title: Maternal diet, prenatal exposure to dioxin-like compounds and birth outcomes in a European prospective mother-child study (NewGeneris).
abstract: Maternal diet can result in exposure to environmental contaminants including dioxins which may influence foetal growth. We investigated the association between maternal diet and birth outcomes by defining a dioxin-rich diet. We used validated food frequency questionnaires to assess the diet of pregnant women from Greece, Spain, United Kingdom, Denmark and Norway and estimated plasma dioxin-like activity by the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR-CALUX®) bioassay in 604 maternal blood samples collected at delivery. We applied reduced rank regression to identify a dioxin-rich dietary pattern based on dioxin-like activity (DR-CALUX®) levels in maternal plasma, and calculated a dioxin-diet score as an estimate of adherence to this dietary pattern. In the five country population, dioxin-diet score was characterised by high consumption of red and white meat, lean and fatty fish, low-fat dairy and low consumption of salty snacks and high-fat cheese, during pregnancy. The upper tertile of the dioxin-diet score was associated with a change in birth weight of -121g (95% confidence intervals: -232, -10g) compared to the lower tertile after adjustment for confounders. A small non-significant reduction in gestational age was also observed (-1.4days, 95% CI: -3.8, 1.0days). Our results suggest that maternal diet might contribute to the exposure of the foetus to dioxins and dioxin-like compounds and may be related to reduced birth weight. More studies are needed to develop updated dietary guidelines for women of reproductive age, aiming to the reduction of dietary exposure to persistent organic pollutants as dioxins and dioxin-like compounds.
authors.affiliation: Division of Environmental Medicine, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway; Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Spain; Pompeu Fabra University, Plaça de la Mercè 10-12, 08002 Barcelona, Spain. Electronic address: Eleni.Papadopoulou@fhi.no.
authors.forename: Eleni
authors.initials: E
authors.lastname: Papadopoulou
authors.affiliation: Pompeu Fabra University, Plaça de la Mercè 10-12, 08002 Barcelona, Spain; Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro 3-5, 28029 Madrid, Spain; National School of Public Health, Alexandras Avenue 196, 11521 Athens, Greece.
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.affiliation: National Hellenic Research Foundation, Institute of Biological Research and Biotechnology, Vassileos Constantinou Avenue 48, 11635 Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Botsivali
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Spain; Pompeu Fabra University, Plaça de la Mercè 10-12, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro 3-5, 28029 Madrid, Spain; INSERM (National Institute of Health Medical Research), Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, BP 170, La Tronche, F-38042 Grenoble Cedex 9, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Pedersen
authors.affiliation: BioDetection Systems B.V., Science Park 406, 1098 XH Amsterdam, The Netherlands.
authors.forename: Harrie
authors.initials: H
authors.lastname: Besselink
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mendez
authors.affiliation: Centre for Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fleming
authors.affiliation: Centre for Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Hardie
authors.affiliation: Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
authors.forename: Lisbeth E
authors.initials: LE
authors.lastname: Knudsen
authors.affiliation: Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK.
authors.forename: John
authors.initials: J
authors.lastname: Wright
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain; Parc de Salut Mar, Obstetrics and Gynaecology Department, Passeig Marítim 25-29, 08003 Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Agramunt
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Spain; Pompeu Fabra University, Plaça de la Mercè 10-12, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro 3-5, 28029 Madrid, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.affiliation: Division of Environmental Medicine, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway.
authors.forename: Berit
authors.initials: B
authors.lastname: Granum
authors.affiliation: Division of Environmental Medicine, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway.
authors.forename: Kristine B
authors.initials: KB
authors.lastname: Gutzkow
authors.affiliation: Division of Environmental Medicine, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Brunborg
authors.affiliation: Division of Environmental Medicine, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Alexander
authors.affiliation: Division of Environmental Medicine, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway.
authors.forename: Helle Margrete
authors.initials: HM
authors.lastname: Meltzer
authors.affiliation: Division of Environmental Medicine, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway.
authors.forename: Anne Lise
authors.initials: AL
authors.lastname: Brantsæter
authors.affiliation: Department of Social Medicine, Medical School, University of Crete, Voutes Campus, Heraklion, Crete GR-71003, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Sarri
authors.affiliation: Department of Social Medicine, Medical School, University of Crete, Voutes Campus, Heraklion, Crete GR-71003, Greece.
authors.forename: Leda
authors.initials: L
authors.lastname: Chatzi
authors.affiliation: Epidemiology, Biostatistics, and Clinical Trials, National Cancer Research Institute, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
authors.forename: Domenico F
authors.initials: DF
authors.lastname: Merlo
authors.affiliation: Department of Toxicogenomics, Maastricht University, Universiteitssingel 40, 6229ER Maastricht, The Netherlands.
authors.forename: Jos C
authors.initials: JC
authors.lastname: Kleinjans
authors.affiliation: Division of Environmental Medicine, Norwegian Institute of Public Health, Lovisenberggata 8, 0456 Oslo, Norway.
authors.forename: Margaretha
authors.initials: M
authors.lastname: Haugen
mesh_terms: D000328:Adult; D001724:Birth Weight; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004032:Diet / Q000706:statistics & numerical data*; D004147:Dioxins / Q000097:blood*; D058735:Environmental Policy; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006115:Greece / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000706:statistics & numerical data*; D009035:Mothers; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D004147:Dioxins; D004785:Environmental Pollutants
keywords: Birth weight; Cohort study; DR-CALUX; Dietary patterns; Dioxins; Pregnancy