title: Persistent organochlorines and hypertensive disorders of pregnancy.
abstract: Although there is indirect evidence to suggest that persistent organochlorines might increase risk of hypertensive disorders of pregnancy, there are no epidemiologic studies directly addressing this question. In this cohort study, sampled from the Collaborative Perinatal Project, 1933 women had complete data on organochlorine measurements, covariates, and pregnancy outcomes. Exposures to organochlorines were divided into quintiles, and levels were much higher in these patients recruited from 1959 to 1965 compared to levels in the general population at present. Among included women, 364 developed gestational hypertension (hypertension without proteinuria) and 131 developed preeclampsia (hypertension with proteinuria). We found essentially no association between serum DDE and total PCBs and risk of either gestational hypertension or preeclampsia. Results for other organochlorines showed varying patterns of results: DDT was inversely associated with risk of gestational hypertension (p for trend <0.001), B-Hexachlorocyclohexane and heptachlor epoxide were inversely related to gestational hypertension (p trend <0.01 and 0.10, respectively), dieldrin had a modestly positive association with gestational hypertension (p for trend=0.12), and hexachlorobenzene, trans-nonachlor, and oxychlordane yielded results close to the null. Hexachlorobenzene showed an inverse association with preeclampsia (p for trend <0.001). The study suggests that persistent organochlorines present at historically high level are not likely to increase the risk of hypertensive disorders of pregnancy, suggesting that other toxicants that have similar biologic effects are also unlikely to do so.
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, 47 George Street, Room 302, Providence, RI 02912, USA. Electronic address: david_savitz@brown.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
authors.affiliation: Nationwide Children׳s Hospital, Departments of Pediatrics and Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA. Electronic address: Mark.Klebanoff@nationwidechildrens.org.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Klebanoff
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, 47 George Street, Room 302, Providence, RI 02912, USA. Electronic address: Gregory_wellenius@brown.edu.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Wellenius
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA. Electronic address: elizabeth.jensen@nih.gov.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Jensen
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA. Electronic address: Longnec1@niehs.nih.gov.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Longnecker
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000009:adverse effects* / Q000097:blood; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006843:Hydrocarbons, Chlorinated
keywords: DDT; Gestational hypertension; Organochlorines; PCBs; Preeclampsia
references.citation: J Anal Toxicol. 1996 Nov-Dec;20(7):528-36
references.pmid: 8934301
references.citation: Environ Health Perspect. 2009 Nov;117(11):1773-9
references.pmid: 20049131
references.citation: Epidemiology. 1995 Jul;6(4):450-4
references.pmid: 7548361
references.citation: BMJ. 2005 Mar 12;330(7491):565
references.pmid: 15743856
references.citation: Environ Int. 2013 May;55:1-8
references.pmid: 23454278
references.citation: Best Pract Res Clin Obstet Gynaecol. 2011 Aug;25(4):391-403
references.pmid: 21333604
references.citation: Environ Health Perspect. 2009 Apr;117(4):568-73
references.pmid: 19440495
references.citation: Am J Obstet Gynecol. 2013 Oct;209(4):327.e1-17
references.pmid: 23711667
references.citation: Epidemiology. 2007 Jul;18(4):461-8
references.pmid: 17568219
references.citation: Best Pract Res Clin Obstet Gynaecol. 2011 Jun;25(3):329-42
references.pmid: 21349772
references.citation: N Engl J Med. 2010 Apr 8;362(14):1282-91
references.pmid: 20375405
references.citation: Environ Health Perspect. 2012 Aug;120(8):1201-7
references.pmid: 22450153
references.citation: J Obstet Gynaecol. 2012 Aug;32(6):512-7
references.pmid: 22779950
references.citation: Epidemiology. 2005 Sep;16(5):641-7
references.pmid: 16135940
references.citation: Matern Child Health J. 2014 May;18(4):829-38
references.pmid: 23793484
references.citation: Epidemiology. 2012 May;23(3):386-92
references.pmid: 22370857
references.citation: Matern Child Health J. 2013 Apr;17(3):545-55
references.pmid: 22544506
references.citation: Lancet. 2001 Jul 14;358(9276):110-4
references.pmid: 11463412