Abstract
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.
Highlights
Persistent organic pollutants (POPs) are a class of compounds that includes pesticides, electrical insulators, surfactants, solvents and flame retardants, among other industrial chemicals
Several POPs were banned more recently, for example the production and import of certain commercial mixtures of polybrominated diphenyl ethers (PBDEs; penta-BDE, which primarily consists of congeners 85, 99 and 100; and octa-BDE, which primarily consists of congeners 183 and 203) were banned in the United States in 2004
One participant was excluded from the area under the GWG curve (AUC) analysis because she only had her measured pre-pregnancy weight and her final self-reported pregnancy weight; her AUC would assume she carried all of the weight she gained over pregnancy (54 pounds) for the full duration of the pregnancy
Summary
Persistent organic pollutants (POPs) are a class of compounds that includes pesticides, electrical insulators, surfactants, solvents and flame retardants, among other industrial chemicals. Many POPs were banned in the United States in the late 1970s, but due to their persistence in the environment and bioaccumulation in the food chain, levels are still detectable in nationally-representative samples [1]. To date, few studies have explored the association of POPs with weight gain in humans over short periods of time, such as weight gain during pregnancy. Excess gestational weight gain (GWG) is associated with increased weight retention and obesity in the mother [5], as well as increased risk of obesity in the offspring [6]. Identifying predictors of excess GWG is an important aspect of addressing the obesity epidemic in the United States and other countries [7]
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