title: Chlordecone exposure, length of gestation, and risk of preterm birth.
abstract: Persistent organic pollutants have not been conclusively associated with length of gestation or with preterm birth. Chlordecone is an organochlorine pesticide that has been extensively used to control the banana root borer population in the French West Indies. Data from the Timoun Mother-Child Cohort Study conducted in Guadeloupe between 2004 and 2007 were used to examine the associations of chlordecone concentrations in maternal plasma with the length of gestation and the rate preterm birth in 818 pregnant women. Data were analyzed using multivariate linear regression for length of gestation and a Cox model for preterm birth. The median plasma chlordecone concentration was 0.39 µg/L (interquartile range, 0.18-0.83). No correlation was observed with plasma concentrations of p,p'-dichlorodiphenyl dichloroethene (ρ = 0.017) or polychlorinated biphenyl 153 (ρ = -0.016), the other main organochlorine compounds detected. A 1-log10 increase in chlordecone concentration was associated with a decreased length of gestation (-0.27 weeks; 95% confidence interval: -0.50, -0.03) and an increased risk of preterm birth (60%; 95% confidence interval: 10, 130). These associations may result from the estrogen-like and progestin-like properties of chlordecone. These results are of public health relevance because of the prolonged persistence of chlordecone in the environment and the high background rate of preterm births in this population.
authors.forename: Philippe
authors.initials: P
authors.lastname: Kadhel
authors.forename: Christine
authors.initials: C
authors.lastname: Monfort
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costet
authors.forename: Florence
authors.initials: F
authors.lastname: Rouget
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Thomé
authors.forename: Luc
authors.initials: L
authors.lastname: Multigner
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Cordier
mesh_terms: D000328:Adult; D007631:Chlordecone / Q000009:adverse effects* / Q000097:blood; D003633:Dichlorodiphenyl Dichloroethylene / Q000009:adverse effects / Q000097:blood; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000097:blood; D005260:Female; D005865:Gestational Age; D019430:Guadeloupe / Q000453:epidemiology; D006801:Humans; D007306:Insecticides / Q000009:adverse effects* / Q000097:blood; D016014:Linear Models; D011078:Polychlorinated Biphenyls / Q000009:adverse effects / Q000097:blood; D011247:Pregnancy / Q000097:blood; D047928:Premature Birth / Q000139:chemically induced* / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D007306:Insecticides; D003633:Dichlorodiphenyl Dichloroethylene; D011078:Polychlorinated Biphenyls; D007631:Chlordecone
keywords: French West Indies; chlordecone; length of gestation; persistent organic pollutants; pesticides; preterm birth