Exposure To Ddt Following Indoor Residual Spraying And Hypertensive Disorders Of Pregnancy In South African Women Participating In The Vhembe Study

Abstract

Introduction: Indoor Residual Spraying (IRS) for malaria control exposes 120 million people to high levels of insecticides such as DDT (dichlorodiphenyltrichloroethane). Evidence suggests DDT exposure may increase blood pressure (BP) but no study has investigated associations with hypertensive disorders of pregnancy (HDP) in an IRS area. Methods: We used data from the NIEHS-funded Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), a birth cohort study of 751 mother-infant pairs in South Africa. Serum concentrations of DDT and its breakdown product, DDE, and proteinuria were measured in pregnant women at delivery. HDP diagnostic (preeclampsia, eclampsia or gestational hypertension) was collected by questionnaire and gestational BP was abstracted from medical records. We used multiple logistic and linear regression models to examine the relation between DDT, DDE and HDP. Results: Geometric mean (GM) concentrations of DDT and DDE in maternal serum were 76.32 ng/g lipid [geometric standard deviation (GSD): 6.02] and 91.66 ng/g lipid (GSD: 4.71), respectively. Current Canadian concentrations measured in an adult population are lower for DDT (GM