American Journal of Epidemiology Advance Access originally published online on April 3, 2007
American Journal of Epidemiology 2007 165(12):1397-1404; doi:10.1093/aje/kwm029
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ORIGINAL CONTRIBUTIONS |
Prenatal Organophosphate Metabolite and Organochlorine Levels and Performance on the Brazelton Neonatal Behavioral Assessment Scale in a Multiethnic Pregnancy Cohort
1 Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY
2 National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
3 Department of Microbiology, Mount Sinai School of Medicine, New York, NY
4 Department of Human Genetics, Mount Sinai School of Medicine, New York, NY
Correspondence to Dr. Stephanie M. Engel, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1043, New York, NY 10029 (e-mail: Stephanie.Engel{at}mssm.edu).
Received for publication August 20, 2006. Accepted for publication December 21, 2006.
Prenatal exposures to organophosphate pesticides and polychlorinated biphenyls have been associated with abnormal neonatal behavior and/or primitive reflexes. In 1998–2002, the Mount Sinai Children's Environmental Health Center (New York City) investigated the effects of indoor pesticide use and exposure to polychlorinated biphenyls on pregnancy outcome and child neurodevelopment in an inner-city multiethnic cohort. The Brazelton Neonatal Behavioral Assessment Scale was administered before hospital discharge (n = 311). Maternal urine samples were analyzed for six dialkylphosphate metabolites and malathion dicarboxylic acid. A random subset of maternal peripheral blood samples from the entire cohort (n = 194) was analyzed for polychlorinated biphenyls and 1,1'-dichloro-2,2'-bis(4-chlorophenyl)ethylene. Malathion dicarboxylic acid levels above the limit of detection were associated with a 2.24-fold increase in the number of abnormal reflexes (95% confidence interval: 1.55, 3.24). Likewise, higher levels of total diethylphosphates and total dialkylphosphates were associated with an increase in abnormal reflexes, as was total dimethylphosphates after paraoxonase expression was considered. No adverse associations were found with polychlorinated biphenyl or 1,1'-dichloro-2,2'-bis(4-chlorophenyl)ethylene levels and any behavior. The authors uncovered additional evidence that prenatal levels of organophosphate pesticide metabolites are associated with anomalies in primitive reflexes, which are a critical marker of neurologic integrity.
neonatal screening; pesticides; polychlorinated biphenyls; pregnancy; prenatal exposure delayed effects; reflex, abnormal
Abbreviations: BNBAS, Brazelton Neonatal Behavioral Assessment Scale; DDE, 1,1'-dichloro-2,2'-bis(4-chlorophenyl)ethylene; MDA, malathion dicarboxylic acid; PCB, polychlorinated biphenyl