Accepted: 06/26/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Phthalates are endocrine-disrupting chemicals with anti-androgenic qualities and studies reported associations between prenatal phthalate exposure and infant genitalia. This study investigated whether increased prenatal phthalate exposure is associated with decreased fetal penile measures. METHODS Data was from the New York University Children's Health and Environment Study (2016-2019). Maternal urinary concentrations of 16 phthalate metabolites were quantified at <18 weeks gestation as a proxy for fetal exposure (n = 334 male pregnancies). We retrospectively measured penile length and width using ultrasounds conducted 18-24 weeks gestation (n = 173 fetuses). Associations of maternal urinary levels of phthalates with fetal penile length and width were determined using linear regression models. RESULTS 57.2% of women were Hispanic, 31.8% Non-Hispanic White, 6.4% Asian, 2.3% Non-Hispanic Black, and 2.3% multiple races. Mean maternal age was 32 years (standard deviation [SD] = 5.7). Mean penile length was 7.13 mm (SD = 1.47) and width was 6.16 mm (SD = 0.87). An inverse relationship was observed between maternal levels of mono-ethyl phthalate and fetal penile length, and mono-(7-carboxy-n-heptyl) phthalate and penile width, though estimates were small and not significant when considering correction for multiple comparisons. CONCLUSIONS In our cohort we found no clinically meaningful associations between early pregnancy phthalate exposure and fetal penile length or width. IMPACT First-trimester phthalate metabolites were assessed in pregnant women in New York City. Penile length and width were retrospectively measured on clinically assessed ultrasounds conducted ≥18 weeks and <24 weeks of gestation. In this cohort, no clinically meaningful associations were observed between first-trimester prenatal phthalate exposure and fetal penile length. This study contributes to the limited but growing research on the impact of prenatal phthalate exposure on male fetal genital development. The results emphasize that there may not be a clear association between prenatal phthalate exposure and fetal penile length and width, and further research on this topic may be required.
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Affiliation(s)
- Nicole B Salvi
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA.
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Hongxiu Liu
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Hubei, P. R. China
| | - Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
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Lugo-Candelas C, Hwei T, Lee S, Lucchini M, Smaniotto Aizza A, Kahn LG, Buss C, O'Connor TG, Ghassabian A, Padula AM, Aschner J, Deoni S, Margolis AE, Canino G, Monk C, Posner J, Duarte CS. Prenatal sleep health and risk of offspring ADHD symptomatology and associated phenotypes: a prospective analysis of timing and sex differences in the ECHO cohort. Lancet Reg Health Am 2023; 27:100609. [PMID: 38106969 PMCID: PMC10725065 DOI: 10.1016/j.lana.2023.100609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 12/19/2023]
Abstract
Background Sleep difficulties are common in pregnancy, yet poor prenatal sleep may be related to negative long-term outcomes for the offspring, including risk for attention-deficit/hyperactivity disorder (ADHD). Existing studies are few and have not examined timing of exposure effects or offspring sex moderation. We thus aimed to test the hypotheses that poor sleep health in pregnancy is associated with increased risk for ADHD symptoms and offspring sleep problems at approximately 4 years of age. Methods Participants were 794 mother-child dyads enrolled in the NIH Environmental Influences on Child Health Outcomes Study (ECHO). Participants self-reported on sleep duration, quality, and disturbances during pregnancy and on children's ADHD symptoms and sleep problems on the Child Behaviour Checklist. Findings Pregnant participants were 32.30 ± 5.50 years and children were 46% female. 44 percent of pregnant participants identified as Hispanic or Latine; 49% identified as White. Second-trimester sleep duration was associated with offspring ADHD symptoms (b = -0.35 [95% CI = -0.57, -0.13], p = 0.026), such that shorter duration was associated with greater symptomatology. Poorer sleep quality in the second trimester was also associated with increased ADHD symptomatology (b = 0.66 [95% CI = 0.18, 1.14], p = 0.037). Greater sleep disturbances in the first trimester were associated with offspring ADHD (b = 1.03 [95% CI = 0.32, 1.03], p = 0.037) and in the second trimester with sleep problems (b = 1.53 [95% CI = 0.42, 2.92], p = 0.026). We did not document substantial offspring sex moderation. Interpretation Poor prenatal sleep health, particularly quality and duration in the second trimester, may be associated with offspring risk of neurodevelopmental disorders and sleep problems in early childhood. Further research is needed to understand mechanisms, yet our study suggests that prenatal maternal sleep may be a modifiable target for interventions aimed at optimizing early neurodevelopment. Funding NIH grants U2COD023375, U24OD023382, U24OD023319, UH3OD023320, UH3OD023305, UH3OD023349, UH3OD023313, UH3OD023272, UH3OD023328, UH3OD023290, K08MH117452 and NARSAD Young Investigator Award 28545.
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Affiliation(s)
- Claudia Lugo-Candelas
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Tse Hwei
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Seonjoo Lee
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | | | - Alice Smaniotto Aizza
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Linda G. Kahn
- NYU Grossman School of Medicine, 227 East 34th Street, Room 811, New York, NY, 10016, USA
| | - Claudia Buss
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstrasse 57, 10117, Berlin, Germany
| | | | - Akhgar Ghassabian
- NYU Grossman School of Medicine, 227 East 34th Street, Room 811, New York, NY, 10016, USA
| | - Amy M. Padula
- University of California, San Francisco, 490 Illinois Street, Box 0132, San Francisco, CA, 94158, USA
| | - Judy Aschner
- Hackensack Meridian School of Medicine, Nutley NJ and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sean Deoni
- Bill & Melinda Gates Foundation, 500 Mercer Str, Seattle, WA, 98275, USA
| | - Amy E. Margolis
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Glorisa Canino
- University of Puerto Rico Medical Sciences Campus, Behavioral Sciences Research Institute, 9th Floor, Rio Piedras, PR, 00935, Puerto Rico
| | - Catherine Monk
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Jonathan Posner
- Duke University, North Pavilion Building, 2400 Pratt Street, Durham, NC, 27705, USA
| | - Cristiane S. Duarte
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
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Lewis JV, Knapp EA, Bakre S, Dickerson AS, Bastain TM, Bendixsen C, Bennett DH, Camargo CA, Cassidy-Bushrow AE, Colicino E, D'Sa V, Dabelea D, Deoni S, Dunlop AL, Elliott AJ, Farzan SF, Ferrara A, Fry RC, Hartert T, Howe CG, Kahn LG, Karagas MR, Ma TF, Koinis-Mitchell D, MacKenzie D, Maldonado LE, Merced-Nieves FM, Neiderhiser JM, Nigra AE, Niu Z, Nozadi SS, Rivera-Núñez Z, O'Connor TG, Osmundson S, Padula AM, Peterson AK, Sherris AR, Starling A, Straughen JK, Wright RJ, Zhao Q, Kress AM. Associations between area-level arsenic exposure and adverse birth outcomes: An Echo-wide cohort analysis. Environ Res 2023; 236:116772. [PMID: 37517496 PMCID: PMC10592196 DOI: 10.1016/j.envres.2023.116772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/20/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Drinking water is a common source of exposure to inorganic arsenic. In the US, the Safe Drinking Water Act (SDWA) was enacted to protect consumers from exposure to contaminants, including arsenic, in public water systems (PWS). The reproductive effects of preconception and prenatal arsenic exposure in regions with low to moderate arsenic concentrations are not well understood. OBJECTIVES This study examined associations between preconception and prenatal exposure to arsenic violations in water, measured via residence in a county with an arsenic violation in a regulated PWS during pregnancy, and five birth outcomes: birth weight, gestational age at birth, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). METHODS Data for arsenic violations in PWS, defined as concentrations exceeding 10 parts per billion, were obtained from the Safe Drinking Water Information System. Participants of the Environmental influences on Child Health Outcomes Cohort Study were matched to arsenic violations by time and location based on residential history data. Multivariable, mixed effects regression models were used to assess the relationship between preconception and prenatal exposure to arsenic violations in drinking water and birth outcomes. RESULTS Compared to unexposed infants, continuous exposure to arsenic from three months prior to conception through birth was associated with 88.8 g higher mean birth weight (95% CI: 8.2, 169.5), after adjusting for individual-level confounders. No statistically significant associations were observed between any preconception or prenatal violations exposure and gestational age at birth, preterm birth, SGA, or LGA. CONCLUSIONS Our study did not identify associations between preconception and prenatal arsenic exposure, defined by drinking water exceedances, and adverse birth outcomes. Exposure to arsenic violations in drinking water was associated with higher birth weight. Future studies would benefit from more precise geodata of water system service areas, direct household drinking water measurements, and exposure biomarkers.
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Affiliation(s)
- Jonathan V Lewis
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shivani Bakre
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Casper Bendixsen
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Viren D'Sa
- Department of Pediatrics, Rhode Island Hospital, Providence, RI, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Sean Deoni
- Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Amy J Elliott
- Avera Research Institute, Sioux Falls, SD, USA; Department of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Tina Hartert
- Departments of Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Caitlin G Howe
- Dartmouth College Geisel School of Medicine, Hanover, NH, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Teng-Fei Ma
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | | | - Debra MacKenzie
- Community Environmental Health Program, University of New Mexico College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
| | - Luis E Maldonado
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Francheska M Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sara S Nozadi
- Community Environmental Health Program, College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
| | - Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Thomas G O'Connor
- Departments of Psychiatry, Neuroscience, Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Sarah Osmundson
- Department of OB/GYN, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Amy M Padula
- Department of Gynecology, Obstetrics and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Alicia K Peterson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Allison R Sherris
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Anne Starling
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | | | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA
| | - Amii M Kress
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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Charifson M, Ghassabian A, Seok E, Naidu M, Mehta-Lee SS, Brubaker SG, Afanasyeva Y, Chen Y, Liu M, Trasande L, Kahn LG. Chronotype and sleep duration interact to influence time to pregnancy: Results from a New York City cohort. Sleep Health 2023; 9:467-474. [PMID: 37055302 PMCID: PMC10514230 DOI: 10.1016/j.sleh.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/19/2022] [Accepted: 02/07/2023] [Indexed: 04/15/2023]
Abstract
STUDY OBJECTIVE To study associations between nighttime sleep characteristics and time to pregnancy. METHODS Pregnant people age ≥18 years and<18 weeks' gestation were recruited from 3 New York University Grossman School of Medicine affiliated hospitals in Manhattan and Brooklyn (n = 1428) and enrolled into the New York University Children's Health and Environment Study. Participants in the first trimester of pregnancy were asked to recall their time to pregnancy and their sleep characteristics in the 3 months before conception. RESULTS Participants who reported sleeping<7 hours per night tended to have shorter time to pregnancy than those who slept 7-9 hours per night (adjusted fecundability odds ratio = 1.16, 95% confidence interval: 0.94, 1.41). Participants with a sleep midpoint of 4 AM or later tended to have longer time to pregnancy compared with those with earlier sleep midpoints (before 4 AM) (adjusted fecundability odds ratio = 0.88, 95% confidence interval: 0.74, 1.04). When stratified by sleep midpoint, sleeping<7 hours was significantly associated with shorter time to pregnancy only among those whose sleep midpoint was before 4 AM (adjusted fecundability odds ratio = 1.33, 95% confidence interval: 1.07, 1.67). CONCLUSIONS The association of sleep duration with time to pregnancy was modified by chronotype, suggesting that both biological and behavioral aspects of sleep may influence fecundability.
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Affiliation(s)
- Mia Charifson
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, USA.
| | - Akhgar Ghassabian
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, USA; Department of Pediatrics, New York University Grossman School of Medicine, New York City, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York City, NY, USA
| | - Eunsil Seok
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, USA
| | - Mrudula Naidu
- Department of Pediatrics, New York University Grossman School of Medicine, New York City, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York City, NY, USA
| | - Shilpi S Mehta-Lee
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, New York University Langone Health, New York City, NY, USA
| | - Sara G Brubaker
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, New York University Langone Health, New York City, NY, USA
| | - Yelena Afanasyeva
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, USA; Department of Pediatrics, New York University Grossman School of Medicine, New York City, NY, USA
| | - Yu Chen
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York City, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York City, NY, USA
| | - Leonardo Trasande
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, USA; Department of Pediatrics, New York University Grossman School of Medicine, New York City, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York City, NY, USA
| | - Linda G Kahn
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, USA; Department of Pediatrics, New York University Grossman School of Medicine, New York City, NY, USA
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9
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Adelman S, Charifson M, Seok E, Mehta-Lee SS, Brubaker SG, Liu M, Kahn LG. State-specific fertility rate changes across the USA following the first two waves of COVID-19. Hum Reprod 2023; 38:1202-1212. [PMID: 37038265 PMCID: PMC10233281 DOI: 10.1093/humrep/dead055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/02/2023] [Indexed: 04/12/2023] Open
Abstract
STUDY QUESTION How did the first two coronavirus disease 2019 (COVID-19) waves affect fertility rates in the USA? SUMMARY ANSWER States differed widely in how their fertility rates changed following the COVID-19 outbreak and these changes were influenced more by state-level economic, racial, political, and social factors than by COVID-19 wave severity. WHAT IS KNOWN ALREADY The outbreak of the COVID-19 pandemic contributed to already declining fertility rates in the USA, but not equally across states. Identifying drivers of differential changes in fertility rates can help explain variations in demographic shifts across states in the USA and motivate policies that support families in general, not only during crises. STUDY DESIGN, SIZE, DURATION This is an ecological study using state-level data from 50 US states and the District of Columbia (n = 51). The study period extends from 2020 to 2021 with historical data from 2016 to 2019. We identified Wave 1 as the first apex for each state after February 2020 and Wave 2 as the second apex, during Fall/Winter 2020-2021. PARTICIPANTS/MATERIALS, SETTING, METHODS State-level COVID-19 wave severity, defined as case acceleration during each 3-month COVID-19 wave (cases/100 000 population/month), was derived from 7-day weekly moving average COVID-19 case rates from the US Centers for Disease Control and Prevention (CDC). State-level fertility rate changes (change in average monthly fertility rate/100 000 women of reproductive age (WRA)/year) were derived from the CDC Bureau of Vital Statistics and from 2020 US Census and University of Virginia 2021 population estimates 9 months after each COVID-19 wave. We performed univariate analyses to describe national and state-level fertility rate changes following each wave, and simple and multivariable linear regression analyses to assess the relation of COVID-19 wave severity and other state-level characteristics with fertility rate changes. MAIN RESULTS AND THE ROLE OF CHANCE Nationwide, fertility dropped by 17.5 births/month/100 000 WRA/year following Wave 1 and 9.2 births/month/100 000 WRA/year following Wave 2. The declines following Wave 1 were largest among majority-Democrat, more non-White states where people practiced greater social distancing. Greater COVID-19 wave severity was associated with steeper fertility rate decline post-Wave 1 in simple regression, but the association was attenuated when adjusted for other covariates. Adjusting for the economic impact of the pandemic (hypothesized mediator) also attenuated the effect. There was no relation between COVID-19 wave severity and fertility rate change following Wave 2. LIMITATIONS, REASONS FOR CAUTION Our study harnesses state-level data so individual-level conclusions cannot be inferred. There may be residual confounding in our multivariable regression and we were underpowered to detect some effects. WIDER IMPLICATIONS OF THE FINDINGS The COVID-19 pandemic initially impacted the national fertility rate but, overall, the fertility rate rebounded to the pre-pandemic level following Wave 2. Consistent with prior literature, COVID-19 wave severity did not appear to predict fertility rate change. Economic, racial, political, and social factors influenced state-specific fertility rates during the pandemic more than the severity of the outbreak alone. Future studies in other countries should also consider whether these factors account for internal heterogeneity when examining the impact of the COVID-19 pandemic and other crises on fertility. STUDY FUNDING/COMPETING INTEREST(S) L.G.K. received funding from the National Institute of Environmental Health Sciences (R00ES030403), M.C. from the National Science Foundation Graduate Research Fellowship Program (20-A0-00-1005789), and M.L. and E.S. from the National Institute of Environmental Health Sciences (R01ES032808). None of the authors have competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Sarah Adelman
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Mia Charifson
- Vilcek Institute of Biomedical Graduate Sciences, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Eunsil Seok
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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10
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Kahn LG. Balancing risks and rewards in the context of shared motherhood IVF. Hum Reprod 2023; 38:777-779. [PMID: 37009807 PMCID: PMC10152161 DOI: 10.1093/humrep/dead062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Indexed: 04/04/2023] Open
Affiliation(s)
- Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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11
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Eick SM, Geiger SD, Alshawabkeh A, Aung M, Barrett ES, Bush N, Carroll KN, Cordero JF, Goin DE, Ferguson KK, Kahn LG, Liang D, Meeker JD, Milne GL, Nguyen RHN, Padula AM, Sathyanarayana S, Taibl KR, Schantz SL, Woodruff TJ, Morello-Frosch R. Urinary oxidative stress biomarkers are associated with preterm birth: an Environmental Influences on Child Health Outcomes program study. Am J Obstet Gynecol 2023; 228:576.e1-576.e22. [PMID: 36400174 PMCID: PMC10149536 DOI: 10.1016/j.ajog.2022.11.1282] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Preterm birth is the leading cause of infant morbidity and mortality worldwide. Elevated levels of oxidative stress have been associated with an increased risk of delivering before term. However, most studies testing this hypothesis have been conducted in racially and demographically homogenous study populations, which do not reflect the diversity within the United States. OBJECTIVE We leveraged 4 cohorts participating in the Environmental Influences on Child Health Outcomes Program to conduct the largest study to date examining biomarkers of oxidative stress and preterm birth (N=1916). Furthermore, we hypothesized that elevated oxidative stress would be associated with higher odds of preterm birth, particularly preterm birth of spontaneous origin. STUDY DESIGN This study was a pooled analysis and meta-analysis of 4 birth cohorts spanning multiple geographic regions in the mainland United States and Puerto Rico (208 preterm births and 1708 full-term births). Of note, 8-iso-prostaglandin-F2α, 2,3-dinor-5,6-dihydro-8-iso-prostaglandin-F2α (F2-IsoP-M; the major 8-iso-prostaglandin-F2α metabolite), and prostaglandin-F2α were measured in urine samples obtained during the second and third trimesters of pregnancy. Logistic regression was used to calculate adjusted odds ratios and 95% confidence intervals for the associations between averaged biomarker concentrations for each participant and all preterm births, spontaneous preterm births, nonspontaneous preterm births (births of medically indicated or unknown origin), and categories of preterm birth (early, moderate, and late). Individual oxidative stress biomarkers were examined in separate models. RESULTS Approximately 11% of our analytical sample was born before term. Relative to full-term births, an interquartile range increase in averaged concentrations of F2-IsoP-M was associated with higher odds of all preterm births (odds ratio, 1.29; 95% confidence interval, 1.11-1.51), with a stronger association observed for spontaneous preterm birth (odds ratio, 1.47; 95% confidence interval, 1.16-1.90). An interquartile range increase in averaged concentrations of 8-iso-prostaglandin-F2α was similarly associated with higher odds of all preterm births (odds ratio, 1.19; 95% confidence interval, 0.94-1.50). The results from our meta-analysis were similar to those from the pooled combined cohort analysis. CONCLUSION Here, oxidative stress, as measured by 8-iso-prostaglandin-F2α, F2-IsoP-M, and prostaglandin-F2α in urine, was associated with increased odds of preterm birth, particularly preterm birth of spontaneous origin and delivery before 34 completed weeks of gestation.
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Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Sarah D Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | | | - Max Aung
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Emily S Barrett
- Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Rutgers University, Piscataway, NJ
| | - Nicole Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA
| | - Kecia N Carroll
- Departments of Pediatrics and Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - José F Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA
| | - Dana E Goin
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA
| | - Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Ginger L Milne
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Amy M Padula
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle, WA; Seattle Children's Research Institute, Seattle, WA
| | - Kaitlin R Taibl
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA; Department of Environmental Science, Policy, and Management, School of Public Health, University of California, Berkeley, Berkeley, CA
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12
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Cowell W, Limaye M, Brukbaker SG, Silverstein JS, Mehta-Lee SS, Kahn LG, Malaga-Dieguez L, Reiser J, Trasande L. Changes in plasma soluble urokinase plasminogen activator receptor levels across pregnancy and in relation to hypertensive disorders. Am J Obstet Gynecol MFM 2023; 5:100825. [PMID: 36775198 PMCID: PMC10655249 DOI: 10.1016/j.ajogmf.2022.100825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 02/12/2023]
Affiliation(s)
- Whitney Cowell
- Department of Pediatrics, NYU Grossman School of Medicine, Translational Research Bldg Room 809, 225 E 30th St., New York, NY 10016.
| | - Meghana Limaye
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY
| | - Sara G Brukbaker
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY
| | - Jenna S Silverstein
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY
| | - Linda G Kahn
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY
| | | | - Jochen Reiser
- Department of Internal Medicine, Rush Medical College, Chicago, IL
| | - Leonardo Trasande
- Division of Environmental Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY
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13
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Cowell W, Jacobson MH, Long SE, Wang Y, Kahn LG, Ghassabian A, Naidu M, Torshizi GD, Afanasyeva Y, Liu M, Mehta-Lee SS, Brubaker SG, Kannan K, Trasande L. Maternal urinary bisphenols and phthalates in relation to estimated fetal weight across mid to late pregnancy. Environ Int 2023; 174:107922. [PMID: 37075581 PMCID: PMC10165618 DOI: 10.1016/j.envint.2023.107922] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Bisphenols and phthalates are high production volume chemicals used as additives in a variety of plastic consumer products leading to near ubiquitous human exposure. These chemicals have established endocrine disrupting properties and have been linked to a range of adverse reproductive and developmental outcomes. Here, we investigated exposure in relation to fetal growth. METHODS Participants included 855 mother-fetal pairs enrolled in the population-based New York University Children's Health and Environment Study (NYU CHES). Bisphenols and phthalates were measured in maternal urine collected repeatedly during pregnancy. Analyses included 15 phthalate metabolites and 2 bisphenols that were detected in 50 % of participants or more. Fetal biometry data were extracted from electronic ultrasonography records and estimated fetal weight (EFW) was predicted for all fetuses at 20, 30, and 36 weeks gestation. We used quantile regression adjusted for covariates to model exposure-outcome relations across percentiles of fetal weight at each gestational timepoint. We examined sex differences using stratified models. RESULTS Few statistically significant associations were observed across chemicals, gestational time periods, percentiles, and sexes. However, within gestational timepoints, we found that among females, the molar sums of the phthalates DiNP and DnOP were generally associated with decreases in EFW among smaller babies and increases in EFW among larger babies. Among males, the opposite trend was observed. However, confidence intervals were generally wide at the tails of the distribution. CONCLUSION In this sample, exposure to bisphenols and phthalates was associated with small sex-specific shifts in fetal growth; however, few associations were observed at the median of fetal weight and confidence intervals in the tails were wide. Findings were strongest for DiNP and DnOP, which are increasingly used as replacements for DEHP, supporting the need for future research on these contaminants.
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Affiliation(s)
- Whitney Cowell
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States; Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States.
| | - Melanie H Jacobson
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States
| | - Sara E Long
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States
| | - Yuyan Wang
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Linda G Kahn
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States; Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Akhgar Ghassabian
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States; Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Mrudula Naidu
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States
| | | | - Yelena Afanasyeva
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States
| | - Mengling Liu
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, NYU Langone Health, New York, NY, United States
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, NYU Langone Health, New York, NY, United States
| | - Kurunthachalam Kannan
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States
| | - Leonardo Trasande
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States; Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States; NYU Wagner School of Public Service, New York, NY, United States; NYU College of Global Public Health, New York, NY, United States
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14
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Widen EM, Burns N, Kahn LG, Grewal J, Backlund G, Nichols AR, Rickman R, Foster S, Nhan-Chang CL, Zhang C, Wapner R, Wing DA, Owen J, Skupski DW, Ranzini AC, Newman R, Grobman W, Daniels MJ. Prenatal weight and regional body composition trajectories and neonatal body composition: The NICHD Foetal Growth Studies. Pediatr Obes 2023; 18:e12994. [PMID: 36605025 PMCID: PMC9924063 DOI: 10.1111/ijpo.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Gestational weight gain (GWG) and anthropometric trajectories may affect foetal programming and are potentially modifiable. OBJECTIVES To assess concomitant patterns of change in weight, circumferences and adiposity across gestation as an integrated prenatal exposure, and determine how they relate to neonatal body composition. METHODS Data are from a prospective cohort of singleton pregnancies (n = 2182) enrolled in United States perinatal centres, 2009-2013. Overall and by prepregnancy BMI group (overweight/obesity and healthy weight), joint latent trajectory models were fit with prenatal weight, mid-upper arm circumference (MUAC), triceps (TSF) and subscapular (SSF) skinfolds. Differences in neonatal body composition by trajectory class were assessed via weighted least squares. RESULTS Six trajectory patterns reflecting co-occurring changes in weight and MUAC, SSF and TSF across pregnancy were identified overall and by body mass index (BMI) group. Among people with a healthy weight BMI, some differences were observed for neonatal subcutaneous adipose tissue, and among individuals with overweight/obesity some differences in neonatal lean mass were found. Neonatal adiposity measures were higher among infants born to individuals with prepregnancy overweight/obesity. CONCLUSIONS Six integrated trajectory patterns of prenatal weight, subcutaneous adipose tissue and circumferences were observed that were minimally associated with neonatal body composition, suggesting a stronger influence of prepregnancy BMI.
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Affiliation(s)
- Elizabeth M Widen
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
- Department of Women's Health & Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Natalie Burns
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Jagteshwar Grewal
- Division of Population Health Research, Division of Intramural Research, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Grant Backlund
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Amy R Nichols
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Rachel Rickman
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Saralyn Foster
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Chia-Ling Nhan-Chang
- Department of Obstetrics and Gynecology, Columbia University Medical Center, Columbia, South Carolina, USA
| | - Cuilin Zhang
- Division of Population Health Research, Division of Intramural Research, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University Medical Center, Columbia, South Carolina, USA
| | - Deborah A Wing
- Division of Maternal-Fetal Medicine, Department of Obstetrics-Gynecology, University of California, Irvine, School of Medicine, Irvine, and Fountain Valley Regional Hospital and Medical Center, Fountain Valley, California, USA
| | - John Owen
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Daniel W Skupski
- Department of Obstetrics and Gynecology, New York-Presbyterian Queens Hospital, Queens, New York, USA
| | - Angela C Ranzini
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, St Peter's University Hospital, New Brunswick, New Jersey, USA
| | - Roger Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Columbia, South Carolina, USA
| | - William Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University (WAG), New Rochelle, New York, USA
| | - Michael J Daniels
- Department of Statistics, University of Florida, Gainesville, Florida, USA
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15
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Ladd-Acosta C, Vang E, Barrett ES, Bulka CM, Bush NR, Cardenas A, Dabelea D, Dunlop AL, Fry RC, Gao X, Goodrich JM, Herbstman J, Hivert MF, Kahn LG, Karagas MR, Kennedy EM, Knight AK, Mohazzab-Hosseinian S, Morin A, Niu Z, O’Shea TM, Palmore M, Ruden D, Schmidt RJ, Smith AK, Song A, Spindel ER, Trasande L, Volk H, Weisenberger DJ, Breton CV. Analysis of Pregnancy Complications and Epigenetic Gestational Age of Newborns. JAMA Netw Open 2023; 6:e230672. [PMID: 36826815 PMCID: PMC9958528 DOI: 10.1001/jamanetworkopen.2023.0672] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/30/2022] [Indexed: 02/25/2023] Open
Abstract
Importance Preeclampsia, gestational hypertension, and gestational diabetes, the most common pregnancy complications, are associated with substantial morbidity and mortality in mothers and children. Little is known about the biological processes that link the occurrence of these pregnancy complications with adverse child outcomes; altered biological aging of the growing fetus up to birth is one molecular pathway of increasing interest. Objective To evaluate whether exposure to each of these 3 pregnancy complications (gestational diabetes, gestational hypertension, and preeclampsia) is associated with accelerated or decelerated gestational biological age in children at birth. Design, Setting, and Participants Children included in these analyses were born between 1998 and 2018 and spanned multiple geographic areas of the US. Pregnancy complication information was obtained from maternal self-report and/or medical record data. DNA methylation measures were obtained from blood biospecimens collected from offspring at birth. The study used data from the national Environmental Influences on Child Health Outcomes (ECHO) multisite cohort study collected and recorded as of the August 31, 2021, data lock date. Data analysis was performed from September 2021 to December 2022. Exposures Three pregnancy conditions were examined: gestational hypertension, preeclampsia, and gestational diabetes. Main Outcomes and Measures Accelerated or decelerated biological gestational age at birth, estimated using existing epigenetic gestational age clock algorithms. Results A total of 1801 child participants (880 male [48.9%]; median [range] chronological gestational age at birth, 39 [30-43] weeks) from 12 ECHO cohorts met the analytic inclusion criteria. Reported races included Asian (49 participants [2.7%]), Black (390 participants [21.7%]), White (1026 participants [57.0%]), and other races (92 participants [5.1%]) (ie, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, multiple races, and other race not specified). In total, 524 participants (29.0%) reported Hispanic ethnicity. Maternal ages ranged from 16 to 45 years of age with a median of 29 in the analytic sample. A range of maternal education levels, from less than high school (260 participants [14.4%]) to Bachelor's degree and above (629 participants [34.9%]), were reported. In adjusted regression models, prenatal exposure to maternal gestational diabetes (β, -0.423; 95% CI, -0.709 to -0.138) and preeclampsia (β, -0.513; 95% CI, -0.857 to -0.170), but not gestational hypertension (β, 0.003; 95% CI, -0.338 to 0.344), were associated with decelerated epigenetic aging among exposed neonates vs those who were unexposed. Modification of these associations, by sex, was observed with exposure to preeclampsia (β, -0.700; 95% CI, -1.189 to -0.210) and gestational diabetes (β, -0.636; 95% CI, -1.070 to -0.200), with associations observed among female but not male participants. Conclusions and Relevance This US cohort study of neonate biological changes related to exposure to maternal pregnancy conditions found evidence that preeclampsia and gestational diabetes delay biological maturity, especially in female offspring.
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Affiliation(s)
- Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth Vang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, New Jersey
| | - Catherine M. Bulka
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- Department of Pediatrics, University of California, San Francisco
| | - Andres Cardenas
- Department of Epidemiology and Population Health, Stanford University, Stanford, California
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Xingyu Gao
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jaclyn M. Goodrich
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts
| | - Linda G. Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, New York
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Elizabeth M. Kennedy
- Gangarosa Department of Environmental Health, Emory Rollins School of Public Health, Atlanta, Georgia
| | - Anna K. Knight
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Sahra Mohazzab-Hosseinian
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Andréanne Morin
- Department of Human Genetics, University of Chicago, Chicago, Illinois
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill
| | - Meredith Palmore
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Douglas Ruden
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
| | - Rebecca J. Schmidt
- Division of Environmental and Occupational Health and Epidemiology, Department of Public Health Sciences and the MIND Institute, School of Medicine, University of California, Davis
| | - Alicia K. Smith
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Ashley Song
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eliot R. Spindel
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, New York
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Heather Volk
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel J. Weisenberger
- Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
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16
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Adelman SM, Charifson M, Brubaker SG, Roman AS, Kahn LG, Mehta-Lee S. The longitudinal impact of the COVID-19 pandemic on births in a single NYC health-care system. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.1236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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17
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Limaye M, Cowell W, Brubaker SG, Kahn LG, Trasande L, Mehta-Lee S. The relationship of suPAR levels and hypertensive disorders of pregnancy. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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18
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Rajeev PT, Kahn LG, Trasande L, Chen Y, Brubaker SG, Mehta-Lee SS. Can blood pressure trajectories indicate who is at risk for developing hypertensive disorders of pregnancy? Am J Obstet Gynecol MFM 2022; 4:100741. [PMID: 36075526 PMCID: PMC9986371 DOI: 10.1016/j.ajogmf.2022.100741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/22/2022] [Accepted: 08/31/2022] [Indexed: 10/31/2022]
Affiliation(s)
- Pournami T Rajeev
- Department of Obstetrics and Gynecology, New York University (NYU) Grossman School of Medicine, New York NY
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, NYU Grossman School of Medicine, New York NY.
| | - Leonardo Trasande
- Departments of Pediatrics, Population Health, and Environmental Medicine, NYU Grossman School of Medicine, New York NY
| | - Yu Chen
- Department of Population Health, NYU Grossman School of Medicine, New York NY
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York NY
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York NY
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19
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Hawks RM, Kahn LG, Fang W, Keefe D, Mehta-Lee SS, Brubaker S, Trasande L. Prenatal phthalate exposure and placental telomere length. Am J Obstet Gynecol MFM 2022; 4:100694. [PMID: 35853584 PMCID: PMC9841060 DOI: 10.1016/j.ajogmf.2022.100694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 01/18/2023]
Affiliation(s)
- Rebecca Mahn Hawks
- Department of Obstetrics and Gynecology, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx 10461, New York, NY.
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, NYU Langone Health, New York, NY
| | - Wang Fang
- Department of Obstetrics and Gynecology, NYU Langone Health, New York, NY
| | - David Keefe
- Department of Obstetrics and Gynecology, NYU Langone Health, New York, NY
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, NYU Langone Health, New York, NY
| | - Sara Brubaker
- Department of Obstetrics and Gynecology, NYU Langone Health, New York, NY
| | - Leonardo Trasande
- Departments of Pediatrics and Environmental Medicine, NYU Langone Health, New York, NY
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20
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Gaylord A, Kannan K, Lakuleswaran M, Zhu H, Ghassabian A, Jacobson MH, Long S, Liu H, Afanasyeva Y, Kahn LG, Gu B, Liu M, Mehta-Lee SS, Brubaker SG, Trasande L. Variability and correlations of synthetic chemicals in urine from a New York City-based cohort of pregnant women. Environ Pollut 2022; 309:119774. [PMID: 35841991 PMCID: PMC9600950 DOI: 10.1016/j.envpol.2022.119774] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/05/2022] [Accepted: 07/10/2022] [Indexed: 05/19/2023]
Abstract
Fetal exposure to environmental chemicals has been associated with adverse health outcomes in children and later into adulthood. While several studies have examined correlations and variability of non-persistent chemical exposures throughout pregnancy, many do not capture more recent exposures, particularly in New York City. Our goal was to characterize exposure to phthalates, bisphenols, polycyclic aromatic hydrocarbons, and organophosphate pesticides among pregnant women residing in New York City who enrolled in the New York University Children's Health and Environment Study (NYU CHES) between 2016 and 2018. We measured urinary chemical metabolite concentrations in 671 women at early, mid, and late pregnancy (median 10.8, 20.8, and 29.3 weeks, respectively). We calculated Spearman correlation coefficients among chemical concentrations at each measurement time point. We compared changes in population-level urinary metabolites at each stage using paired Wilcoxon signed-rank tests and calculated intraclass correlation coefficients (ICCs) to quantify intra-individual variability of metabolites across pregnancy. Geometric means and ICCs were compared to nine other pregnancy cohorts that recruited women in 2011 or later as well as nationally reported levels from women of child-bearing age. Compared with existing cohorts, women in NYU CHES had higher geometric means of organophosphate pesticides (Σdiethylphosphates = 28.7 nmol/g cr, Σdimethylphosphates = 57.3 nmol/g cr, Σdialkyl phosphates = 95.9 nmol/g cr), bisphenol S (0.56 μg/g cr), and 2-naphthalene (8.98 μg/g cr). Five PAH metabolites and two phthalate metabolites increased between early to mid and early to late pregnancy at the population level. Spearman correlation coefficients for chemical metabolites were generally below 0.50. Intra-individual exposures varied over time, as indicated by low ICCs (0.22-0.88, median = 0.38). However, these ICCs were often higher than those observed in other pregnancy cohorts. These results provide a general overview of the chemical metabolites measured in NYU CHES in comparison to other contemporary pregnancy cohorts and highlight directions for future studies.
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Affiliation(s)
- Abigail Gaylord
- Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Mathusa Lakuleswaran
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Hongkai Zhu
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Akhgar Ghassabian
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Melanie H Jacobson
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Sara Long
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Hongxiu Liu
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Hubei, PR China
| | - Yelena Afanasyeva
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Linda G Kahn
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Bo Gu
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - Leonardo Trasande
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; New York University Wagner School of Public Service, New York, NY, USA; New York University College of Global Public Health, New York, NY, USA
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21
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Lucchini M, O’Brien LM, Kahn LG, Brennan PA, Glazer Baron K, Knapp EA, Lugo-Candelas C, Shuffrey L, Dunietz GL, Zhu Y, Wright RJ, Wright RO, Duarte C, Karagas MR, Ngai P, O’Connor TG, Herbstman JB, Dioni S, Singh AM, Alcantara C, Fifer WP, Elliott AJ. Racial/ethnic disparities in subjective sleep duration, sleep quality, and sleep disturbances during pregnancy: an ECHO study. Sleep 2022; 45:zsac075. [PMID: 35724979 PMCID: PMC9453625 DOI: 10.1093/sleep/zsac075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/23/2022] [Indexed: 01/10/2023] Open
Abstract
In the United States, racial/ethnic minoritized groups experience worse sleep than non-Hispanic Whites (nHW), but less is known about pregnant people. This is a key consideration since poor sleep during pregnancy is common and associated with increased risk of adverse perinatal outcomes. This study reports the prevalence of subjective sleep measures in a multi-racial/ethnic pregnant population from the Environmental influences on Child Health Outcomes (ECHO) program. Participants' self-reported race and ethnicity were grouped into: nHW, non-Hispanic Black/African American (nHB/AA), Hispanic, non-Hispanic Asian (nHA). Analyses examined trimester-specific (first (T1), second (T2), third (T3)) nocturnal sleep duration, quality, and disturbances (Pittsburgh Sleep Quality Index and ECHO maternal sleep health questionnaire). Linear or multinomial regressions estimated the associations between race/ethnicity and each sleep domain by trimester, controlling for body mass index and age, with nHW as reference group. We repeated analyses within maternal education strata. nHB/AA participants reported shorter sleep duration (T2: β = -0.55 [-0.80,-0.31]; T3: β = -0.65 [-0.99,-0.31]) and more sleep disturbances (T2: β = 1.92 [1.09,2.75]; T3: β = 1.41 [0.09,2.74]). Hispanic participants reported longer sleep duration (T1: β = 0.22 [0.00004,0.44]; T2: β = 0.61 [0.47,0.76]; T3: β = 0.46 [0.22,0.70]), better sleep quality (Reference group: Very good. Fairly good T1: OR = 0.48 [0.32,0.73], T2: OR = 0.36 [0.26,0.48], T3: OR = 0.31 [0.18,0.52]. Fairly bad T1: OR = 0.27 [0.16,0.44], T2: OR = 0.46 [0.31, 0.67], T3: OR = 0.31 [0.17,0.55]), and fewer sleep disturbances (T2: β = -0.5 [-1.0,-0.12]; T3: β = -1.21 [-2.07,-0.35]). Differences persisted within the high-SES subsample. Given the stark racial/ethnic disparities in perinatal outcomes and their associations with sleep health, further research is warranted to investigate the determinants of these disparities.
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Affiliation(s)
- Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Louise M O’Brien
- Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Kelly Glazer Baron
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Claudia Lugo-Candelas
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Lauren Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cristiane Duarte
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Pakkay Ngai
- Division of Pediatric Pulmonology, Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Thomas G O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, New York NY, USA
| | - Sean Dioni
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - William P Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
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22
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Liu H, Wang Y, Kannan K, Liu M, Zhu H, Chen Y, Kahn LG, Jacobson MH, Gu B, Mehta-Lee S, Brubaker SG, Ghassabian A, Trasande L. Determinants of phthalate exposures in pregnant women in New York City. Environ Res 2022; 212:113203. [PMID: 35358547 PMCID: PMC9232940 DOI: 10.1016/j.envres.2022.113203] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 05/17/2023]
Abstract
Previous studies have provided data on determinants of phthalates in pregnant women, but results were disparate across regions. We aimed to identify the food groups and demographic factors that predict phthalate exposure in an urban contemporary pregnancy cohort in the US. The study included 450 pregnant women from the New York University Children's Health and Environment Study in New York City. Urinary concentrations of 22 phthalate metabolites, including metabolites of di-2-ethylhexylphthalate (DEHP), were determined at three time points across pregnancy by liquid chromatography coupled with tandem mass spectrometry. The Diet History Questionnaire II was completed by pregnant women at mid-pregnancy to assess dietary information. Linear mixed models were fitted to examine determinants of urinary phthalate metabolite concentrations. Using partial-linear single-index (PLSI) models, we assessed the major contributors, among ten food groups, to phthalate exposure. Metabolites of DEHP and its ortho-phthalate replacement, diisononyl phthalate (DiNP), were found in >90% of the samples. The sum of creatinine-adjusted DiNP metabolite concentrations was higher in older and single women and in samples collected in summer. Hispanic and non-Hispanic Black women had lower urinary concentrations of summed metabolites of di-n-octyl phthalate (DnOP), but higher concentrations of low molecular weight phthalates compared with non-Hispanic White women. Each doubling of grain products consumed was associated with a 20.9% increase in ∑DiNP concentrations (95%CI: 4.5, 39.9). PLSI models revealed that intake of dried beans and peas was the main dietary factor contributing to urinary ∑DEHP, ∑DiNP, and ∑DnOP levels, with contribution proportions of 76.3%, 35.8%, and 27.4%, respectively. Urinary metabolite levels of phthalates in pregnant women in NYC varied by age, marital status, seasonality, race/ethnicity, and diet. These results lend insight into the major determinants of phthalates levels, and may be used to identify exposure sources and guide interventions to reduce exposures in susceptible populations.
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Affiliation(s)
- Hongxiu Liu
- Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Hubei, PR China; Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Yuyan Wang
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Hongkai Zhu
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Yu Chen
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Melanie H Jacobson
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Bo Gu
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Shilpi Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA.
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA; NYU Wagner School of Public Service, New York, NY, USA; NYU College of Global Public Health, New York, NY, USA
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23
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Siegel EL, Ghassabian A, Hipwell AE, Factor-Litvak P, Zhu Y, Steinthal HG, Focella C, Battaglia L, Porucznik CA, Collingwood SC, Klein-Fedyshin M, Kahn LG. Indoor and outdoor air pollution and couple fecundability: a systematic review. Hum Reprod Update 2022; 29:45-70. [PMID: 35894871 PMCID: PMC9825271 DOI: 10.1093/humupd/dmac029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 05/27/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Air pollution is both a sensory blight and a threat to human health. Inhaled environmental pollutants can be naturally occurring or human-made, and include traffic-related air pollution (TRAP), ozone, particulate matter (PM) and volatile organic compounds, among other substances, including those from secondhand smoking. Studies of air pollution on reproductive and endocrine systems have reported associations of TRAP, secondhand smoke (SHS), organic solvents and biomass fueled-cooking with adverse birth outcomes. While some evidence suggests that air pollution contributes to infertility, the extant literature is mixed, and varying effects of pollutants have been reported. OBJECTIVE AND RATIONALE Although some reviews have studied the association between common outdoor air pollutants and time to pregnancy (TTP), there are no comprehensive reviews that also include exposure to indoor inhaled pollutants, such as airborne occupational toxicants and SHS. The current systematic review summarizes the strength of evidence for associations of outdoor air pollution, SHS and indoor inhaled air pollution with couple fecundability and identifies gaps and limitations in the literature to inform policy decisions and future research. SEARCH METHODS We performed an electronic search of six databases for original research articles in English published since 1990 on TTP or fecundability and a number of chemicals in the context of air pollution, inhalation and aerosolization. Standardized forms for screening, data extraction and study quality were developed using DistillerSR software and completed in duplicate. We used the Newcastle-Ottawa Scale to assess risk of bias and devised additional quality metrics based on specific methodological features of both air pollution and fecundability studies. OUTCOMES The search returned 5200 articles, 4994 of which were excluded at the level of title and abstract screening. After full-text screening, 35 papers remained for data extraction and synthesis. An additional 3 papers were identified independently that fit criteria, and 5 papers involving multiple routes of exposure were removed, yielding 33 articles from 28 studies for analysis. There were 8 papers that examined outdoor air quality, while 6 papers examined SHS exposure and 19 papers examined indoor air quality. The results indicated an association between outdoor air pollution and reduced fecundability, including TRAP and specifically nitrogen oxides and PM with a diameter of ≤2.5 µm, as well as exposure to SHS and formaldehyde. However, exposure windows differed greatly between studies as did the method of exposure assessment. There was little evidence that exposure to volatile solvents is associated with reduced fecundability. WIDER IMPLICATIONS The evidence suggests that exposure to outdoor air pollutants, SHS and some occupational inhaled pollutants may reduce fecundability. Future studies of SHS should use indoor air monitors and biomarkers to improve exposure assessment. Air monitors that capture real-time exposure can provide valuable insight about the role of indoor air pollution and are helpful in assessing the short-term acute effects of pollutants on TTP.
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Affiliation(s)
- Eva L Siegel
- Columbia University, Mailman School of Public Health, New York, NY, USA
| | | | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pam Factor-Litvak
- Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Carolina Focella
- New York University Grossman School of Medicine, New York, NY, USA
| | - Lindsey Battaglia
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | | | - Linda G Kahn
- Correspondence address. E-mail: https://orcid.org/0000-0002-6512-6160
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24
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Obsekov V, Kahn LG, Trasande L. Leveraging Systematic Reviews to Explore Disease Burden and Costs of Per- and Polyfluoroalkyl Substance Exposures in the United States. Expo Health 2022; 15:373-394. [PMID: 37213870 PMCID: PMC10198842 DOI: 10.1007/s12403-022-00496-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/03/2022] [Accepted: 06/23/2022] [Indexed: 05/23/2023]
Abstract
Accelerating evidence confirms the contribution of per- and polyfluoroalkyl substances (PFAS) to disease burden and disability across the lifespan. Given that policy makers raise the high cost of remediation and of substituting PFAS with safer alternatives in consumer products as barriers to confronting adverse health outcomes associated with PFAS exposure, it is important to document the costs of inaction even in the presence of uncertainty. We therefore quantified disease burdens and related economic costs due to legacy PFAS exposures in the US in 2018. We leveraged systematic reviews and used meta-analytic inputs whenever possible, identified previously published exposure-response relationships, and calculated PFOA- and PFOS-attributable increases in 13 conditions. These increments were then applied to census data to determine total annual PFOA- and PFOS-attributable cases of disease, from which we calculated economic costs due to medical care and lost productivity using previously published cost-of-illness data. We identified PFAS-attributable disease costs in the US of $5.52 billion across five primary disease endpoints shown to be associated with PFAS exposure in meta-analyses. This estimate represented the lower bound, with sensitivity analyses revealing as much as $62.6 billion in overall costs. While further work is needed to assess probability of causation and establish with greater certainty effects of the broader category of PFAS, the results confirm further that public health and policy interventions are still necessary to reduce exposure to PFOA and PFOS and their endocrine-disrupting effects. This study demonstrates the large potential economic implications of regulatory inaction. Supplementary Information The online version contains supplementary material available at 10.1007/s12403-022-00496-y.
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Affiliation(s)
- Vladislav Obsekov
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY USA
| | - Linda G. Kahn
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY USA
| | - Leonardo Trasande
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY USA
- Department of Environmental Health, NYU Grossman School of Medicine, New York, NY USA
- NYU Wagner School of Public Service, New York, NY USA
- NYU School of Global Public Health, New York, NY USA
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25
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Freije SL, Enquobahrie DA, Day DB, Loftus C, Szpiro AA, Karr CJ, Trasande L, Kahn LG, Barrett E, Kannan K, Bush NR, LeWinn KZ, Swan S, Alex Mason W, Robinson M, Sathyanarayana S. Prenatal exposure to polycyclic aromatic hydrocarbons and gestational age at birth. Environ Int 2022; 164:107246. [PMID: 35453081 PMCID: PMC9269995 DOI: 10.1016/j.envint.2022.107246] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous chemicals with mechanisms of toxicity that include endocrine disruption. We examined associations of prenatal urinary PAH with spontaneous preterm birth (PTB) and gestational age (GA) at birth. We also assessed whether infant sex modifies the association of PAH exposure with spontaneous PTB and GA at birth. METHODS Participants included 1,677 non-smoking women from three cohorts (CANDLE, TIDES, and GAPPS) in the ECHO PATHWAYS Consortium. Twelve monohydroxylated-PAHs were measured in second trimester maternal urine. Seven metabolites with >60% overall detection were included in analyses: 1-hydroxynaphthalene [1-OH-NAP], 2-hydroxynaphthalene [2-OH-NAP], 2-hydroxyphenanthrene [2-OH-PHEN], 3-hydroxyphenanthrene [3-OH-PHEN], 1/9-hydroxyphenanthrene [1/9-OH-PHEN], 2/3/9-hydroxyfluorene [2/3/9-OH-FLUO], and 1-hydroxypyrene [1-OH-PYR]. Logistic and linear regression models were fit for spontaneous PTB and GA among births ≥34 weeks, respectively, with log10-transformed OH-PAH concentrations as the exposure, adjusted for specific gravity and suspected confounders. Effect modification by infant sex was assessed using interaction terms and marginal estimates. RESULTS Percent detection was highest for 2-OH-NAP (99.8%) and lowest for 1-OH-PYR (65.2%). Prevalence of spontaneous PTB was 5.5% (N = 92). Ten-fold higher 2-OH-NAP exposure was associated with 1.60-day (95% CI: -2.92, -0.28) earlier GA at birth. Remaining associations in the pooled population were null. Among females, we observed significant inverse associations between 1-OH-PYR and PTB (OR: 2.65 [95% CI: 1.39, 5.05]); and 2-OH-NAP with GA: -2.46 days [95% CI: -4.15, -0.77]). Among males, we observed an inverse association between 2/3/9-OH-FLUO and PTB (OR = 0.40 [95% CI: 0.17,0.98]). ORs for PTB were higher among females than males for 2-OH-PHEN (p = 0.02) and 1-OH-PYR (p = 0.02). DISCUSSION We observed inverse associations of 2-OH-NAP exposure with GA and null associations of remaining OH-PAHs with GA and PTB. Females may be more susceptible to spontaneous PTB or shorter GA following prenatal exposure to some OH-PAHs. This study is the first to assess sex-specific OH-PAH toxicity in relation to spontaneous PTB and GA.
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Affiliation(s)
- Sophia L Freije
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Daniel A Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, USA
| | - Christine Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Catherine J Karr
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Leonardo Trasande
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine and New York University School of Global Public Health, New York University, New York, NY, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, New Brunswick, NJ, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, USA
| | - Shanna Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - W Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
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26
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Jacobson MH, Wang Y, Long SE, Liu M, Ghassabian A, Kahn LG, Afanasyeva Y, Brubaker SG, Mehta-Lee SS, Trasande L. The Effect of Maternal US Nativity on Racial/Ethnic Differences in Fetal Growth. Am J Epidemiol 2022; 191:1568-1583. [PMID: 35434731 PMCID: PMC9618163 DOI: 10.1093/aje/kwac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/01/2022] [Accepted: 04/06/2022] [Indexed: 01/29/2023] Open
Abstract
While racial/ethnic differences in fetal growth have been documented, few studies have examined whether they vary by exogenous factors, which could elucidate underlying causes. The purpose of this study was to characterize longitudinal fetal growth patterns by maternal sociodemographic, behavioral, and clinical factors and examine whether associations with maternal race/ethnicity varied by these other predictors. Between 2016 and 2019, pregnant women receiving prenatal care at NYU Langone Health (New York, New York) were invited to participate in a birth cohort study. Women completed questionnaires, and clinical data were abstracted from ultrasound examinations. Maternal characteristics were assessed in relation to fetal biometric measures throughout pregnancy using linear mixed models. Maternal race/ethnicity was consistently associated with fetal biometry: Black, Hispanic, and Asian women had fetuses with smaller head circumference, abdominal circumference, and biparietal diameter than White women. The associations between race/ethnicity and fetal growth varied by nativity for Asian women, such that the disparity between Asian and White women was much greater for US-born women than for foreign-born women. However, associations for Black and Hispanic women did not vary by nativity. While race/ethnicity-specific fetal growth standards have been proposed, additional work is needed to elucidate what could be driving these differences, including factors that occur in parallel and differentially affect fetal growth.
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Affiliation(s)
- Melanie H Jacobson
- Correspondence to Dr. Melanie H. Jacobson, Department of Pediatrics, Grossman School of Medicine, New York University, 227 East 30th Street, 8th Floor, New York, NY 10016 (e-mail: )
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27
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Ghassabian A, Jacobson MH, Kahn LG, Brubaker SG, Mehta-Lee SS, Trasande L. Maternal Perceived Stress During the COVID-19 Pandemic: Pre-Existing Risk Factors and Concurrent Correlates in New York City Women. Int J Public Health 2022; 67:1604497. [PMID: 35479764 PMCID: PMC9035490 DOI: 10.3389/ijph.2022.1604497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: We examined whether pre-pandemic mental health and sociodemographic characteristics increased the susceptibility of pregnant women and mothers of young children to stress in the early months of the COVID-19 pandemic. Methods: Between April and August 2020, we surveyed 1560 women participating in a sociodemographically diverse birth cohort in New York City. Women reported their perceived stress, resiliency, and financial, familial/societal, and health-related concerns. We extracted pre-pandemic information from questionnaires and electronic health records. Results: Pre-pandemic history of depression, current financial difficulties, and COVID-19 infection were the main risk factors associated with high perceived stress. Being Hispanic and having higher resiliency scores and preexisting social support were protective against high perceived stress. Major contributors to current perceived stress were financial and familial/societal factors related to the COVID-19 pandemic. Among pregnant women, changes to prenatal care were common, as were changes to experiences following birth among postpartum women and difficulties in arranging childcare among mothers of young children. Conclusion: Our findings suggest that major risk factors of higher stress during the pandemic were similar to those of other major traumatic events.
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Affiliation(s)
- Akhgar Ghassabian
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
- *Correspondence: Akhgar Ghassabian,
| | - Melanie H. Jacobson
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
| | - Linda G. Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Sara G. Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, United States
| | - Shilpi S. Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, United States
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
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28
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El-Shahawy O, Labib K, Stevens E, Kahn LG, Anwar W, Oncken C, Loney T, Sherman SE, Mead-Morse EL. Exclusive and Dual Cigarette and Hookah Smoking Is Associated with Adverse Perinatal Outcomes among Pregnant Women in Cairo, Egypt. Int J Environ Res Public Health 2021; 18:ijerph182412974. [PMID: 34948585 PMCID: PMC8701206 DOI: 10.3390/ijerph182412974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
This study assessed the prevalence of prenatal smoking, factors associated with prenatal smoking, and its association with birth outcomes in a sample of pregnant women in Egypt. Pregnant women were recruited during their last trimester from antenatal clinics in Cairo from June 2015 to May 2016. Participants completed an interviewer-administered survey that assessed tobacco use and attitudes, and exhaled carbon monoxide (CO) was measured. Gestational age at delivery and offspring birth weight were collected via a postnatal phone interview. Two hundred pregnant women ages 16–37 years participated. More than a quarter (29.0%) of women reported smoking (cigarettes, hookah, or both) during their current pregnancy, and hookah was more popular than cigarettes. Most women who smoked prior to their current pregnancy either maintained their current smoking habits (46.6%) or switched from dual to hookah-only smoking (46.6%). Current smokers during pregnancy had a higher mean (±SD) exhaled CO level (2.97 ± 1.45 vs. 0.25 ± 0.60 ppm, p < 0.001) and had babies with a lower mean birth weight (2583 ± 300 vs. 2991 ± 478 g, p < 0.001) than non-smokers. Smokers during pregnancy had greater odds of premature birth and/or low birth weight babies compared to non-smokers. Dual cigarette-hookah smokers had the highest risk. Additional focused programs are required to prevent women of childbearing age from initiating tobacco use and empower women to stop tobacco use during the preconception and gestational periods.
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Affiliation(s)
- Omar El-Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY 10016, USA; (E.S.); (S.E.S.)
- School of Global Public Health, New York University, New York, NY 10013, USA
- Correspondence: or ; Tel.: +1-646-501-3587
| | - Kareem Labib
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo 11517, Egypt;
| | - Elizabeth Stevens
- Department of Population Health, New York University School of Medicine, New York, NY 10016, USA; (E.S.); (S.E.S.)
| | - Linda G. Kahn
- Departments of Pediatrics and Population Health, New York University School of Medicine, New York, NY 10016, USA;
| | - Wagida Anwar
- Department of Community and Environmental Medicine, Faculty of Medicine, Ain Shams University, Cairo 11517, Egypt;
| | - Cheryl Oncken
- Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA; (C.O.); (E.L.M.-M.)
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Heath Sciences, Dubai P.O. Box 505055, United Arab Emirates;
| | - Scott E. Sherman
- Department of Population Health, New York University School of Medicine, New York, NY 10016, USA; (E.S.); (S.E.S.)
| | - Erin L. Mead-Morse
- Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA; (C.O.); (E.L.M.-M.)
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29
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Kahn LG, Ghassabian A, Jacobson MH, Yu K, Trasande L. COVID-19 Symptoms and Diagnoses among a Sociodemographically Diverse Cohort of Children from New York City: Lessons from the First Wave, Spring 2020. Int J Environ Res Public Health 2021; 18:11886. [PMID: 34831640 PMCID: PMC8623025 DOI: 10.3390/ijerph182211886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/27/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
Early in the pandemic, in the North American epicenter, we investigated associations between sociodemographic factors and rates of pediatric COVID-19 diagnoses in a non-clinical setting and whether symptoms varied by child age. From 20 April-31 August 2020, COVID-19-related data were collected on 2694 children aged ≤ 18 years living in households participating in the New York University Children's Health and Environment Study. We examined differences in rates of subjective and objective diagnoses according to sociodemographic characteristics and differences in reported symptoms by child age. Children of women who were non-Hispanic White, had private health insurance, higher income, or more education were more likely to be diagnosed via WHO criteria or healthcare provider. Children of women who were Hispanic or Asian, reported low income, had less education, or were/lived with an essential worker were more likely to test positive. Older children were less likely to experience cough or runny nose and more likely to experience muscle/body aches, sore throat, headache, and loss of smell or taste than younger children. In conclusion, relying on subjective disease ascertainment methods, especially in the early stage of an outbreak when testing is not universally available, may misrepresent the true prevalence of disease among sociodemographic subgroups. Variations in symptoms by child age should be considered when determining diagnostic criteria.
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Affiliation(s)
- Linda G. Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Akhgar Ghassabian
- Departments of Pediatrics, Population Health, and Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (A.G.); (L.T.)
| | - Melanie H. Jacobson
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, USA; (M.H.J.); (K.Y.)
| | - Keunhyung Yu
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, USA; (M.H.J.); (K.Y.)
| | - Leonardo Trasande
- Departments of Pediatrics, Population Health, and Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (A.G.); (L.T.)
- Wagner School of Public Service, New York University, New York, NY 10012, USA
- College of Global Public Health, New York University, New York, NY 10003, USA
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Lewkowitz AK, Schlichting L, Werner EF, Vivier PM, Kahn LG, Clark MA. Risk factors for new-onset postpartum depression or anxiety symptoms during the COVID-19 pandemic. Am J Obstet Gynecol MFM 2021; 4:100502. [PMID: 34637960 PMCID: PMC8501517 DOI: 10.1016/j.ajogmf.2021.100502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/26/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Adam K Lewkowitz
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, 101 Dudley St., Providence, RI 02905.
| | - Lauren Schlichting
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, RI
| | - Erika F Werner
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, RI; Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI
| | - Patrick M Vivier
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, RI; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY
| | - Melissa A Clark
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, RI; Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI
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Kahn LG, Trasande L, Liu M, Mehta-Lee SS, Brubaker SG, Jacobson MH. Factors Associated With Changes in Pregnancy Intention Among Women Who Were Mothers of Young Children in New York City Following the COVID-19 Outbreak. JAMA Netw Open 2021; 4:e2124273. [PMID: 34524437 PMCID: PMC8444024 DOI: 10.1001/jamanetworkopen.2021.24273] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IMPORTANCE Early evidence shows a decrease in the number of US births during the COVID-19 pandemic, yet few studies have examined individual-level factors associated with pregnancy intention changes, especially among diverse study populations or in areas highly affected by COVID-19 in the US. OBJECTIVE To study changes in pregnancy intention following the outbreak of the COVID-19 pandemic and identify factors possibly associated with these changes. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, population-based study was conducted among women who were currently pregnant or had delivered a live infant and responded to a survey emailed to 2603 women (n = 1560). Women who were mothers of young children enrolled in the prospective New York University Children's Health and Environment Study birth cohort were included; women who were not currently pregnant or recently postpartum were excluded. EXPOSURES Demographic, COVID-19-related, stress-related, and financial/occupational factors were assessed via a survey administered from April 20 to August 31, 2020. MAIN OUTCOMES AND MEASURES Pregnancy intentions before the COVID-19 pandemic and change in pregnancy intentions following the outbreak. RESULTS Of the 2603 women who were sent the survey, 1560 (59.9%) who were currently pregnant or had delivered a live infant responded, and 1179 women (75.6%) answered the pregnancy intention questions. Mean (SD) age was 32.2 (5.6) years. Following the outbreak, 30 of 61 (49.2%) women who had been actively trying to become pregnant had ceased trying, 71 of 191 (37.2%) women who had been planning to become pregnant were no longer planning, and 42 of 927 (4.5%) women who were neither planning nor trying were newly considering pregnancy. Among those who ceased trying, fewer than half (13 [43.3%]) thought they would resume after the pandemic. Of those pre-COVID-19 planners/triers who stopped considering or attempting pregnancy, a greater proportion had lower educational levels, although the difference was not statistically significant on multivariable analysis (odds ratio [OR], 2.14; 95% CI, 0.92-4.96). The same was true for those with higher stress levels (OR, 1.09; 95% CI, 0.99-1.20) and those with greater financial insecurity (OR, 1.37; 95% CI, 0.97-1.92. Those who stopped considering or attempting pregnancy were more likely to respond to the questionnaire during the peak of the outbreak (OR, 2.04; 95% CI, 1.01-4.11). Of those pre-COVID-19 nonplanners/nontriers who reported newly thinking about becoming pregnant, a smaller proportion responded during the peak, although the finding was not statistically significant on multivariable analysis (OR, 0.52; 95% CI, 0.26-1.03). Likewise, fewer respondents who were financially insecure reported newly considering pregnancy, although the finding was not statistically significant (OR, 0.69; 95% CI, 0.46-1.03). They were significantly less likely to be of Hispanic ethnicity (OR, 0.27; 955 CI, 0.10-0.71) and more likely to have fewer children in the home (OR, 0.62; 95% CI, 0.40-0.98) or self-report a COVID-19 diagnosis (OR, 2.70; 95% CI, 1.31-5.55). CONCLUSIONS AND RELEVANCE In this cross-sectional study of 1179 women who were mothers of young children in New York City, increased stress and financial insecurity owing to the COVID-19 pandemic paralleled a reduction in pregnancy intention in the early months of the pandemic, potentially exacerbating long-term decreases in the fertility rate.
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Affiliation(s)
- Linda G. Kahn
- Division of Environmental Pediatrics, Department of Pediatrics, NYU Langone Medical Center, New York, New York
- Department of Population Health, NYU Langone Medical Center, New York, New York
| | - Leonardo Trasande
- Division of Environmental Pediatrics, Department of Pediatrics, NYU Langone Medical Center, New York, New York
- Department of Population Health, NYU Langone Medical Center, New York, New York
- Department of Environmental Medicine, NYU Langone Medical Center, New York, New York
- NYU Wagner School of Public Service, New York, New York
- NYU College of Global Public Health, New York, New York
| | - Mengling Liu
- Department of Population Health, NYU Langone Medical Center, New York, New York
- Department of Environmental Medicine, NYU Langone Medical Center, New York, New York
| | - Shilpi S. Mehta-Lee
- Department of Obstetrics and Gynecology, NYU Langone Medical Center, New York, New York
| | - Sara G. Brubaker
- Department of Obstetrics and Gynecology, NYU Langone Medical Center, New York, New York
| | - Melanie H. Jacobson
- Division of Environmental Pediatrics, Department of Pediatrics, NYU Langone Medical Center, New York, New York
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Liu H, Campana AM, Wang Y, Kannan K, Liu M, Zhu H, Mehta-Lee S, Brubaker SG, Kahn LG, Trasande L, Ghassabian A. Organophosphate pesticide exposure: Demographic and dietary predictors in an urban pregnancy cohort. Environ Pollut 2021; 283:116920. [PMID: 33839620 DOI: 10.1016/j.envpol.2021.116920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
Pregnant women are widely exposed to organophosphate (OP) pesticides, which are potentially neurotoxicant for the developing fetus. We aimed to identify principal demographic and dietary predictors of OP pesticide exposure among 450 pregnant women participating in the New York University Children's Health and Environment Study (enrolled 2016-19). Urinary concentrations of six dialkyl phosphate (DAP) metabolites (3 dimethyl (DM) metabolites and 3 diethyl (DE) metabolites) of OP pesticides were determined at three time points across pregnancy. At mid-gestation, the Diet History Questionnaire II was used to assess women's dietary intake over the past year. Demographic characteristics were obtained using questionnaires and/or electronic health records. We used linear mixed models to evaluate the associations of demographic and food groups with DAP metabolite levels, and partial-linear single-index (PLSI) models to analyze the contribution proportions of food groups to DAP metabolite concentrations and the dose-response relationships between them. We observed that pregnant women in NYC had lower levels of OP pesticide metabolites than pregnant populations in Europe, Asia, and other regions in the U.S. Having lower pre-pregnancy body mass index and being Asian, employed, and single were associated with higher DAP metabolite concentrations. Fruit and grain intakes were associated with higher ∑DM, ∑DE, and ∑DAP levels. ∑DE concentrations increased 9.0% (95% confidence interval (CI) = 1.2%, 17.4%) per two-fold increase in dairy consumption, whereas ∑DE concentrations decreased 1.8% (95%CI = -3.1%, -0.4%) per two-fold increase in seafood consumption. The PLSI model indicated that among the food mixture, fruit and grains were the main food groups contributed to higher levels of ∑DAP, while meat contributed to lower levels of ∑DAP. The contribution proportions of fruit, grains, and meat were 18.7%, 17.9%, and 39.3%, respectively. Our results suggest that fruit, grains, and meat are major dietary components associated with OP pesticide exposure in urban pregnant women.
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Affiliation(s)
- Hongxiu Liu
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
| | - Anna Maria Campana
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Yuyan Wang
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Hongkai Zhu
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Shilpi Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA; NYU Wagner School of Public Service, New York, NY, USA; NYU College of Global Public Health, New York, NY, USA
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
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Breton CV, Landon R, Kahn LG, Enlow MB, Peterson AK, Bastain T, Braun J, Comstock SS, Duarte CS, Hipwell A, Ji H, LaSalle JM, Miller RL, Musci R, Posner J, Schmidt R, Suglia SF, Tung I, Weisenberger D, Zhu Y, Fry R. Exploring the evidence for epigenetic regulation of environmental influences on child health across generations. Commun Biol 2021; 4:769. [PMID: 34158610 PMCID: PMC8219763 DOI: 10.1038/s42003-021-02316-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 06/03/2021] [Indexed: 02/08/2023] Open
Abstract
Environmental exposures, psychosocial stressors and nutrition are all potentially important influences that may impact health outcomes directly or via interactions with the genome or epigenome over generations. While there have been clear successes in large-scale human genetic studies in recent decades, there is still a substantial amount of missing heritability to be elucidated for complex childhood disorders. Mounting evidence, primarily in animals, suggests environmental exposures may generate or perpetuate altered health outcomes across one or more generations. One putative mechanism for these environmental health effects is via altered epigenetic regulation. This review highlights the current epidemiologic literature and supporting animal studies that describe intergenerational and transgenerational health effects of environmental exposures. Both maternal and paternal exposures and transmission patterns are considered, with attention paid to the attendant ethical, legal and social implications.
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Affiliation(s)
- Carrie V Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Remy Landon
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Linda G Kahn
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Alicia K Peterson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa Bastain
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Joseph Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Sarah S Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Cristiane S Duarte
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Alison Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hong Ji
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, California National Primate Research Center, University of California, Davis, Davis, CA, USA
| | - Janine M LaSalle
- Department of Medical Microbiology and Immunology, MIND Institute, Genome Center, University of California, Davis, Davis, CA, USA
| | | | - Rashelle Musci
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jonathan Posner
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Rebecca Schmidt
- Department of Public Health Sciences, UC Davis School of Medicine, Davis, CA, USA
| | | | - Irene Tung
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel Weisenberger
- Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California and Department of Epidemiology and Biostatistics, University of California, San Francisco, Oakland, CA, USA
| | - Rebecca Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC, USA
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Long SE, Kahn LG, Trasande L, Jacobson MH. Urinary phthalate metabolites and alternatives and serum sex steroid hormones among pre- and postmenopausal women from NHANES, 2013-16. Sci Total Environ 2021; 769:144560. [PMID: 33493905 PMCID: PMC7969426 DOI: 10.1016/j.scitotenv.2020.144560] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/07/2020] [Accepted: 12/13/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Exposure to phthalates is ubiquitous across the United States. While phthalates have anti-androgenic effects in men, there is little research on their potential impacts on sex hormone concentrations in women and that also take into account menopausal status. METHODS Cross-sectional data on urinary phthalate metabolites, serum sex hormones, and relevant covariates were obtained from the National Health and Nutrition Examination Survey 2013-14 and 2015-16. Women over the age of 20 who were not pregnant or breastfeeding and had not undergone oophorectomy were included (n = 698 premenopausal, n = 557 postmenopausal). Weighted multivariable linear and Tobit regression models stratified by menopausal status were fit with natural log-transformed phthalate concentrations and sex hormone outcomes adjusting for relevant covariates. RESULTS Phthalate metabolites were associated with differences in sex hormone concentrations among postmenopausal women only. Di-2-ethylhexyl phthalate (DEHP) was associated with lower serum estradiol and bioavailable testosterone concentrations. Specifically, a doubling of DEHP concentrations was associated with 5.9% (95% Confidence Interval (CI): 0.2%, 11.3%) lower estradiol and 6.2% (95% CI: 0.0%, 12.1%) lower bioavailable testosterone concentrations. In contrast, 1,2-cyclohexane dicarboxylic acid di-isononyl ester (DINCH) was associated with higher free testosterone, bioavailable testosterone, and free androgen index. Finally, di-2-ethylhexyl terephthalate (DEHTP) was associated with a higher testosterone-to-estradiol ratio. None of these results retained statistical significance when adjusted for multiple comparisons. CONCLUSIONS DEHP, DINCH, and DEHTP were associated with differences in serum sex hormone concentrations among postmenopausal women, highlighting the need for further research into the safety of these chemicals.
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Affiliation(s)
- Sara E Long
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY, USA
| | - Linda G Kahn
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY, USA
| | - Leonardo Trasande
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY, USA; Departments of Population Health and Environmental Medicine, NYU Langone Medical Center, New York, NY, USA; NYU Wagner School of Public Service, New York, NY, USA; NYU College of Global Public Health, New York, NY, USA
| | - Melanie H Jacobson
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY, USA.
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Deierlein AL, Ghassabian A, Kahn LG, Afanasyeva Y, Mehta-Lee SS, Brubaker SG, Trasande L. Dietary Quality and Sociodemographic and Health Behavior Characteristics Among Pregnant Women Participating in the New York University Children's Health and Environment Study. Front Nutr 2021; 8:639425. [PMID: 33898496 PMCID: PMC8062781 DOI: 10.3389/fnut.2021.639425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/11/2021] [Indexed: 12/12/2022] Open
Abstract
Maternal diet, prior to and during pregnancy, plays an important role in the immediate and long-term health of the mother and her offspring. Our objectives were to assess diet quality among a large, diverse, urban cohort of pregnant women, and examine associations with sociodemographic and health behavior characteristics. Data were from 1,325 pregnant women enrolled in New York University Children's Health and Environment Study (NYU CHES). Diet quality was assessed using the Healthy Eating Index (HEI)-2015. Mean total HEI-2015 score was 74.9 (SD = 8.5); 376 (28%), 612 (46%), 263 (20%), and 74 (6%) of women had scores that fell into the grade range of A/B, C, D, and F, respectively. Mean HEI-2015 component scores were high for fruit and whole grains and low for protein-related, sodium, and fat-related components. In multivariable linear regression models, Hispanic women scored 1.65 points higher on the total HEI-2015 (95% CI: 0.21, 3.10) compared to non-Hispanic White women, while younger age (<30 years), parity, single status, pre-pregnancy obesity, smoking, pre-existing hypertension, moderate/severe depressive symptoms, not meeting physical activity recommendations, and not taking a vitamin before pregnancy were associated with ~1.5–5-point lower mean total HEI-2015 scores. Diet is a modifiable behavior; our results suggest a continued need for pre-conceptional and prenatal nutritional counseling.
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Affiliation(s)
- Andrea L Deierlein
- School of Global Public Health, New York University, New York, NY, United States.,Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Akhgar Ghassabian
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.,Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States.,Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
| | - Yelena Afanasyeva
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.,Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
| | - Shilpi S Mehta-Lee
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, New York University Langone Health, New York, NY, United States
| | - Sara G Brubaker
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, New York University Langone Health, New York, NY, United States
| | - Leonardo Trasande
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.,Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States.,Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
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Kahn LG, Harley KG, Siegel EL, Zhu Y, Factor-Litvak P, Porucznik CA, Klein-Fedyshin M, Hipwell AE. Persistent organic pollutants and couple fecundability: a systematic review. Hum Reprod Update 2021; 27:339-366. [PMID: 33147335 PMCID: PMC7903116 DOI: 10.1093/humupd/dmaa037] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/22/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite increasing regulation, exposure to persistent organic pollutants (POPs) remains a serious public health concern due to their accumulation in the environment and ability to biomagnify up the food chain. POPs are associated with endocrine-disrupting effects including adverse reproductive outcomes that could affect fecundability, i.e. the capacity to conceive a pregnancy, quantified as time to pregnancy (TTP). OBJECTIVE AND RATIONALE Results of epidemiologic studies that examine the impact of various chemical classes of POPs on TTP have not been synthesised. We undertook a systematic review to summarise the strength of evidence for associations of four common groups of POPs with couple fecundability and to identify gaps and limitations in the literature in order to inform policy decisions and future research. SEARCH METHODS We performed an electronic search of literature published between 1 January 2007 and 6 August 2019 in MEDLINE, EMBASE.com, Global Health, DART/TOXLINE and POPLINE. We included empirical research papers that examined human exposure to organochlorine (OC) pesticides, brominated flame retardants, polychlorinated organic compounds and/or per- and polyfluoroalkyl substances (PFAS) and considered TTP or fecundability as an outcome. Standardised forms for screening, data extraction and study quality were developed using DistillerSR software, and all reviews were completed in duplicate. We used the Newcastle-Ottawa Scale to assess risk of bias and devised additional quality metrics based on specific methodological features of fecundability studies. OUTCOMES The search returned 4573 articles, and 28 papers from 19 different studies met inclusion criteria. Among them, four studies measured TTP prospectively, three had data on participants' prenatal exposure, three examined associations in both male and female partners and one focused exclusively on males. Analyses varied widely in terms of exposure characterisation, precluding a meta-analytic approach. Evidence was strongest for adverse associations of female exposure to polychlorinated biphenyls with TTP, with some additional support for associations of female exposure to polybrominated diphenyl ethers and PFAS with longer TTP. Our review provided little or no support for associations between female exposure to OC pesticides or male exposure to any of the POP groups and TTP. WIDER IMPLICATIONS Evidence suggests that female exposure to at least some POPs may reduce fecundability. Although many of these chemicals are no longer in production, they are still detectable in human biosamples because of their persistence in the environment. Replacement chemicals that are being introduced as older ones are restricted may have similar reproductive consequences. Future studies should examine these newer POPs, assess interactions between POPs and other chemical and non-chemical exposures, investigate how POPs are distributed in and metabolised by the human body and focus on populations that may be disproportionately exposed.
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Affiliation(s)
- Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016 USA
| | - Kim G Harley
- Center for Environmental Research and Children’s Health, University of California Berkeley, Berkley, CA 94720, USA
| | - Eva L Siegel
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Christina A Porucznik
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | | | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Kahn LG, Philippat C, Nakayama SF, Slama R, Trasande L. Endocrine-disrupting chemicals: implications for human health. Lancet Diabetes Endocrinol 2020; 8:703-718. [PMID: 32707118 PMCID: PMC7437820 DOI: 10.1016/s2213-8587(20)30129-7] [Citation(s) in RCA: 287] [Impact Index Per Article: 71.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/03/2020] [Accepted: 04/02/2020] [Indexed: 12/27/2022]
Abstract
Since reports published in 2015 and 2016 identified 15 probable exposure-outcome associations, there has been an increase in studies in humans of exposure to endocrine-disrupting chemicals (EDCs) and a deepened understanding of their effects on human health. In this Series paper, we have reviewed subsequent additions to the literature and identified new exposure-outcome associations with substantial human evidence. Evidence is particularly strong for relations between perfluoroalkyl substances and child and adult obesity, impaired glucose tolerance, gestational diabetes, reduced birthweight, reduced semen quality, polycystic ovarian syndrome, endometriosis, and breast cancer. Evidence also exists for relations between bisphenols and adult diabetes, reduced semen quality, and polycystic ovarian syndrome; phthalates and prematurity, reduced anogenital distance in boys, childhood obesity, and impaired glucose tolerance; organophosphate pesticides and reduced semen quality; and occupational exposure to pesticides and prostate cancer. Greater evidence has accumulated than was previously identified for cognitive deficits and attention-deficit disorder in children following prenatal exposure to bisphenol A, organophosphate pesticides, and polybrominated flame retardants. Although systematic evaluation is needed of the probability and strength of these exposure-outcome relations, the growing evidence supports urgent action to reduce exposure to EDCs.
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Affiliation(s)
- Linda G Kahn
- Department of Pediatrics, New York University, New York, NY, USA
| | - Claire Philippat
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Shoji F Nakayama
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Rémy Slama
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Leonardo Trasande
- Department of Pediatrics, New York University, New York, NY, USA; Department of Environmental Medicine, and Department of Population Health, New York University Grossman School of Medicine and New York University School of Global Public Health, New York University, New York, NY, USA.
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Philips EM, Trasande L, Kahn LG, Gaillard R, Steegers EAP, Jaddoe VWV. Early pregnancy bisphenol and phthalate metabolite levels, maternal hemodynamics and gestational hypertensive disorders. Hum Reprod 2020; 34:365-373. [PMID: 30576447 DOI: 10.1093/humrep/dey364] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 11/23/2018] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Are early-pregnancy urinary bisphenol and phthalate metabolite concentrations associated with placental function markers, blood pressure (BP) trajectories during pregnancy and risk of gestational hypertensive disorders? SUMMARY ANSWER Early-pregnancy bisphenols and phthalate metabolites were not consistently associated with maternal BP changes or gestational hypertensive disorders, but subclinical, statistically significant associations with placental angiogenic markers and placental hemodynamics were identified. WHAT IS KNOWN ALREADY In vitro studies suggest that bisphenols and phthalate metabolites may disrupt early placental development and affect the risk of gestational hypertensive disorders. Previous studies investigating effects of bisphenols and phthalate metabolites on gestational hypertensive disorders reported inconsistent results and did not examine placental function or BP throughout pregnancy. STUDY DESIGN, SIZE, DURATION In a population-based prospective cohort study, bisphenol and phthalate metabolite concentrations were measured in a spot urine sample in early pregnancy among 1396 women whose children participated in postnatal follow-up measurements. PARTICIPANTS/MATERIALS, SETTING, METHODS After exclusion of women without any BP measurement or with pre-existing hypertension, 1233 women were included in the analysis. Urinary bisphenol and phthalate metabolite concentrations were measured in early-pregnancy [median gestational age 13.1 weeks, inter-quartile range 12.1-14.5]. Molar sums of total bisphenols and of low molecular weight phthalate, high molecular weight (HMW) phthalate, di-2-ethylhexylphthalate, and di-n-octylphthalate metabolites were calculated. Placental angiogenic markers (placental growth factor (PlGF), soluble fms-like tyrosine kinase (sFlt)-1), placental hemodynamic function measures (umbilical artery pulsatility index (PI), uterine artery resistance index (RI), notching and placental weight), and maternal BP were measured in different trimesters. Information on gestational hypertensive disorders was obtained from medical records. MAIN RESULTS AND THE ROLE OF CHANCE Each log unit increase in HMW phthalate metabolites was associated with a 141.72 (95% CI: 29.13, 373.21) higher early pregnancy sFlt-1/PlGF ratio (range in total sample 9-900). This association was driven by mono-[(2-carboxymethyl)hexyl]phthalate. In the repeated measurements regression models, each log unit increase in bisphenol A was associated with a 0.15 SD (95% CI: 0.03, 0.26) higher intercept and -0.01 SD (95% CI: -0.01, -0.00) decreasing slope of the umbilical artery PI Z-score and a -1.28 SD (95% CI: -2.24, -0.33) lower intercept and 0.06 SD (95% CI: 0.02, 0.11) increasing slope of the uterine artery RI Z-score. These associations remained significant after Bonferroni correction. Early-pregnancy bisphenols or phthalate metabolites showed no consistent associations with any other outcome. LIMITATIONS, REASONS FOR CAUTION Information on a large number of potential confounders was available but was partly self-reported. Bisphenols and phthalate metabolites, which typically have a half-life of 24-48 h, were measured via single spot urine samples in early-pregnancy. In addition, at the current sample size, the study was powered to detect an odds ratio of 1.57 for gestational hypertension and 1.78 for pre-eclampsia, but was underpowered to perform multivariable analyses for these outcomes. Further studies combining data from different cohorts may be necessary to increase power. These limitations are possible sources of non-differential misclassification leading to bias toward the null. WIDER IMPLICATIONS OF THE FINDINGS Bisphenols and phthalate metabolites were not associated with longitudinal changes in BP in pregnancy in our low-risk population. The observed subclinical associations of phthalates with the sFlt-1/PlGF ratio and of bisphenol A with placental hemodynamics may contribute to adverse pregnancy outcomes. Our results are therefore more supportive of an association of early pregnancy bisphenols and phthalate metabolites with risk for pre-eclampsia than with gestational hypertension. STUDY FUNDING/COMPETING INTEREST(S) This analysis was supported by Grant (ES022972) from the National Institutes of Health, USA. The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health. The authors report no conflicts of interest.
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Affiliation(s)
- Elise M Philips
- The Generation R Study Group, Erasmus Medical Center, CA Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, CA Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, CA Rotterdam, The Netherlands
| | - Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, New York City, NY, USA.,Department of Environmental Medicine, New York University School of Medicine, New York City, NY, USA.,Department of Population Health, New York University School of Medicine, New York City, NY, USA.,New York University Wagner School of Public Service, New York City, NY, USA.,New York University College of Global Public Health, New York City, NY, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, New York City, NY, USA
| | - Romy Gaillard
- The Generation R Study Group, Erasmus Medical Center, CA Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, CA Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, CA Rotterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics & Gynaecology, Erasmus University Medical Center, CA Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus Medical Center, CA Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, CA Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, CA Rotterdam, The Netherlands
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Woodward MJ, Obsekov V, Jacobson MH, Kahn LG, Trasande L. Phthalates and Sex Steroid Hormones Among Men From NHANES, 2013-2016. J Clin Endocrinol Metab 2020; 105:dgaa039. [PMID: 31996892 PMCID: PMC7067547 DOI: 10.1210/clinem/dgaa039] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/27/2020] [Indexed: 12/31/2022]
Abstract
CONTEXT Phthalates are commonly found in commercial packaging, solvents, vinyl, and personal care products, and there is concern for potential endocrine-disrupting effects in males. The commonly used di-2-ethylhexyl phthalate (DEHP) has progressively been replaced by seldom studied compounds, such as bis-2-ethylhexyl terephthalate and 1,2-cyclohexane dicarboxylic acid di-isononyl ester (DINCH). OBJECTIVE To investigate the associations between the urinary phthalate metabolites and serum sex steroid hormone concentrations in a nationally representative sample of adult males. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION This was a cross-sectional analysis of data from the 2013-2016 National Health and Nutrition Examination Survey among 1420 male participants aged ≥20 years. MAIN OUTCOME MEASURES Serum levels of total testosterone, estradiol, SHBG, and derived sex hormone measurements of free testosterone, bioavailable testosterone, and free androgen index were examined as log-transformed continuous variables. RESULTS Phthalate metabolites were not statistically significantly associated with sex hormone concentrations among all men. However, associations varied by age. High molecular weight phthalates were associated with lower total, free, and bioavailable testosterone among men age ≥60. Specifically, each doubling of ΣDEHP was associated with 7.72% lower total testosterone among older men (95% confidence interval, -12.76% to -2.39%). Low molecular phthalates were associated with lower total, free, and bioavailable testosterone among men age 20 to 39 and ∑DINCH was associated with lower total testosterone among men age ≥40. CONCLUSIONS Our results indicate that males may be vulnerable to different phthalate metabolites in age-specific ways. These results support further investigation into the endocrine-disrupting effects of phthalates.
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Affiliation(s)
- Miriam J Woodward
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY
| | - Vladislav Obsekov
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY
| | - Melanie H Jacobson
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY
| | - Linda G Kahn
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY
| | - Leonardo Trasande
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY
- Department of Population Health, NYU Langone Medical Center, New York, NY
- Department of Environmental Medicine, NYU Langone Medical Center, New York, NY
- NYU Wagner School of Public Service, New York, NY
- NYU College of Global Public Health, New York, NY
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40
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Trasande L, Ghassabian A, Kahn LG, Jacobson MH, Afanasyeva Y, Liu M, Chen Y, Naidu M, Alcedo G, Gilbert J, Koshy TT. The NYU Children's Health and Environment Study. Eur J Epidemiol 2020; 35:305-320. [PMID: 32212050 PMCID: PMC7154015 DOI: 10.1007/s10654-020-00623-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/11/2020] [Indexed: 10/31/2022]
Abstract
The aims of the NYU Children's Health and Environment Study (CHES) are to evaluate influences of prenatal non-persistent chemical exposures on fetal and postnatal growth and pool our data with the US National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Program to answer collaborative research questions on the impact of the preconceptual, prenatal, and postnatal environment on childhood obesity, neurodevelopment, pre/peri/postnatal outcomes, upper and lower airway outcomes, and positive health. Eligible women were ≥ 18 years old, < 18 weeks pregnant, had a pregnancy that is not medically threatened, and planned to deliver at NYU Langone Hospital-Manhattan, Bellevue Hospital, or NYU Langone Hospital-Brooklyn. Between March 22, 2016 and April 15, 2019, we recruited 2469 pregnant women, from whom 2193 completed an initial questionnaire and continued into NYU CHES. Of the 2193, 88 miscarried, 28 terminated, and 20 experienced stillbirth, while 57 were lost to follow up. We report here demographic and other characteristics of the 2000 live deliveries (2037 children), from whom 1624 (80%) consented to postnatal follow-up. Data collection in pregnancy was nested in clinical care, with questionnaire and specimen collection conducted during routine prenatal visits at < 18, 18-25, and > 25 weeks gestation. These have been followed by questionnaire and specimen collection at birth and regular postpartum intervals.
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Affiliation(s)
- Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA. .,Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA. .,Department of Population Health, New York University School of Medicine, New York, NY, USA. .,NYU Wagner School of Public Service, New York, NY, USA. .,NYU College of Global Public Health, New York, NY, USA.
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA.,Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.,Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Melanie H Jacobson
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Yelena Afanasyeva
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA.,Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.,Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Yu Chen
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.,Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Mrudula Naidu
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA.,Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Garry Alcedo
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Joseph Gilbert
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Tony T Koshy
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
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Widen EM, Nichols AR, Kahn LG, Factor-Litvak P, Insel BJ, Hoepner L, Dube SM, Rauh V, Perera F, Rundle A. Prepregnancy obesity is associated with cognitive outcomes in boys in a low-income, multiethnic birth cohort. BMC Pediatr 2019; 19:507. [PMID: 31862007 PMCID: PMC6924019 DOI: 10.1186/s12887-019-1853-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 11/22/2019] [Indexed: 01/13/2023] Open
Abstract
Background Maternal obesity and high gestational weight gain (GWG) disproportionally affect low-income populations and may be associated with child neurodevelopment in a sex-specific manner. We examined sex-specific associations between prepregnancy BMI, GWG, and child neurodevelopment at age 7. Methods Data are from a prospective low-income cohort of African American and Dominican women (n = 368; 44.8% male offspring) enrolled during the second half of pregnancy from 1998 to 2006. Neurodevelopment was measured using the Wechsler Intelligence Scale for Children (WISC-IV) at approximately child age 7. Linear regression estimated associations between prepregnancy BMI, GWG, and child outcomes, adjusting for race/ethnicity, marital status, gestational age at delivery, maternal education, maternal IQ and child age. Results Overweight affected 23.9% of mothers and obesity affected 22.6%. At age 7, full-scale IQ was higher among girls (99.7 ± 11.6) compared to boys (96.9 ± 13.3). Among boys, but not girls, prepregnancy overweight and obesity were associated with lower full-scale IQ scores [overweight β: − 7.1, 95% CI: (− 12.1, − 2.0); obesity β: − 5.7, 95% CI: (− 10.7, − 0.7)]. GWG was not associated with full-scale IQ in either sex. Conclusions Prepregnancy overweight and obesity were associated with lower IQ among boys, but not girls, at 7 years. These findings are important considering overweight and obesity prevalence and the long-term implications of early cognitive development.
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Affiliation(s)
- Elizabeth M Widen
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, 103 W 24TH ST A2703, Austin, TX, 78712, USA. .,Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA.
| | - Amy R Nichols
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, 103 W 24TH ST A2703, Austin, TX, 78712, USA.,Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, 403 East 34th St, New York, NY, 10016, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street Room 1614, New York, NY, 10032, USA
| | - Beverly J Insel
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street Room 1614, New York, NY, 10032, USA.,Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lori Hoepner
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA.,Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Environmental and Occupational Health Sciences, SUNY Downstate Medical Center, School of Public Health, 450 Clarkson Avenue, MSC 43, Brooklyn, NY, 11203, USA
| | - Sara M Dube
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, 103 W 24TH ST A2703, Austin, TX, 78712, USA.,Department of Nutritional Sciences, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Virginia Rauh
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, B-2, Room 213, New York, NY, 10032, USA
| | - Frederica Perera
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street Room 1614, New York, NY, 10032, USA
| | - Andrew Rundle
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street Room 1614, New York, NY, 10032, USA
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42
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Douglas C, Parekh N, Kahn LG, Henkel R, Agarwal A. A Novel Approach to Improving the Reliability of Manual Semen Analysis: A Paradigm Shift in the Workup of Infertile Men. World J Mens Health 2019; 39:172-185. [PMID: 31749341 PMCID: PMC7994658 DOI: 10.5534/wjmh.190088] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/08/2019] [Accepted: 10/28/2019] [Indexed: 12/13/2022] Open
Abstract
Conventional semen analysis (SA) is an essential component of the male infertility workup, but requires laboratories to rigorously train and monitor technicians as well as regularly perform quality assurance assessments. Without such measures there is room for error and, consequently, unreliable results. Furthermore, clinicians often rely heavily on SA results when making diagnostic and treatment decisions, however conventional SA is only a surrogate marker of male fecundity and does not guarantee fertility. Considering these challenges, the last several decades have seen the development of many advances in SA methodology, including tests for sperm DNA fragmentation, acrosome reaction, and capacitation. While these new diagnostic tests have improved the scope of information available to clinicians, they are expensive, time-consuming, and require specialized training. The latest advance in laboratory diagnostics is the measurement of seminal oxidation-reduction potential (ORP). The measurement of ORP in an easy, reproducible manner using a new tool called the Male Infertility Oxidative Stress System (MiOXSYS) has demonstrated ORP's potential as a feasible adjunct test to conventional SA. Additionally, the measurement of ORP by this device has been shown to be predictive of both poor semen quality and male infertility. Assessing ORP is a novel approach to both validating manual SA results and identifying patients who may benefit from treatment of male oxidative stress infertility.
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Affiliation(s)
- Christopher Douglas
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Neel Parekh
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Linda G Kahn
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Pediatrics, New York University School of Medicine, New York City, NY, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.
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43
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Agarwal A, Parekh N, Panner Selvam MK, Henkel R, Shah R, Homa ST, Ramasamy R, Ko E, Tremellen K, Esteves S, Majzoub A, Alvarez JG, Gardner DK, Jayasena CN, Ramsay JW, Cho CL, Saleh R, Sakkas D, Hotaling JM, Lundy SD, Vij S, Marmar J, Gosalvez J, Sabanegh E, Park HJ, Zini A, Kavoussi P, Micic S, Smith R, Busetto GM, Bakırcıoğlu ME, Haidl G, Balercia G, Puchalt NG, Ben-Khalifa M, Tadros N, Kirkman-Browne J, Moskovtsev S, Huang X, Borges E, Franken D, Bar-Chama N, Morimoto Y, Tomita K, Srini VS, Ombelet W, Baldi E, Muratori M, Yumura Y, La Vignera S, Kosgi R, Martinez MP, Evenson DP, Zylbersztejn DS, Roque M, Cocuzza M, Vieira M, Ben-Meir A, Orvieto R, Levitas E, Wiser A, Arafa M, Malhotra V, Parekattil SJ, Elbardisi H, Carvalho L, Dada R, Sifer C, Talwar P, Gudeloglu A, Mahmoud AMA, Terras K, Yazbeck C, Nebojsa B, Durairajanayagam D, Mounir A, Kahn LG, Baskaran S, Pai RD, Paoli D, Leisegang K, Moein MR, Malik S, Yaman O, Samanta L, Bayane F, Jindal SK, Kendirci M, Altay B, Perovic D, Harlev A. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World J Mens Health 2019; 37:296-312. [PMID: 31081299 PMCID: PMC6704307 DOI: 10.5534/wjmh.190055] [Citation(s) in RCA: 214] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/02/2019] [Indexed: 12/29/2022] Open
Abstract
Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA.
| | - Neel Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Manesh Kumar Panner Selvam
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA
- Department of Medical Bioscience, University of the Western Cape, Cape Town, South Africa
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Sheryl T Homa
- School of Biosciences, University of Kent, Canterbury, UK
| | | | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, Australia
| | - Sandro Esteves
- Division of Urology, Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil
- Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Ahmad Majzoub
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA
- Department of Urology, Hamad Medical Corporation and Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Juan G Alvarez
- Centro Androgen, La Coruña, Spain and Harvard Medical School, Boston, MA, USA
| | - David K Gardner
- School of BioSciences, University of Melbourne, Parkville, Australia
| | - Channa N Jayasena
- Section of Investigative Medicine, Imperial College London, UK
- Department of Andrology, Hammersmith Hospital, London, UK
| | | | - Chak Lam Cho
- Department of Surgery, Union Hospital, Shatin, Hong Kong
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | | | - James M Hotaling
- Department of Urology, University of Utah, Salt Lake City, UT, USA
| | - Scott D Lundy
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Sarah Vij
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | | | - Jaime Gosalvez
- Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Parviz Kavoussi
- Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Sava Micic
- Uromedica Polyclinic, Kneza Milosa, Belgrade, Serbia
| | - Ryan Smith
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | | | | | - Gerhard Haidl
- Department of Dermatology, University Hospital Bonn, Bonn, Germany
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Umberto I Hospital, Ancona, Italy
| | - Nicolás Garrido Puchalt
- IVI Foundation Edificio Biopolo - Instituto de Investigación Sanitaria la Fe, Valencia, Spain
| | - Moncef Ben-Khalifa
- University Hospital, School of Médicine and PERITOX Laboratory, Amiens, France
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Jackson Kirkman-Browne
- Centre for Human Reproductive Science, IMSR, College of Medical & Dental Sciences, The University of Birmingham Edgbaston, UK
- The Birmingham Women's Fertility Centre, Birmingham Women's and Children's NHS Foundation Trust, Mindelsohn Drive, Edgbaston, UK
| | - Sergey Moskovtsev
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada
| | - Xuefeng Huang
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | | | - Daniel Franken
- Department of Obstetrics & Gynecology, Andrology Unit Faculties of Health Sciences, Tygerberg Hospital, Tygerberg, South Africa
| | - Natan Bar-Chama
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Kazuhisa Tomita
- IVF Japan Group, Horac Grand Front Osaka Clinic, Osaka, Japan
| | | | - Willem Ombelet
- Genk Institute for Fertility Technology, Genk, Belgium
- Hasselt University, Biomedical Research Institute, Diepenbeek, Belgium
| | - Elisabetta Baldi
- Department of Experimental and Clinical Medicine, Center of Excellence DeNothe, University of Florence, Italy
| | - Monica Muratori
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Unit of Sexual Medicine and Andrology, Center of Excellence DeNothe, University of Florence, Florence, Italy
| | - Yasushi Yumura
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Marlon P Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | | | | | - Matheus Roque
- Origen, Center for Reproductive Medicine, Rio de Janeiro, Brazil
| | | | - Marcelo Vieira
- Division of Urology, Infertility Center ALFA, São Paulo, Brazil
- Head of Male Infertility Division, Andrology Department, Brazilian Society of Urology, Rio de Janeiro, Brazil
| | - Assaf Ben-Meir
- Fertility and IVF Unit, Department of Obstetrics and Gynecology, Hebrew-University Hadassah Medical Center, Jerusalem, Israel
| | - Raoul Orvieto
- Infertility and IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Eliahu Levitas
- Soroka University Medical Center, Ben-Gurion University of the Negev Beer-Sheva, Beersheba, Israel
| | - Amir Wiser
- IVF Unit, Meir Medical Center, Kfar Sava, Israel
- Sackler Medicine School, Tel Aviv University, Tel Aviv, Israel
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Vineet Malhotra
- Department of Andrology and Urology, Diyos Hospital, New Delhi, India
| | - Sijo Joseph Parekattil
- PUR Clinic, South Lake Hospital, Clermont, FL, USA
- University of Central Florida, Orlando, FL, USA
| | | | - Luiz Carvalho
- Baby Center, Institute for Reproductive Medicine, São Paulo, Brazil
- College Institute of Clinical Research and Teaching Development, São Paulo, Brazil
| | - Rima Dada
- Lab for Molecular Reproduction and Genetics, Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Christophe Sifer
- Department of Reproductive Biology, Hôpitaux Universitaires Paris Seine Saint-Denis, Bondy, France
| | - Pankaj Talwar
- Department of Reproductive Medicine and Embryology, Manipal Hospital, New Delhi, India
| | - Ahmet Gudeloglu
- Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ahmed M A Mahmoud
- Department of Endocrinology/ Andrology, University Hospital Ghent, Ghent, Belgium
| | - Khaled Terras
- Department of Reproductive Medicine, Hannibal International Clinic, Tunis, Tunisia
| | - Chadi Yazbeck
- Department of Obstetrics, Gynecology and Reproductive Medicine, Pierre Cherest and Hartman Clinics, Paris, France
| | - Bojanic Nebojsa
- Clinic of Urology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, Selangor, Malaysia
| | - Ajina Mounir
- Department of Embryology, Faculty of Medicine, University of Sousse, Sousse, Tunisia
| | - Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA
| | - Rishma Dhillon Pai
- Department of Obstetrics and Gynaecology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Donatella Paoli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Kristian Leisegang
- School of Natural Medicine, University of the Western Cape, Cape Town, South Africa
| | | | | | - Onder Yaman
- Department of Urology, School of Medicine, University of Ankara, Ankara, Turkey
| | - Luna Samanta
- Redox Biology Laboratory, Department of Zoology and Center of Excellence in Environment and Public Health, Ravenshaw University, Cutrack, India
| | - Fouad Bayane
- Marrakech Fertility Institute, Marrakech, Morocco
| | | | - Muammer Kendirci
- Department of Urology, Istinye University Faculty of Medicine, Liv Hospital Ulus, Istanbul, Turkey
| | - Baris Altay
- Department of Urology, Ege University School of Medicine, İzmir, Turkey
| | | | - Avi Harlev
- Fertility and IVF Unit, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
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Hipwell AE, Kahn LG, Factor-Litvak P, Porucznik CA, Siegel EL, Fichorova RN, Hamman RF, Klein-Fedyshin M, Harley KG. Exposure to non-persistent chemicals in consumer products and fecundability: a systematic review. Hum Reprod Update 2019; 25:51-71. [PMID: 30307509 PMCID: PMC6295794 DOI: 10.1093/humupd/dmy032] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/17/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Exposure to non-persistent chemicals in consumer products is ubiquitous and associated with endocrine-disrupting effects. These effects have been linked to infertility and adverse pregnancy outcomes in some studies and could affect couple fecundability, i.e. the capacity to conceive a pregnancy, quantified as time to pregnancy (TTP). OBJECTIVE AND RATIONALE Few epidemiologic studies have examined the impact of non-persistent chemicals specifically on TTP, and the results of these studies have not been synthesized. We undertook a systematic review to summarize the strength of evidence for associations of common non-persistent chemicals with couple fecundability and to identify gaps and limitations in the literature, with the aim of informing policy decisions and future research. SEARCH METHODS We performed an electronic search of English language literature published between 1 January 2007 and 25 August 2017 in MEDLINE, EMBASE.com, Global Health, DART/TOXLINE, POPLINE and DESTAF. We included human retrospective and prospective cohort, cross-sectional and case-control studies that examined phthalates, bisphenol A, triclosan, triclocarban, benzophenones, parabens and glycol ethers in consumer products, and considered TTP or fecundability as an outcome among women, men and couples conceiving without medical assistance. We excluded editorials, opinion pieces, introductions to special sections, articles that described only lifestyle (e.g. caffeine, stress) or clinical factors (e.g. semen parameters, IVF success). Standardized forms for screening, data extraction and study quality were developed using DistillerSR software and completed in duplicate. We used the Newcastle-Ottawa Scale to assess risk of bias and devised additional quality metrics based on specific methodological features of fecundability studies. OUTCOMES The search returned 3456 articles. There were 15 papers from 12 studies which met inclusion criteria, of which eight included biomarkers of chemical exposure. Studies varied widely in terms of exposure characterization, precluding a meta-analytic approach. Among the studies that measured exposure using biospecimens, results were equivocal for associations between either male or female phthalate exposure and TTP. There was preliminary support for associations of female exposure to some parabens and glycol ethers and of male exposure to benzophenone with longer TTP, but further research and replication of these results are needed. The results provided little to no indication that bisphenol A, triclocarban or triclosan exposure was associated with TTP. WIDER IMPLICATIONS Despite a growing literature on couple exposure to non-persistent endocrine-disrupting chemicals and fecundability, evidence for associations between biologically measured exposures and TTP is limited. Equivocal results with different non-persistent chemical compounds and metabolites complicate the interpretation of our findings with respect to TTP, but do not preclude action, given the documented endocrine disrupting effects on other reproductive outcomes as well as fetal development. We therefore advocate for common-sense lifestyle changes in which both females and males seeking to conceive minimize their exposure to non-persistent chemicals. SYSTEMATIC REVIEW REGISTRATION NUMBER CRD42018084304.
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Affiliation(s)
- Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, 403 East 34th Street, New York, NY, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street, New York, NY, USA
| | - Christina A Porucznik
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, 375 Chipeta Way, Salt Lake City, UT, USA
| | - Eva L Siegel
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street, New York, NY, USA
| | - Raina N Fichorova
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - Richard F Hamman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, 13001 East 17th Place, Denver, CO, USA
| | - Michele Klein-Fedyshin
- Health Sciences Library System, School of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, USA
| | - Kim G Harley
- Center for Environmental Research and Children’s Health, University of California Berkeley, 1995 University Avenue, Berkley CA, USA
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Philips EM, Kahn LG, Jaddoe VWV, Shao Y, Asimakopoulos AG, Kannan K, Steegers EAP, Trasande L. First Trimester Urinary Bisphenol and Phthalate Concentrations and Time to Pregnancy: A Population-Based Cohort Analysis. J Clin Endocrinol Metab 2018; 103:3540-3547. [PMID: 30016447 PMCID: PMC6693040 DOI: 10.1210/jc.2018-00855] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 06/27/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Increasing evidence suggests that exposure to synthetic chemicals such as bisphenols and phthalates can influence fecundability. The current study describes associations of first trimester urinary concentrations of bisphenol A (BPA), BPA analogs, and phthalate metabolites with time to pregnancy (TTP). METHODS Among 877 participants in the population-based Generation R pregnancy cohort, we measured first trimester urinary concentrations of bisphenols and phthalates [median gestational age, 12.9 weeks (interquartile range, 12.1, 14.4)]. We used fitted covariate-adjusted Cox proportional hazard models to examine associations of bisphenol and phthalate concentrations with TTP. Participants who conceived using infertility treatment were censored at 12 months. Biologically plausible effect measure modification by folic acid supplement use was tested. RESULTS In the main models, bisphenol and phthalate compounds were not associated with fecundability. In stratified models, total bisphenols and phthalic acid were associated with longer TTP among women who did not use folic acid supplements preconceptionally [respective fecundability ratios per each natural log increase were 0.90 (95% CI, 0.81 to 1.00) and 0.88 (95% CI, 0.79 to 0.99)]. Using an interaction term for the exposure and folic acid supplement use showed additional effect measure modification by folic acid supplement use for high-molecular-weight phthalate metabolites. CONCLUSIONS We found no associations of bisphenols and phthalates with fecundability. Preconception folic acid supplementation seems to modify effects of bisphenols and phthalates on fecundability. Folic acid supplements may protect against reduced fecundability among women exposed to these chemicals. Further studies are needed to replicate these findings and investigate potential mechanisms.
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Affiliation(s)
- Elise M Philips
- The Generation R Study Group, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
- Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
| | - Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, New York City, New York
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
- Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
| | - Yongzhao Shao
- Department of Population of Health, New York University School of Medicine, New York City, New York
| | - Alexandros G Asimakopoulos
- Wadsworth Center, New York State Department of Health, New York, New York
- Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, New York, USA
- Department of Chemistry, the Norwegian University of Science and Technology, Trondheim, Norway
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health, New York, New York
- Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, New York, USA
- Biochemistry Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Eric A P Steegers
- Department of Obstetrics & Gynecology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
| | - Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, New York City, New York
- Department of Population of Health, New York University School of Medicine, New York City, New York
- New York University College of Global Public Health, New York City, New York
- Department of Environmental Medicine, New York University School of Medicine, New York City, New York
- New York Wagner School of Public Service, New York City, New York
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Shiau S, Kahn LG, Platt J, Li C, Guzman JT, Kornhauser ZG, Keyes KM, Martins SS. Evaluation of a flipped classroom approach to learning introductory epidemiology. BMC Med Educ 2018; 18:63. [PMID: 29609654 PMCID: PMC5879803 DOI: 10.1186/s12909-018-1150-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/09/2018] [Indexed: 05/07/2023]
Abstract
BACKGROUND Although the flipped classroom model has been widely adopted in medical education, reports on its use in graduate-level public health programs are limited. This study describes the design, implementation, and evaluation of a flipped classroom redesign of an introductory epidemiology course and compares it to a traditional model. METHODS One hundred fifty Masters-level students enrolled in an introductory epidemiology course with a traditional format (in-person lecture and discussion section, at-home assignment; 2015, N = 72) and a flipped classroom format (at-home lecture, in-person discussion section and assignment; 2016, N = 78). Using mixed methods, we compared student characteristics, examination scores, and end-of-course evaluations of the 2016 flipped classroom format and the 2015 traditional format. Data on the flipped classroom format, including pre- and post-course surveys, open-ended questions, self-reports of section leader teaching practices, and classroom observations, were evaluated. RESULTS There were no statistically significant differences in examination scores or students' assessment of the course between 2015 (traditional) and 2016 (flipped). In 2016, 57.1% (36) of respondents to the end-of-course evaluation found watching video lectures at home to have a positive impact on their time management. Open-ended survey responses indicated a number of strengths of the flipped classroom approach, including the freedom to watch pre-recorded lectures at any time and the ability of section leaders to clarify targeted concepts. Suggestions for improvement focused on ways to increase regular interaction with lecturers. CONCLUSIONS There was no significant difference in students' performance on quantitative assessments comparing the traditional format to the flipped classroom format. The flipped format did allow for greater flexibility and applied learning opportunities at home and during discussion sections.
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Affiliation(s)
- Stephanie Shiau
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 509, New York, NY 10032 USA
| | - Linda G. Kahn
- Department of Pediatrics, New York University School of Medicine, New York, NY USA
| | - Jonathan Platt
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 509, New York, NY 10032 USA
| | - Chihua Li
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 509, New York, NY 10032 USA
| | - Jason T. Guzman
- Center for Teaching and Learning, Columbia University, New York, NY USA
| | | | - Katherine M. Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 509, New York, NY 10032 USA
| | - Silvia S. Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 509, New York, NY 10032 USA
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Franco-Sena AB, Kahn LG, Farias DR, Ferreira AA, Eshriqui I, Figueiredo ACC, Factor-Litvak P, Schlüssel MM, Kac G. Sleep duration of 24 h is associated with birth weight in nulli- but not multiparous women. Nutrition 2018; 55-56:91-98. [PMID: 29980093 DOI: 10.1016/j.nut.2018.03.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 03/06/2018] [Accepted: 03/21/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVES This study aimed to evaluate the association between nightly, napping, and 24-h sleep duration throughout pregnancy and birth weight z-score among nulli- and multiparous women. METHODS Nightly,napping, and 24-h sleep duration and birth weight z-score (calculated on thebasis of the International Fetal and Newborn Growth Consortium for the 21st century standards) were studied in a cohort of 176 pregnant women from Brazil. Linear mixed-effect analyses were performed to assess the longitudinal evolution of sleep duration and the best unbiased linear predictors of the random coefficients were estimated. The best unbiased linear predictor estimates of sleep duration intercept and slope were included in the linear regression models with birth weight z-score as the outcome. RESULTS The mean hours of nightly sleep decreased during pregnancy in nulliparous women (β = -0.55; 95% confidence interval [CI], -0.83 to -0.27) but the decrease was not statistically significant in multiparous women (β = -0.19; 95% CI, -0.30 to 0.01). Twenty-four hour sleep duration decreased during pregnancy in both multiparous (β = -0.50; 95% CI, -0.76 to -0.25) and nulliparous women (β = 0.77; 95% CI, -1.06 to -0.48). Napping sleep duration did not change in either group. Among the nulliparous women, both first-trimester 24-h sleep duration and its change throughout pregnancy were inversely associated with birth weight (β = -0.44; 95% CI, -0.68 to -0.21; β = -1.75; 95% CI, -3.17 to -0.30, respectively). No associations were detected in multiparous women for nightly and napping sleep duration. CONCLUSIONS Nulliparous women with greater decreases in sleep duration throughout their pregnancy gave birth to newborns with lower birth weight z-scores.
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Affiliation(s)
- Ana Beatriz Franco-Sena
- Department of Social Nutrition, Emilia de Jesus Ferreiro Nutrition School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
| | - Dayana R Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Aline A Ferreira
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Ilana Eshriqui
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Amanda C C Figueiredo
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Michael M Schlüssel
- Centre for Statistics in Medicine, Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.
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Smarr MM, Sapra KJ, Gemmill A, Kahn LG, Wise LA, Lynch CD, Factor-Litvak P, Mumford SL, Skakkebaek NE, Slama R, Lobdell DT, Stanford JB, Jensen TK, Boyle EH, Eisenberg ML, Turek PJ, Sundaram R, Thoma ME, Buck Louis GM. Is human fecundity changing? A discussion of research and data gaps precluding us from having an answer. Hum Reprod 2018; 32:499-504. [PMID: 28137753 DOI: 10.1093/humrep/dew361] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 01/03/2017] [Indexed: 12/14/2022] Open
Abstract
Fecundity, the biologic capacity to reproduce, is essential for the health of individuals and is, therefore, fundamental for understanding human health at the population level. Given the absence of a population (bio)marker, fecundity is assessed indirectly by various individual-based (e.g. semen quality, ovulation) or couple-based (e.g. time-to-pregnancy) endpoints. Population monitoring of fecundity is challenging, and often defaults to relying on rates of births (fertility) or adverse outcomes such as genitourinary malformations and reproductive site cancers. In light of reported declines in semen quality and fertility rates in some global regions among other changes, the question as to whether human fecundity is changing needs investigation. We review existing data and novel methodological approaches aimed at answering this question from a transdisciplinary perspective. The existing literature is insufficient for answering this question; we provide an overview of currently available resources and novel methods suitable for delineating temporal patterns in human fecundity in future research.
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Affiliation(s)
- Melissa M Smarr
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr. Room 3131A, Bethesda, MD 20829, USA
| | - Katherine J Sapra
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr. Room 3131A, Bethesda, MD 20829, USA
| | - Alison Gemmill
- Department of Demography, University of California, Berkeley, CA 94720, USA
| | - Linda G Kahn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Courtney D Lynch
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, Columbus, OH 43212, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Sunni L Mumford
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20829, USA
| | - Niels E Skakkebaek
- Department of Growth and Reproduction and EDMaRC, University of Copenhagen, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Rémy Slama
- Team of Environmental Epidemiology, Inserm, CNRS, University Grenoble Alpes, IAB Joint Research Center, F-38000 Grenoble, France
| | - Danelle T Lobdell
- Office of Research and Development, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA
| | - Joseph B Stanford
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Tina Kold Jensen
- Department of Growth and Reproduction and EDMaRC, University of Copenhagen, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Elizabeth Heger Boyle
- Department of Sociology and College of Law, University of Minnesota, Minneapolis, MN 55455, USA
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | | | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20829, USA
| | - Marie E Thoma
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Germaine M Buck Louis
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr. Room 3131A, Bethesda, MD 20829, USA
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Kahn LG, Han X, Koshy TT, Shao Y, Chu DB, Kannan K, Trasande L. Adolescents exposed to the World Trade Center collapse have elevated serum dioxin and furan concentrations more than 12years later. Environ Int 2018; 111:268-278. [PMID: 29246432 PMCID: PMC5800899 DOI: 10.1016/j.envint.2017.11.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/06/2017] [Accepted: 11/28/2017] [Indexed: 05/30/2023]
Abstract
BACKGROUND The collapse of the World Trade Center (WTC) on September 11, 2001 released a dust cloud containing numerous environmental contaminants, including polychlorinated dibenzo-para-dioxins and polychlorinated dibenzofurans (PCDD/Fs). PCDD/Fs are toxic and are associated with numerous adverse health outcomes including cancer, diabetes, and impaired reproductive and immunologic function. Prior studies have found adults exposed to the WTC disaster to have elevated levels of PCDD/Fs. This is the first study to assess PCDD/F levels in WTC-exposed children. METHODS This analysis includes 110 participants, a subset of the 2014-2016 WTC Adolescent Health Study, a group of both exposed youths who lived, attended school, or were present in lower Manhattan on 9/11 recruited from the WTC Health Registry (WTCHR) and unexposed youths frequency matched on age, sex, race, ethnicity, and income. Our sample was selected to maximize the contrast in their exposure to dust from the WTC collapse. Questionnaire data, including items about chronic home dust and acute dust cloud exposure, anthropometric measures, and biologic specimens were collected during a clinic visit. Serum PCDD/F concentrations were measured according to a standardized procedure at the New York State Department of Health Organic Analytical Laboratory. We used multivariable linear regression to assess differences in PCCD/Fs between WTCHR and non-WTCHR participants. We also compared mean and median PCDD/F and toxic equivalency (TEQ) concentrations in our cohort to 2003-4 National Health and Nutrition Examination Survey (NHANES) levels for youths age 12-19. RESULTS Median PCDD/F levels were statistically significantly higher among WTCHR participants compared to non-WTCHR participants for 16 out of 17 congeners. Mean and median TEQ concentrations in WTCHR participants were >7 times those in non-WTCHR participants (72.5 vs. 10.1 and 25. 3 vs. 3.39pg/g lipid, respectively). Among WTCHR participants, median concentrations of several PCDD/Fs were higher than the NHANES 95th percentiles. After controlling for dust cloud exposure, home dust exposure was significantly associated with higher PCDD/F level. CONCLUSIONS Adolescents in lower Manhattan on the day of the WTC attack and exposed to particulate contamination from the WTC collapse had significantly elevated PCDD/F levels >12years later compared to a matched comparison group, driven by chronic home dust exposure rather than acute dust cloud exposure. PCDD/F and TEQ levels substantially exceeded those in similar-aged NHANES participants. Future studies are warranted to explore associations of PCDD/Fs with health and developmental outcomes among individuals exposed to the WTC disaster as children.
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Affiliation(s)
- Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, 403 East 34th Street, New York, NY 10016, USA.
| | - Xiaoxia Han
- Department of Population Health, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA.
| | - Tony T Koshy
- Department of Pediatrics, New York University School of Medicine, 403 East 34th Street, New York, NY 10016, USA.
| | - Yongzhao Shao
- Department of Population Health, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA; Department of Environmental Medicine, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA.
| | - Dinh Binh Chu
- Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, NY 12201, USA.
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, NY 12201, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY 12201-0509, USA.
| | - Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, 403 East 34th Street, New York, NY 10016, USA; Department of Population Health, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA; Department of Environmental Medicine, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA; Department of Medicine, New York University School of Medicine, 550 1st Avenue, New York, NY 10016, USA; NYU Wagner School of Public Service, 295 Lafayette Street, New York, NY 10012, USA; NYU College of Global Public Health, 726 Broadway, New York, NY 10012, USA.
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Kahn LG, Buka SL, Cirillo PM, Cohn BA, Factor-Litvak P, Gillman MW, Susser E, Lumey LH. Evaluating the Relationship Between Birth Weight for Gestational Age and Adult Blood Pressure Using Participants From a Cohort of Same-Sex Siblings, Discordant on Birth Weight Percentile. Am J Epidemiol 2017; 186:550-554. [PMID: 28911011 PMCID: PMC5860079 DOI: 10.1093/aje/kwx126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/14/2016] [Accepted: 09/14/2016] [Indexed: 02/03/2023] Open
Abstract
Many studies have described an inverse relationship between birth weight and blood pressure (BP). Debate continues, however, over the magnitude and validity of the association. This analysis draws on the Early Determinants of Adult Health study (2005-2008), a cohort of 393 US adults (mean age 43 years; 47% male), including 114 same-sex sibling pairs deliberately sampled to be discordant on sex-specific birth weight for gestational age (BW/GA) in order to minimize confounding in studies of fetal growth and midlife health outcomes. Every quintile increment in BW/GA percentile was associated with a 1.04-mm Hg decrement in adult systolic BP (95% confidence interval (CI): -2.14, 0.06) and a 0.63-mm Hg decrement in diastolic BP (95% CI: -1.35, 0.09), controlling for sex, age, site, smoking, and race/ethnicity. The relationship was strongest among those in the lowest decile of BW/GA. Adding adult body mass index to the models attenuated the estimates (e.g., to -0.90 mm Hg (95% CI: -1.94, 0.14) for systolic BP). In the sibling-pair subgroup, associations were slightly stronger but with wider confidence intervals (e.g., -1.22 mm Hg (95% CI: -5.20, 2.75) for systolic BP). In conclusion, we found a small inverse relationship between BW/GA and BP in cohort and sibling-pair analyses, but the clinical or public health significance is likely limited.
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Affiliation(s)
| | | | | | | | | | | | | | - L. H. Lumey
- Correspondence to Dr. L. H. Lumey, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1617, New York, NY 10032 (e-mail: )
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