title: Impact of low-level gestational exposure to organophosphate pesticides on neurobehavior in early infancy: a prospective study.
abstract: BACKGROUND
  National data suggest widespread gestational exposure to organophosphate pesticides (OPs) based on the detection of OP metabolites in the urine of pregnant women. Associations with early infant neurobehavior are largely understudied, with only two studies reporting abnormal reflexes in newborns in association with gestational exposure to OPs. Our objective was to utilize biological markers of OP metabolites in pregnant women and a comprehensive assessment of infant neurobehavior to determine the association of gestational exposure to OPs with neurobehavioral outcomes during early infancy.
  
  
  METHODS
  Among a cohort of 350 mother/infant pairs, we measured six common dialkylphosphate metabolites of OP pesticides in maternal urine, at two times during pregnancy (16 w & 26 w gestation), then calculated aggregate concentrations of diethylphosphate, dimethylphosphate, and total dialkyphosphate metabolites. We measured infant neurobehavior at about five weeks of age using the NICU Network Neurobehavioral Scale (NNNS), a comprehensive assessment of neurobehavior in young infants. Analyses of associations between gestational exposure to OPs and neurobehavior at five weeks included multiple linear and logistic regression.
  
  
  RESULTS
  After adjustment for covariates, higher creatinine-corrected urinary concentrations of diethylphosphate metabolites were associated with improved attention and reduced lethargy and hypotonia in young infants. Higher creatinine-corrected urinary concentrations of total dialkylphosphate metabolites were associated with fewer signs of autonomic stress. Women who were white, married, had advanced education, and reported more frequent consumption of fresh fruits and vegetables had higher concentrations of OP metabolites during pregnancy.
  
  
  CONCLUSIONS
  In this sample of pregnant women whose urinary concentrations of dialkylphosphate metabolites are representative of national exposure levels, we found no detrimental effects of gestational exposure to OPs on neurobehavioral outcomes among young infants. These results are important as they suggest there may be minimal to no detectable adverse impact of low level prenatal OP exposure on the neurobehavior of young infants.
authors.affiliation: Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. kimberly.yolton@cchmc.org.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Yolton
authors.forename: Yingying
authors.initials: Y
authors.lastname: Xu
authors.forename: Heidi
authors.initials: H
authors.lastname: Sucharew
authors.forename: Paul
authors.initials: P
authors.lastname: Succop
authors.forename: Mekibib
authors.initials: M
authors.lastname: Altaye
authors.forename: Ann
authors.initials: A
authors.lastname: Popelar
authors.forename: M Angela
authors.initials: MA
authors.lastname: Montesano
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Calafat
authors.forename: Jane C
authors.initials: JC
authors.lastname: Khoury
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine; D015331:Cohort Studies; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000652:urine*; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000187:drug effects*; D007231:Infant, Newborn; D018811:Maternal Exposure; D009820:Ohio; D010755:Organophosphates / Q000652:urine*; D009943:Organophosphorus Compounds / Q000652:urine; D010575:Pesticides / Q000652:urine*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004785:Environmental Pollutants; D010755:Organophosphates; D009943:Organophosphorus Compounds; D010575:Pesticides; C007477:dimethyl phosphate
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