Pre-Pregnancy Maternal Exposure to Persistent Organic Pollutants and Gestational Weight Gain: A Prospective Cohort Study.
Persistent organic pollutants (POPs) have been implicated in the development of obesity in non-pregnant adults. However, few studies have explored the association of POPs with gestational weight gain (GWG), an important predictor of future risk of obesity in both the mother and offspring. We estimated the association of maternal pre-pregnancy levels of 63 POPs with GWG. Data are from women (18-40 years; n = 218) participating in a prospective cohort study. POPs were assessed using established protocols in pre-pregnancy, non-fasting blood samples. GWG was assessed using three techniques: (1) total GWG (difference between measured pre-pregnancy weight and final self-reported pre-delivery weight); (2) category based on pre-pregnancy body mass index (BMI)-specific Institute of Medicine (IOM) recommendations; and (3) area under the GWG curve (AUC). In an exploratory analysis, effects were estimated separately for women with BMI < 25 kg/m² versus BMI ≥ 25 kg/m². Multivariable polytomous logistic regression and linear regression were used to estimate the association between each chemical or congener and the three GWG outcomes. p,p'-dichlorodiphenyl trichloroethane (p,p'-DDT) was significantly inversely associated with AUC after adjustment for lipids and pre-pregnancy BMI: beta {95% confidence interval (CI)}, -378.03 (-724.02, -32.05). Perfluorooctane sulfonate (PFOS) was significantly positively associated with AUC after adjustment for lipids among women with a BMI < 25 kg/m² {beta (95% CI), 280.29 (13.71, 546.86)}, but not among women with a BMI ≥ 25 kg/m² {beta (95% CI), 56.99 (-328.36, 442.34)}. In summary, pre-pregnancy levels of select POPs, namely, p,p'-DDT and PFOS, were moderately associated with GWG. The association between POPs and weight gain during pregnancy may be more complex than previously thought, and adiposity prior to pregnancy may be an important effect modifier.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA. jaacks@hsph.harvard.edu.
Lindsay M
LM
Jaacks
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. dbbarr@emory.edu.
Dana
D
Boyd Barr
Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD 20852, USA. sundaramr2@mail.nih.gov.
Rajeshwari
R
Sundaram
Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD 20852, USA. grewalja@mail.nih.gov.
Jagteshwar
J
Grewal
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD 20852, USA. zhangcu@mail.nih.gov.
Cuilin
C
Zhang
Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD 20852, USA. louisg@mail.nih.gov.
Germaine M
GM
Buck Louis
D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016014:Linear Models; D018811:Maternal Exposure / Q000009:adverse effects*; D009930:Organic Chemicals / Q000009:adverse effects* / Q000032:analysis; D011247:Pregnancy; D011446:Prospective Studies; D012306:Risk; D015430:Weight Gain / Q000187:drug effects*; D055815:Young Adult
D004785:Environmental Pollutants; D009930:Organic Chemicals
obesity; organochlorine pesticides; persistent organic pollutants; pregnancy