title: Hypertensive disorders of pregnancy and gestational diabetes mellitus among French Caribbean women chronically exposed to chlordecone.
abstract: Few studies have explored the consequences of environmental exposure to organochlorine pesticides for gestational hypertension (GH), preeclampsia (PE) and gestational diabetes mellitus (GDM). Chlordecone is a persistent organochlorine pesticide that was used intensively, and almost exclusively, in the French West Indies until 1993. We investigated the impact of prenatal exposure to chlordecone on the occurrence of GDM, GH and PE by studying 779 pregnant women enrolled in a prospective mother-child cohort (Timoun Study) in Guadeloupe between 2004 and 2007. Chlordecone exposure was determined by assaying maternal plasma and information about pregnancy complications was obtained from midwives, pediatricians and hospital medical records after delivery. The risks of GH (n=65), PE (n=31) and GDM (n=71) were estimated by multiple logistic regression including potential confounders. Levels of chlordecone plasma concentration in the third (OR=0.2; 95% confidence interval (CI): 0.1, 0.5) and fourth quartiles (OR=0.3; 95% CI: 0.2, 0.7) were associated with a statistically significant decrease in the risk of GH. A log10 increase in chlordecone concentration was significantly associated with lower risk of GH (OR=0.4; 95% CI: 0.2, 0.6). No significant associations were observed between the chlordecone exposure and the risk of PE or GDM. This study suggests an inverse association between chlordecone exposure during pregnancy and GH. Further studies are required to determine the underlying mechanism, or the potential unknown confounding factors, resulting in this association.
authors.affiliation: Team of Epidemiological Research on Environment, Reproduction and Development, National Institute for Health and Medical Research (INSERM UMR1085, IRSET), Rennes, France.
authors.forename: Lauren
authors.initials: L
authors.lastname: Saunders
authors.affiliation: Team of Epidemiological Research on Environment, Reproduction and Development, National Institute for Health and Medical Research (INSERM UMR1085, IRSET), Rennes, France; Gynecology and Obstetric Unit, CHU Pointe à Pitre/Abymes, Guadeloupe, French West Indies, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Kadhel
authors.affiliation: Team of Epidemiological Research on Environment, Reproduction and Development, National Institute for Health and Medical Research (INSERM UMR1085, IRSET), Rennes, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costet
authors.affiliation: Team of Epidemiological Research on Environment, Reproduction and Development, National Institute for Health and Medical Research (INSERM UMR1085, IRSET), Rennes, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Rouget
authors.affiliation: Team of Epidemiological Research on Environment, Reproduction and Development, National Institute for Health and Medical Research (INSERM UMR1085, IRSET), Rennes, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Monfort
authors.affiliation: Center for Analytical Research and Technology, Liege University, Belgium.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Thomé
authors.affiliation: French Institute for Public Health Surveillance (InVS), Department of Environmental Health, St-Maurice, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Guldner
authors.affiliation: Team of Epidemiological Research on Environment, Reproduction and Development, National Institute for Health and Medical Research (INSERM UMR1085, IRSET), Rennes, France.
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Cordier
authors.affiliation: Team of Epidemiological Research on Environment, Reproduction and Development, National Institute for Health and Medical Research (INSERM UMR1085, IRSET), Rennes, France. Electronic address: luc.multigner@inserm.fr.
authors.forename: Luc
authors.initials: L
authors.lastname: Multigner
mesh_terms: D000328:Adult; D017691:Caribbean Region; D007631:Chlordecone / Q000009:adverse effects* / Q000097:blood; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000209:etiology; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000097:blood / Q000737:chemistry; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology* / Q000209:etiology; D007306:Insecticides / Q000009:adverse effects* / Q000097:blood; D016015:Logistic Models; D018811:Maternal Exposure; D008875:Middle Aged; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D004785:Environmental Pollutants; D007306:Insecticides; D007631:Chlordecone
keywords: Chlordecone; Endocrine disruptor; Gestational diabetes; Gestational hypertension; Organochlorine pesticides; Preeclampsia