title: Prenatal exposure to chlordecone, gestational weight gain, and birth weight in a Guadeloupean birth cohort.
abstract: BACKGROUND
  Chlordecone is a persistent organochlorine insecticide with well-defined estrogenic properties. It was intensively used in the French West Indies until 1993 to control the banana root borer. Because of the long-term contamination of soils and water, the population is currently exposed to chlordecone through food consumption. Chlordecone has been found in the blood of pregnant women and in cord blood. It has been shown to be an endocrine-disrupting chemical and exposure during pregnancy may affect fetal growth.
  
  
  OBJECTIVE
  The objective of our study was to examine the association between prenatal exposure to chlordecone and fetal growth based on the TIMOUN birth cohort conducted in Guadeloupe, with a focus on the potential modification of this relationship by maternal body mass index (BMI) and gestational weight gain (GWG).
  
  
  METHODS
  Chlordecone was determined in cord plasma at birth in 593 babies. Birth weight was the indicator of fetal growth. Maternal pre-pregnancy BMI and GWG were determined. Adherence to GWG recommendations of the US Institute of Medicine based on maternal pre-pregnancy BMI was assessed. Birth weight was analyzed relative to cord blood chlordecone levels using linear and non-linear regression models.
  
  
  RESULTS
  Overall chlordecone in cord blood was not associated with birth weight, but we found an interaction between chlordecone exposure with GWG and adherence to GWG recommendations. After stratification by GWG, we found a significant U-shaped association between birth weight and chlordecone exposure, within the upper quartiles of GWG or excessive GWG.
  
  
  CONCLUSIONS
  Chlordecone exposure may affect fetal growth, particularly when excessive GWG is present.
authors: INSERM, IRSET, UMR 1085, Rennes, France; University Rennes 1, Rennes, France.
authors: David
authors: D
authors: Hervé
authors: INSERM, IRSET, UMR 1085, Rennes, France; University Rennes 1, Rennes, France. Electronic address: nathalie.costet@univ-rennes1.fr.
authors: Nathalie
authors: N
authors: Costet
authors: INSERM, IRSET, UMR 1085, Rennes, France; Pôle Parent-Enfant, Service de Gynécologie et Obstétrique, CHU Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France.
authors: Philippe
authors: P
authors: Kadhel
authors: INSERM, IRSET, UMR 1085, Rennes, France; Department of Pediatrics, University Hospital, Rennes, France.
authors: Florence
authors: F
authors: Rouget
authors: INSERM, IRSET, UMR 1085, Rennes, France; University Rennes 1, Rennes, France.
authors: Christine
authors: C
authors: Monfort
authors: Laboratory of Animal Ecology and Ecotoxicology, Centre of Analytical Research and Technology (CART), University of Liège, Liège, Belgium.
authors: Jean-Pierre
authors: JP
authors: Thomé
authors: INSERM, IRSET, UMR 1085, Rennes, France; University Rennes 1, Rennes, France.
authors: Luc
authors: L
authors: Multigner
authors: INSERM, IRSET, UMR 1085, Rennes, France; University Rennes 1, Rennes, France.
authors: Sylvaine
authors: S
authors: Cordier
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight / Q000187:drug effects*; D007631:Chlordecone / Q000097:blood / Q000633:toxicity*; D005260:Female; D047109:Fetal Development / Q000187:drug effects*; D019430:Guadeloupe; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D015430:Weight Gain / Q000187:drug effects; D055815:Young Adult
chemical_list: D007631:Chlordecone
keywords: Birth weight; Chlordecone; Gestational weight gain; Organochlorine insecticide; Prenatal exposure