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Pre-Pregnancy Maternal Exposure to Persistent Organic Pollutants and Gestational Weight Gain: A Prospective Cohort Study

View Article: PubMed Central - PubMed

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.

No MeSH data available.


Schematic representation of area under the gestational weight gain curve (AUC). Two lines represent women who gained the same total amount of weight during their pregnancies, but one (dotted line) had a greater AUC, because she gained weight faster earlier in pregnancy.
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ijerph-13-00905-f001: Schematic representation of area under the gestational weight gain curve (AUC). Two lines represent women who gained the same total amount of weight during their pregnancies, but one (dotted line) had a greater AUC, because she gained weight faster earlier in pregnancy.

Mentions: In monthly pregnancy journals, women were instructed to record their weight. We assessed gestational weight gain 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 BMI-specific IOM recommendations [18]: (i) gained inadequate weight, (ii) gained adequate weight or (iii) gained excessive weight; and (3) area under the gestational weight gain curve (AUC) [19]. The AUC was calculated by summing the areas of trapezoids formed by successive measures of weight gain in pounds relative to pre-pregnancy weight over the time period in days spanning the baseline (pre-pregnancy) visit to the last self-reported weight before delivery (Figure 1). The AUC is interpreted as the additional pound-days carried by a woman during her pregnancy relative to remaining at her pre-pregnancy weight. For women who self-reported weights during pregnancy that were smaller than their pre-pregnancy weight indicative of weight loss, the values were replaced with their pre-pregnancy weight to avoid negative pound-days [19]. This was the case for n = 78 women for the first pregnancy journal (completed at 12 weeks gestation), n = 50 for the second (16 weeks gestation), n = 29 for the third (20 weeks gestation), n = 12 for the fourth (24 weeks gestation), n = 6 for the fifth (28 weeks gestation), sixth (32 weeks gestation) and seventh (36 weeks gestation), n = 2 for the eighth (40 weeks gestation) and n = 1 for the ninth (>40 weeks gestation). On average, women had 7 (range: 2–9) weight values included in the AUC calculation; 99.1% had at least 3 weight values.


Pre-Pregnancy Maternal Exposure to Persistent Organic Pollutants and Gestational Weight Gain: A Prospective Cohort Study
Schematic representation of area under the gestational weight gain curve (AUC). Two lines represent women who gained the same total amount of weight during their pregnancies, but one (dotted line) had a greater AUC, because she gained weight faster earlier in pregnancy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036738&req=5

ijerph-13-00905-f001: Schematic representation of area under the gestational weight gain curve (AUC). Two lines represent women who gained the same total amount of weight during their pregnancies, but one (dotted line) had a greater AUC, because she gained weight faster earlier in pregnancy.
Mentions: In monthly pregnancy journals, women were instructed to record their weight. We assessed gestational weight gain 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 BMI-specific IOM recommendations [18]: (i) gained inadequate weight, (ii) gained adequate weight or (iii) gained excessive weight; and (3) area under the gestational weight gain curve (AUC) [19]. The AUC was calculated by summing the areas of trapezoids formed by successive measures of weight gain in pounds relative to pre-pregnancy weight over the time period in days spanning the baseline (pre-pregnancy) visit to the last self-reported weight before delivery (Figure 1). The AUC is interpreted as the additional pound-days carried by a woman during her pregnancy relative to remaining at her pre-pregnancy weight. For women who self-reported weights during pregnancy that were smaller than their pre-pregnancy weight indicative of weight loss, the values were replaced with their pre-pregnancy weight to avoid negative pound-days [19]. This was the case for n = 78 women for the first pregnancy journal (completed at 12 weeks gestation), n = 50 for the second (16 weeks gestation), n = 29 for the third (20 weeks gestation), n = 12 for the fourth (24 weeks gestation), n = 6 for the fifth (28 weeks gestation), sixth (32 weeks gestation) and seventh (36 weeks gestation), n = 2 for the eighth (40 weeks gestation) and n = 1 for the ninth (>40 weeks gestation). On average, women had 7 (range: 2–9) weight values included in the AUC calculation; 99.1% had at least 3 weight values.

View Article: PubMed Central - PubMed

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.

No MeSH data available.