title: Maternal exposure to brominated flame retardants and infant Apgar scores.
abstract: Brominated flame retardants (BFRs) and other persistent organic pollutants have been associated with adverse health outcomes in humans and may be particularly toxic to the developing fetus. We investigated the association between in utero polybrominated biphenyl (PBB) and polychlorinated biphenyl (PCB) exposures and infant Apgar scores in a cohort of Michigan residents exposed to PBB through contaminated food after an industrial accident. PBB and PCB concentrations were measured in serum at the time the women were enrolled in the cohort. PBB concentrations were also estimated at the time of conception for each pregnancy using a validated elimination model. Apgar scores, a universal measure of infant health at birth, measured at 1 and 5min, were taken from birth certificates for 613 offspring born to 330 women. Maternal PCB concentrations at enrollment were not associated with below-median Apgar scores in this cohort. However, maternal PBB exposure was associated with a dose-related increase in the odds of a below-median Apgar score at 1min and 5min. Among infants whose mothers had an estimated PBB at conception above the limit of detection of 1 part per billion (ppb) to <2.5ppb, the odds ratio=2.32 (95% CI: 1.22-4.40); for those with PBB⩾2.5ppb the OR=2.62 (95% CI: 1.38-4.96; test for trend p<0.01). Likewise, the odds of a below-median 5min Apgar score increased with higher maternal PBB at conception. It remains critical that future studies examine possible relationships between in utero exposures to brominated compounds and adverse health outcomes.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States. Electronic address: mterrel@emory.edu.
authors.forename: Metrecia L
authors.initials: ML
authors.lastname: Terrell
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
authors.forename: Kathleen P
authors.initials: KP
authors.lastname: Hartnett
authors.affiliation: Departments of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas, Houston, TX, United States.
authors.forename: Hyeyeun
authors.initials: H
authors.lastname: Lim
authors.affiliation: Departments of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States; Division of Environmental Health, Bureau of Epidemiology, Michigan Department of Community Health, Lansing, MI, United States.
authors.forename: Julie
authors.initials: J
authors.lastname: Wirth
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Department of Pediatrics, Emory University, Atlanta, GA, United States; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
authors.forename: Michele
authors.initials: M
authors.lastname: Marcus
mesh_terms: D000328:Adult; D001034:Apgar Score; D004785:Environmental Pollutants / Q000097:blood* / Q000633:toxicity; D005260:Female; D005411:Flame Retardants / Q000032:analysis* / Q000633:toxicity; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D057230:Limit of Detection; D018811:Maternal Exposure; D008824:Michigan; D016017:Odds Ratio; D011075:Polybrominated Biphenyls / Q000097:blood* / Q000633:toxicity; D011078:Polychlorinated Biphenyls / Q000097:blood / Q000633:toxicity; D011247:Pregnancy; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D005411:Flame Retardants; D011075:Polybrominated Biphenyls; D011078:Polychlorinated Biphenyls
keywords: Brominated flame retardants; In utero exposures; Infant Apgar scores; Polybrominated biphenyls; Polychlorinated biphenyls