title: A rapid questionnaire assessment of environmental exposures to pregnant women in the INTERGROWTH-21st Project.
abstract: Impaired fetal growth and preterm birth are the leading causes of neonatal and infant mortality worldwide and there is a growing scientific literature suggesting that environmental exposures during pregnancy may play a causal role in these outcomes. Our purpose was to assess the environmental exposure of the Fetal Growth Longitudinal Study (FGLS) participants in the multinational INTERGROWTH-21(st) Project. First, we developed a tool that could be used internationally to screen pregnant women for such exposures and administered it in eight countries on a subsample (n = 987) of the FGLS participants. The FGLS is a study of fetal growth among healthy pregnant women living in relatively affluent areas, at low risk of adverse pregnancy outcomes and environmental exposures. We confirmed that most women were not exposed to major environmental hazards that could affect pregnancy outcomes according to the protocol's entry criteria. However, the instrument was able to identify some women that reported various environmental concerns in their homes such as peeling paint, high residential density (>1 person per room), presence of rodents or cockroaches (hence the use of pesticides), noise pollution and safety concerns. This screening tool was therefore useful for the purposes of the project and can be used to ascertain environmental exposures in studies in which the primary aim is not focused on environmental exposures. The instrument can be used to identify subpopulations for more in-depth assessment, (e.g. environmental and biological laboratory markers) to pinpoint areas requiring education, intervention or policy change.
authors.affiliation: Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Eskenazi
authors.forename: A
authors.initials: A
authors.lastname: Bradman
authors.forename: D
authors.initials: D
authors.lastname: Finkton
authors.forename: M
authors.initials: M
authors.lastname: Purwar
authors.forename: J A
authors.initials: JA
authors.lastname: Noble
authors.forename: R
authors.initials: R
authors.lastname: Pang
authors.forename: O
authors.initials: O
authors.lastname: Burnham
authors.forename: L
authors.initials: L
authors.lastname: Cheikh Ismail
authors.forename: F
authors.initials: F
authors.lastname: Farhi
authors.forename: F C
authors.initials: FC
authors.lastname: Barros
authors.forename: A
authors.initials: A
authors.lastname: Lambert
authors.forename: A T
authors.initials: AT
authors.lastname: Papageorghiou
authors.forename: M
authors.initials: M
authors.lastname: Carvalho
authors.forename: Y A
authors.initials: YA
authors.lastname: Jaffer
authors.forename: E
authors.initials: E
authors.lastname: Bertino
authors.forename: M G
authors.initials: MG
authors.lastname: Gravett
authors.forename: D G
authors.initials: DG
authors.lastname: Altman
authors.forename: E O
authors.initials: EO
authors.lastname: Ohuma
authors.forename: S H
authors.initials: SH
authors.lastname: Kennedy
authors.forename: Z A
authors.initials: ZA
authors.lastname: Bhutta
authors.forename: J
authors.initials: J
authors.lastname: Villar
mesh_terms: D002985:Clinical Protocols; D005260:Female; D047109:Fetal Development; D014943:Global Health; D057238:Growth Charts; D006801:Humans; D008137:Longitudinal Studies / Q000379:methods; D018811:Maternal Exposure / Q000706:statistics & numerical data; D015337:Multicenter Studies as Topic / Q000379:methods*; D011247:Pregnancy; D012107:Research Design; D011795:Surveys and Questionnaires
keywords: Environmental exposure; exposure questionnaire; fetal exposure; fetal growth; low birth weight; maternal exposure; pregnancy; preterm