scholarly journals Maternal exposure to airborne polychlorinated biphenyls (PCBs) and risk of adverse birth outcomes

2021 ◽  
Author(s):  
Ane Bungum Kofoed ◽  
Laura Deen ◽  
Karin Sørig Hougaard ◽  
Kajsa Ugelvig Petersen ◽  
Harald William Meyer ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Sex Ratio ◽  
Polychlorinated Biphenyls ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Exposure ◽  
Adverse Birth Outcomes ◽  
Secondary Sex Ratio

AbstractHuman health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was − 32 g (95% CI—79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose–response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy

scholarly journals Dengue during pregnancy and live birth outcomes: a cohort of linked data from Brazil

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e023529 ◽  
Author(s):  
Enny S Paixão ◽  
Oona M Campbell ◽  
Maria Gloria Teixeira ◽  
Maria CN Costa ◽  
Katie Harron ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Live Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Severe Dengue ◽  
Maternal Risk ◽  
Increased Risk

ObjectivesDengue is the most common viral mosquito-borne disease, and women of reproductive age who live in or travel to endemic areas are at risk. Little is known about the effects of dengue during pregnancy on birth outcomes. The objective of this study is to examine the effect of maternal dengue severity on live birth outcomes.Design and settingWe conducted a population-based cohort study using routinely collected Brazilian data from 2006 to 2012.ParticipatingWe linked birth registration records and dengue registration records to identify women with and without dengue during pregnancy. Using multinomial logistic regression and Firth method, we estimated risk and ORs for preterm birth (<37 weeks’ gestation), low birth weight (<2500 g) and small for gestational age (<10thcentile). We also investigated the effect of time between the onset of the disease and each outcome.ResultsWe included 16 738 000 live births. Dengue haemorrhagic fever was associated with preterm birth (OR=2.4; 95% CI 1.3 to 4.4) and low birth weight (OR=2.1; 95% CI 1.1 to 4.0), but there was no evidence of effect for small for gestational age (OR=2.1; 95% CI 0.4 to 12.2). The magnitude of the effects was higher in the acute disease period.ConclusionThis study showed an increased risk of adverse birth outcomes in women with severe dengue during pregnancy. Medical intervention to mitigate maternal risk during severe acute dengue episodes may improve outcomes for infants born to exposed mothers.

scholarly journals Adverse birth outcomes and their clinical phenotypes in an urban Zambian cohort

2019 ◽  
Vol 3 ◽  
pp. 1533
Author(s):  
Joan T Price ◽  
Bellington Vwalika ◽  
Katelyn J Rittenhouse ◽  
Humphrey Mwape ◽  
Jennifer Winston ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Phase I ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Sub Saharan Africa ◽  
Age Dating ◽  
Adverse Birth Outcomes ◽  
Short Cervix ◽  
Sub Saharan

Background: Few cohort studies of pregnancy in sub-Saharan Africa use rigorous gestational age dating and clinical phenotyping. As a result, incidence and risk factors of adverse birth outcomes are inadequately characterized. Methods: The Zambian Preterm Birth Prevention Study (ZAPPS) is a prospective observational cohort established to investigate adverse birth outcomes at a referral hospital in urban Lusaka. This report describes ZAPPS phase I, enrolled August 2015 to September 2017. Women were followed through pregnancy and 42 days postpartum. At delivery, study staff assessed neonatal vital status, birthweight, sex, and assigned a delivery phenotype. Primary outcomes were: (1) preterm birth (PTB; delivery <37 weeks), (2) small-for-gestational-age (SGA; <10th percentile weight-for-age at birth), and (3) stillbirth (SB; delivery of an infant without signs of life). Results: ZAPPS phase I enrolled 1450 women with median age 27 years (IQR 23–32). Most participants (68%) were multiparous, of whom 41% reported a prior PTB and 14% reported a prior stillbirth. Twins were present in 3% of pregnancies, 3% of women had short cervix (<25mm), 24% of women were HIV seropositive, and 5% were syphilis seropositive. Of 1216 (84%) retained at delivery, 15% were preterm, 18% small-for-gestational-age, and 4% stillborn. PTB risk was higher with prior PTB (aRR 1.88; 95%CI 1.32–2.68), short cervix (aRR 2.62; 95%CI 1.68–4.09), twins (aRR 5.22; 95%CI 3.67–7.43), and antenatal hypertension (aRR 2.04; 95%CI 1.43–2.91). SGA risk was higher with twins (aRR 2.75; 95%CI 1.81–4.18) and antenatal hypertension (aRR 1.62; 95%CI 1.16–2.26). SB risk was higher with short cervix (aRR 6.42; 95%CI 2.56–16.1). Conclusions: This study confirms high rates of PTB, SGA, and SB among pregnant women in Lusaka, Zambia. Accurate gestational age dating and careful ascertainment of delivery data are critical to understanding the scope of adverse birth outcomes in low-resource settings.

scholarly journals Relatively Low Maternal Aflatoxin Exposure Is Associated with Small-for-Gestational-Age but Not with Other Birth Outcomes in a Prospective Birth Cohort Study of Nepalese Infants

2019 ◽  
Vol 149 (10) ◽  
pp. 1818-1825 ◽  
Author(s):  
Johanna Y Andrews-Trevino ◽  
Patrick Webb ◽  
Gerald Shively ◽  
Beatrice L Rogers ◽  
Kedar Baral ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Birth Cohort ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Serum ◽  
Birth Cohort Study ◽  
Adverse Birth Outcomes ◽  
Z Scores

ABSTRACT Background Exposure to aflatoxin has garnered increased attention as a possible contributor to adverse birth outcomes. Objective The objective of this study was to investigate the relation of maternal aflatoxin exposure with adverse birth outcomes such as birth weight, birth length, anthropometric z scores, low birth weight (LBW), small-for-gestational-age (SGA), stunting, and preterm birth (PTB). Methods This study used maternal and newborn data from the AflaCohort Study, an ongoing birth cohort study in Banke, Nepal (n = 1621). Data on aflatoxin B1 (AFB1)-lysine adducts in maternal serum were collected once during pregnancy (at mean ± SD: 136 ± 43 d of gestation). Maternal serum AFB1-lysine adduct concentration was measured via HPLC. Linear and logistic regression analyses were used to determine if maternal aflatoxin exposure was associated with 1) birth weight and length (primary outcomes) and 2) anthropometric z scores, LBW (weight <2.5 kg), SGA (weight <10th percentile for gestational age and sex), stunting at birth (length-for-age z score less than −2), or PTB (born <37 weeks of gestation) (secondary outcomes). Results The geometric mean of maternal serum AFB1-lysine adduct concentration was 1.37 pg/mg albumin (95% CI: 1.30, 1.44 pg/mg albumin). Twenty percent of infants were of LBW and 32% were SGA. Sixteen percent of infants were stunted at birth. In addition, 13% of infants were born preterm. In logistic multivariate regression models, mean maternal serum AFB1-lysine adduct concentrations were significantly associated with SGA (OR: 1.13; 95% CI: 1.00, 1.27; P < 0.05). Conclusions Findings from this study suggest a small but significant association between serum AFB1-lysine adduct concentrations in pregnant women and SGA. Maternal aflatoxin exposure was not associated with other birth outcomes. These results highlight the need for future research on a threshold level of aflatoxin exposure needed to produce detectable adverse birth outcomes. This trial was registered at clinicaltrials.gov as NCT03312049.

scholarly journals Adverse birth outcomes and their clinical phenotypes in an urban Zambian cohort

2020 ◽  
Vol 3 ◽  
pp. 1533
Author(s):  
Joan T Price ◽  
Bellington Vwalika ◽  
Katelyn J Rittenhouse ◽  
Humphrey Mwape ◽  
Jennifer Winston ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Phase I ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Sub Saharan Africa ◽  
Age Dating ◽  
Adverse Birth Outcomes ◽  
Short Cervix ◽  
Sub Saharan

Background: Few cohort studies of pregnancy in sub-Saharan Africa use rigorous gestational age dating and clinical phenotyping. As a result, incidence and risk factors of adverse birth outcomes are inadequately characterized. Methods: The Zambian Preterm Birth Prevention Study (ZAPPS) is a prospective observational cohort established to investigate adverse birth outcomes at a referral hospital in urban Lusaka. This report describes ZAPPS phase I, enrolled August 2015 to September 2017. Women were followed through pregnancy and 42 days postpartum. At delivery, study staff assessed neonatal vital status, birthweight, and sex, and assigned a delivery phenotype. Primary outcomes were: (1) preterm birth (PTB; delivery <37 weeks), (2) small-for-gestational-age (SGA; <10th percentile weight-for-age at birth), and (3) stillbirth (SB; delivery of an infant without signs of life). Results: ZAPPS phase I enrolled 1450 women with median age 27 years (IQR 23–32). Most participants (68%) were multiparous, of whom 41% reported a prior PTB and 14% reported a prior stillbirth. Twins were present in 3% of pregnancies, 3% of women had short cervix (<25mm), 24% of women were HIV seropositive, and 5% were syphilis seropositive. Of 1216 (84%) retained at delivery, 15% were preterm, 18% small-for-gestational-age, and 4% stillborn. PTB risk was higher with prior PTB (aRR 1.88; 95%CI 1.32–2.68), short cervix (aRR 2.62; 95%CI 1.68–4.09), twins (aRR 5.22; 95%CI 3.67–7.43), and antenatal hypertension (aRR 2.04; 95%CI 1.43–2.91). SGA risk was higher with twins (aRR 2.75; 95%CI 1.81–4.18) and antenatal hypertension (aRR 1.62; 95%CI 1.16–2.26). SB risk was higher with short cervix (aRR 6.42; 95%CI 2.56–16.1). Conclusions: This study confirms high rates of PTB, SGA, and SB among pregnant women in Lusaka, Zambia. Accurate gestational age dating and careful ascertainment of delivery data are critical to understanding the scope of adverse birth outcomes in low-resource settings.

scholarly journals Occupational exposure to inorganic particles during pregnancy and birth outcomes: a nationwide cohort study in Sweden

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023879 ◽  
Author(s):  
Filip Norlén ◽  
Per Gustavsson ◽  
Pernilla Wiebert ◽  
Lars Rylander ◽  
Maria Albin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Welding Fumes ◽  
High Exposure ◽  
Inorganic Particles ◽  
Increased Risk

ObjectivesThe aim of this study was to investigate if occupational exposure to inorganic particles or welding fumes during pregnancy is associated with negative birth outcomes.DesignA prospective national cohort study.SettingAll single births from 1994 to 2012 in Sweden. Information on birth weight, preterm birth, small for gestational age, smoking habits, nationality, age, occupation, absence from work and education was obtained from nationwide registers. Exposure to inorganic particles (mg/m3) was assessed from a job exposure matrix.ParticipantsThis study included all single births by occupationally active mothers (995 843).Outcome measuresAssociations between occupational exposures and negative birth outcomes in the form of low birth weight, preterm birth and small for gestational age.ResultsMothers who had high exposure to inorganic particles and had less than 50 days (median) of absence from work during pregnancy showed an increased risk of preterm birth (OR 1.18; 95% CI 1.07 to 1.30), low birth weight (OR 1.32; 95% CI 1.18 to 1.48) as well as small for gestational age (OR 1.20; 95% CI 1.04 to 1.39). The increased risks were driven by exposure to iron particles. No increased risks were found in association with exposure to stone and concrete particles. High exposure to welding fumes was associated with an increased risk of low birth weight (OR 1.22; 95% CI 1.02 to 1.45) and preterm birth (OR 1.24; 95% CI 1.07 to 1.42).ConclusionsThe results indicate that pregnant women should not be exposed to high levels of iron particles or welding fumes.

scholarly journals Variation in Birth Outcomes by Mother’s Country of Birth Among Hispanic Women in the United States, 2013

2018 ◽  
Vol 133 (3) ◽  
pp. 318-328 ◽  
Author(s):  
Carla L. DeSisto ◽  
Jill A. McDonald
Keyword(s):  
United States ◽  
Birth Weight ◽  
Preterm Birth ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Hispanic Women ◽  
The United States ◽  
Country Of Birth ◽  
Foreign Born

Objectives: Despite knowledge that the Hispanic population is growing in the United States and that birth outcomes may vary by maternal country of birth, data on birth outcomes by maternal country of birth among Hispanic women are scant. We compared the rates of 3 birth outcomes for infants born in the United States—preterm birth, low birth weight, and small for gestational age—between foreign-born Hispanic women and US-born Hispanic women, and then we examined these birth outcomes by mother’s country of birth for foreign-born Hispanic women. Methods: Using the 2013 natality file from the National Vital Statistics System of the National Center for Health Statistics, we examined data on the 3 birth outcomes and maternal characteristics by maternal country of birth. We used log binomial models to calculate unadjusted and adjusted relative risks for preterm birth, low birth weight, and small for gestational age for US-born Hispanic women compared with foreign-born Hispanic women. We also compared the relative risk of each adverse birth outcome for foreign-born Hispanic women by country of birth. Results: US-born Hispanic women had higher rates of the 3 birth outcomes than did foreign-born Hispanic women (preterm birth: 8.0% vs 7.0%; low birth weight: 6.1% vs 5.2%; small for gestational age: 9.2% vs 7.9%). These higher rates persisted after adjusting for maternal characteristics. The rates for these 3 birth outcomes varied significantly by country of birth for foreign-born Hispanic women, with Puerto Rican women consistently having the poorest birth outcomes. Conclusions: Our results demonstrated heterogeneity in rates of adverse birth outcomes by country of birth for foreign-born Hispanic women. Presenting rates for foreign-born mothers as a group masks differences by country. To understand possible changes in data on birth outcomes, states should stratify data by maternal country of birth.

scholarly journals Exploring the Relationships in Prenatal Weight Gain, Birth Outcomes, and Postnatal Growth up to 2 Years of Age Using a Longitudinal Cohort in Niger

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1021-1021
Author(s):  
Kristin Kohlmann ◽  
Ousmane Guindo ◽  
Issaka Soumana ◽  
Rebecca Grais ◽  
Sheila Isanaka
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Postnatal Growth ◽  
Adverse Birth Outcomes ◽  
The Relationship ◽  
Over Time

Abstract Objectives The first 1000 days of life, from conception until a child's second birthday, is a crucial period during which life-long foundations for good health, growth, and development are established. It has been shown that poor maternal weight gain can contribute to adverse birth outcomes, such as low birth weight, small for gestational age, and prematurity, and such adverse birth outcomes can place children at greater risk for developing wasting and stunting as they age. While it has been suggested that the development of wasting and stunting may be related, the relative impact of poor birth outcomes on weight and height attainment over time is not clear. The objective of this study is to use recently collected longitudinal data to explore the inter-relationships between prenatal weight gain, birth outcomes, and postnatal risk of both wasting and stunting over time. Methods Using longitudinal data nested within a large randomized trial conducted in Madarounfa, Niger, we describe prenatal weight gain, the risk of adverse birth outcomes (preterm, small for gestational age, and low birthweight) and postnatal child growth (weight and length/height) up to 2 years of age. We use binomial regression to examine the relationship between prenatal weight gain and adverse birth outcomes. We use generalized estimating equations to examine the risk of wasting and stunting over time and evaluate potential effect modification of postnatal growth by birth outcomes. Results We followed 2796 mother-child pairs from pregnancy through 2 years of age. We found that 55.9% of the children were born preterm, 6.4% were born small for gestational weight, and 6.8% were born with low birth weight. Using longitudinal analysis, we are examining the relationship between the risk of wasting and stunting over time. Conclusions This analysis will provide evidence to describe the inter-relationships between prenatal weight gain, adverse birth outcomes, and risk of both wasting and stunting over time, with special attention to the inter-relationships between prenatal and postnatal growth. Funding Sources Médecins Sans Frontières-Operational Center Geneva and the Kavli Foundation, Norway.

scholarly journals Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren Dyer ◽  
Rachel Hardeman ◽  
Dovile Vilda ◽  
Katherine Theall ◽  
Maeve Wallace
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Black Women ◽  
Low Birth Weight ◽  
Racial Disparities ◽  
Population Health ◽  
Birth Outcomes ◽  
Mass Incarceration ◽  
Interquartile Range ◽  
Adverse Birth Outcomes

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

scholarly journals Perinatal Outcomes of Small for Gestational Age in Twin Pregnancies: Twin vs. Singleton Charts

2021 ◽  
Vol 10 (4) ◽  
pp. 643
Author(s):  
Veronica Giorgione ◽  
Corey Briffa ◽  
Carolina Di Fabrizio ◽  
Rohan Bhate ◽  
Asma Khalil
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Chi Square ◽  
Increased Risk ◽  
Twin Pregnancies

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.

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