Fetal, Neonatal And Childhood Effects Of In Utero Exposu

Child Health And Human Development

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Abstract

The long-term effects of in utero exposure to organochlorine compounds is of great potential importance. These compounds, which are detectable in nearly 100% of humans worldwide, have been linked to impaired neurodevelopment in children. In addition, p,p'-DDE, the primary metabolite of DDT, is a weak estrogen, and an androgen receptor blocker at concentrations observed in humans. One objective of this project is to determine whether maternal serum concentration of DDE, obtained during pregnancy, is a risk factor for cryptorchidism, hypospadias and polythelia in male offspring. These malformations were chosen because they are markers of deficient androgen activity in utero. Other objectives are to determine whether in utero exposure to DDE is subsequently associated with an altered age at menarche in adolescent females and an increased risk of obesity in adolescent males, and whether in utero exposure to PCBs is associated with suboptimal muscle tone, reflexes, IQ and hearing during childhood. Work to date has demonstrated that these compounds can be recovered from the study population at relevant concentrations, and that the correlation between concentrations of these compounds in first and third trimester serum is sufficiently high to employ third-trimester serum as a surrogate for first-trimester exposure. Work completed in FY 2001 found that elevated maternal serum DDE was strongly associated with both preterm (odds ratio for 60 mg/l=3.1, p for trend <0.0001) and SGA (odds ratio for 60 mg/l=2.6, p for trend=0.04) birth. Since DDT is still used for malaria control in many developing countries, these findings have important implications for international health. It was also found that serum PCB levels are higher in pregnant diabetic women than in non-diabetic women, even after adjustment for the hyperlipidemia associated with diabetes. Finally, a modest positive association was observed between maternal serum DDE concentration during pregnancy and congenital anomalies suggestive of deficient androgen action in male infants.