PMID- 31886849 OWN - NLM STAT- MEDLINE DCOM- 20201125 LR - 20221207 IS - 2168-6211 (Electronic) IS - 2168-6203 (Print) IS - 2168-6203 (Linking) VI - 174 IP - 2 DP - 2020 Feb 1 TI - Association of Maternal Exposure to Persistent Organic Pollutants in Early Pregnancy With Fetal Growth. PG - 149-161 LID - 10.1001/jamapediatrics.2019.5104 [doi] AB - IMPORTANCE: Prenatal exposure to persistent organic pollutants (POPs) has been associated with birth size, but data on fetal growth and among racially/ethnically diverse pregnant women remain scarce. OBJECTIVES: To assess the association between maternal plasma POPs in early pregnancy and fetal growth and by infant sex and maternal race/ethnicity. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used the National Institute of Child Health and Human Development Fetal Growth Studies-Singleton cohort, which recruited nonobese, low-risk pregnant women before 14 weeks' gestation between July 1, 2009, and January 31, 2013, in 12 community-based clinics throughout the United States. Participants self-identified their race/ethnicity, self-reported their behavioral risk factors, and were followed up throughout their pregnancy. Data were analyzed from July 31, 2018, to June 3, 2019. EXPOSURES: Levels of 76 POPs in early gestation plasma were measured: 11 perfluoroalkyl and polyfluoroalkyl substances, 1 polybrominated biphenyl, 9 polybrominated diphenyl ethers (PBDEs), 44 polychlorinated biphenyls (PCBs), and 11 organochlorine pesticides (OCPs). The bayesian kernel machine regression method was used to examine chemical class mixtures, and generalized additive mixed model was used to analyze individual chemicals. MAIN OUTCOMES AND MEASURES: Fourteen fetal biometrics were measured, including head circumference, abdominal circumference, and femur length, within 5 ultrasonography appointments. RESULTS: A total of 2284 low-risk pregnant women were included: 606 women (26.5%) self-identified as white with a mean (SD) age of 30.3 (4.4) years, 589 (25.8%) as black with a mean (SD) age of 25.5 (5.5) years, 635 (27.8%) as Hispanic with a mean (SD) age of 27.1 (5.5) years, and 454 (19.9%) as Asian with a mean (SD) age of 30.5 (4.5) years. A comparison between the 75th and 25th percentile of exposure revealed that the OCP mixture was negatively associated with most fetal growth measures, with a reduction of 4.7 mm (95% CI, -6.7 to -2.8 mm) in head circumference, 3.5 mm (95% CI, -4.7 to -2.2 mm) in abdominal circumference, and 0.6 mm (95% CI, -1.1 to -0.2 mm) in femur length. Higher exposure to the PBDE mixture was associated with reduced abdominal circumference (-2.4 mm; 95% CI, -4.0 to -0.5 mm) and femur length (-0.5 mm; 95% CI, -1.0 to -0.1 mm), and the dioxin-like PCB mixture was associated with reduced head circumference (-6.4 mm; 95% CI, -8.4 to -4.3 mm) and abdominal circumference (-2.4 mm; 95% CI, -3.9 to -0.8 mm). Associations with individual chemicals were less consistent. There were some interactions by fetal sex, although most of the results did not vary by maternal race/ethnicity. For example, oxychlordane (-0.98 mm; 95% CI, -1.60 to -0.36 mm; P for interaction <.001), trans-nonachlor (-0.31 mm; 95% CI, -0.54 to -0.08 mm; P for interaction = .005), and p,p'-dichlorodiphenyldichloroethylene (-0.19 mm; 95% CI, -0.22 to -0.09 mm; P for interaction = .006) were associated with shorter femur length among boys only. CONCLUSIONS AND RELEVANCE: This study found that, among pregnant women with low POP levels, a mixture of OCPs was negatively associated with most fetal growth measures and that mixtures of PBDEs and dioxin-like PCBs were associated with reduced abdominal circumference. These findings suggested that, although exposures may be low, associations with fetal growth are apparent. FAU - Ouidir, Marion AU - Ouidir M AD - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland. FAU - Buck Louis, Germaine M AU - Buck Louis GM AD - College of Health and Human Services, George Mason University, Fairfax, Virginia. FAU - Kanner, Jenna AU - Kanner J AD - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland. FAU - Grantz, Katherine L AU - Grantz KL AD - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland. FAU - Zhang, Cuilin AU - Zhang C AD - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland. FAU - Sundaram, Rajeshwari AU - Sundaram R AD - Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. FAU - Rahman, Mohammad L AU - Rahman ML AD - Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts. FAU - Lee, Sunmi AU - Lee S AD - Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, University at Albany School of Public Health, State University of New York, Albany. FAU - Kannan, Kurunthachalam AU - Kannan K AD - Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, University at Albany School of Public Health, State University of New York, Albany. FAU - Tekola-Ayele, Fasil AU - Tekola-Ayele F AD - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland. FAU - Mendola, Pauline AU - Mendola P AD - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland. LA - eng GR - HHSN275200800013C/HD/NICHD NIH HHS/United States GR - HHSN275200800002I/HD/NICHD NIH HHS/United States GR - HHSN275200800014C/HD/NICHD NIH HHS/United States GR - HHSN275200800012C/HD/NICHD NIH HHS/United States GR - HHSN275200800028C/HD/NICHD NIH HHS/United States GR - HHSN275201000009C/HD/NICHD NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Intramural PL - United States TA - JAMA Pediatr JT - JAMA pediatrics JID - 101589544 RN - 0 (Environmental Pollutants) SB - IM CIN - JAMA Pediatr. 2020 Feb 1;174(2):126-128. PMID: 31886835 MH - Adult MH - Black or African American MH - Asian MH - Cohort Studies MH - Environmental Pollutants/*adverse effects/*blood MH - Female MH - Fetal Development/*drug effects MH - Growth Disorders/*chemically induced MH - Hispanic or Latino MH - Humans MH - Male MH - Maternal Exposure/*adverse effects MH - Pregnancy MH - Pregnancy Trimester, First/*blood MH - White People MH - Young Adult PMC - PMC6990715 COIS- Conflict of Interest Disclosures: None reported. EDAT- 2019/12/31 06:00 MHDA- 2020/11/26 06:00 PMCR- 2020/12/30 CRDT- 2019/12/31 06:00 PHST- 2019/12/31 06:00 [pubmed] PHST- 2020/11/26 06:00 [medline] PHST- 2019/12/31 06:00 [entrez] PHST- 2020/12/30 00:00 [pmc-release] AID - 2757555 [pii] AID - poi190089 [pii] AID - 10.1001/jamapediatrics.2019.5104 [doi] PST - ppublish SO - JAMA Pediatr. 2020 Feb 1;174(2):149-161. doi: 10.1001/jamapediatrics.2019.5104.