Dataset Information

Pregnant Inuit Women's Exposure to Metals and Association with Fetal Growth Outcomes: ACCEPT 2010?2015.

ABSTRACT: Environmental contaminants such as heavy metals are transported to the Arctic regions via atmospheric and ocean currents and enter the Arctic food web. Exposure is an important risk factor for health and can lead to increased risk of a variety of diseases. This study investigated the association between pregnant women's levels of heavy and essential metals and the birth outcomes of the newborn child. This cross-sectional study is part of the ACCEPT birth cohort (Adaption to Climate Change, Environmental Pollution, and dietary Transition) and included 509 pregnant Inuit women ?18 years of age. Data were collected in five Greenlandic regions during 2010?2015. Population characteristics and birth outcomes were obtained from medical records and midwives, respectively, and blood samples were analyzed for 13 metals. Statistical analysis included one-way ANOVA, Spearman's rho, and multiple linear and logistic regression analyses. The proportion of current smokers was 35.8%. The levels of cadmium, chromium, and nickel were higher compared to reported normal ranges. Significant regional differences were observed for several metals, smoking, and parity. Cadmium and copper were significantly inversely related to birth outcomes. Heavy metals in maternal blood can adversely influence fetal development and growth in a dose?response relationship. Diet and lifestyle factors are important sources of toxic heavy metals and deviant levels of essential metals. The high frequency of smokers in early pregnancy is of concern, and prenatal exposure to heavy metals and other environmental contaminants in the Greenlandic Inuit needs further research.

SUBMITTER: Bank-Nielsen PI

PROVIDER: S-EPMC6479494 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Pregnant Inuit Women's Exposure to Metals and Association with Fetal Growth Outcomes: ACCEPT 2010⁻2015.

Bank-Nielsen Per I PI Long Manhai M Bonefeld-Jørgensen Eva C EC

International journal of environmental research and public health 20190401 7

Environmental contaminants such as heavy metals are transported to the Arctic regions via atmospheric and ocean currents and enter the Arctic food web. Exposure is an important risk factor for health and can lead to increased risk of a variety of diseases. This study investigated the association between pregnant women's levels of heavy and essential metals and the birth outcomes of the newborn child. This cross-sectional study is part of the ACCEPT birth cohort (Adaption to Climate Change, Envir ...[more]

PMID: 30939809

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Project description:BACKGROUND:Exposure to particulate matter, particularly with aerodynamic diameter <?2.5?µm (PM2.5), may increase inflammation and oxidative stress in pregnant women and affect fetal growth. We examined trimester specific PM2.5 exposure levels and small for gestational age (SGA) using the statewide birth registry of Ohio from 2007 to 2010. METHODS:Exposure to PM2.5 in each trimester and for each gestational week was determined using data from 57 Environmental Protection Agency network monitoring stations across the state of Ohio. We restricted the data to 224,921 singleton live births, with a gestational age of 20-42 weeks, no genetic disorders or congenital abnormalities, and who had home addresses within a 10?km radius of any PM2.5 monitoring station. We estimated odds ratios of SGA using Generalized Linear Models (GLMs) and Distributed Lag Models (DLMs), and adjustment for maternal age, race, education, parity, body mass index, insurance type, tobacco use, prenatal care initiation, birth year, season of birth, and sex of the baby. RESULTS:Mean PM2.5 levels during the entire pregnancy were 13.03?µg/m3 with a standard deviation of 1.57?µg/m3. Covariates adjusted odds ratios and 95% confidence intervals of a 10?µg/m3 increase in PM2.5 levels with a 10?km buffer radius for SGA and trimesters modeled separately were 0.94 (0.88, 1.00) for the first trimester, 0.93 (0.86, 1.00) for the second trimester, 1.07 (1.00, 1.15) for the third trimester, and 0.92 (0.81, 1.06) for the entire pregnancy. When a 5?km buffer radius was used, adjusted odds ratios and 95% confidence intervals for SGA were 0.97 (0.89, 1.05) for the first trimester, 0.96 (0.88, 1.05) for the second trimester, 1.09 (1.02, 1.17) for the third trimester, and 0.99 (0.85, 1.14) for the overall pregnancy, indicating sensitivity to buffer choice. DLMs showed gestational weeks 30-35 to be a particular window of vulnerability. CONCLUSION:Increasing exposure to PM2.5 during the third trimester of pregnancy was associated with a small increase in risk of SGA in this population-based study. Selection of a buffer radius significantly impacted our results in the first trimester, but not in the third trimester.

Project description:ObjectivesIncreasingly more women conceive on antiretroviral therapy (ART) with non-nucleoside reverse transcriptase-based regimens. This study assessed the effect of preconception tenofovir disoproxil fumarate (TDF)-lamivudine (3TC)/emtricitabine (FTC)-efavirenz (EFV) and post-conception TDF-(3TC/FTC)-EFV (versus other regimens) on preterm delivery (PTD) and small-for-gestational age (SGA) births.MethodsWe analysed data of 2549 HIV-infected women attending antenatal clinics in KwaZulu-Natal from 2010 through 2015 in this retrospective cohort study. Preconception, TDF-(3TC/FTC)-EFV was compared to nevirapine (NVP)-based regimens and other 3-drug EFV-based regimens. Post-conception, TDF-(3TC/FTC)-EFV was compared to NVP-based ART and zidovudine (ZDV) prophylaxis. Outcomes included PTD <37 weeks and SGA births. Generalized linear mixed effects were used to fit logistic regression models to account for repeat pregnancies.ResultsAmong 2549 singleton live births, 10.4% (n = 264) were PTD and 10.4% (n = 265) SGA. PTD declined from 16.3% in 2010 to 9.3% in 2015 and SGA remained stable from 9.9% in 2010 to 10% in 2015. Preconception NVP-based regimens [adjusted odds ratio (aOR) 0.66; 95% CI 0.27-1.63] and other 3-drug EFV-based regimens (aOR 0.72; 95% CI 0.24-2.12) were not associated with PTD versus TDF-(3TC/FTC)-EFV. NVP-based (aOR 0.75; 95% CI 0.40-1.42) and other 3-drug EFV-based regimens (aOR 1.55; 95% CI 0.76-3.16) were not associated with SGA births versus TDF-(3TC/FTC)-EFV. Post-conception NVP-based ART (1.77; 95% CI 0.89-3.51) and ZDV (1.03; 95% CI 0.68-1.58) were not associated with PTD versus TDF-(3TC/FTC)-EFV. NVP-based ART (1.55; 95% CI 0.66-3.61) and ZDV (0.89; 95% CI 0.53-1.47) were not associated with SGA versus TDF-(3TC/FTC)-EFV.ConclusionsPreconception TDF-(3TC/FTC)-EFV and post-conception TDF-(3TC/FTC)-EFV were not associated with PTD or SGA, compared with other regimens. Increasing ART use merits further study of the optimum ART regimen for safe birth outcomes.

Dataset Information

Pregnant Inuit Women's Exposure to Metals and Association with Fetal Growth Outcomes: ACCEPT 2010?2015.

Publications

Pregnant Inuit Women's Exposure to Metals and Association with Fetal Growth Outcomes: ACCEPT 2010⁻2015.

Similar Datasets

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