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American Journal of Epidemiology Advance Access originally published online on August 24, 2005
American Journal of Epidemiology 2005 162(8):709-716; doi:10.1093/aje/kwi275
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTIONS

Preconception Serum DDT and Pregnancy Loss: A Prospective Study Using a Biomarker of Pregnancy

Scott A. Venners1, Susan Korrick1,2, Xiping Xu1, Changzhong Chen1, Wenwei Guang3, Aiqun Huang3, Larisa Altshul1, Melissa Perry1, Lingling Fu4 and Xiaobin Wang4

1 Department of Environmental Health, Harvard School of Public Health, Boston, MA
2 The Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
3 Institute for Biomedicine, Anhui Medical University, Anhui, China
4 Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL

Correspondence to Dr. Xiaobin Wang, Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Hospital, 2300 Children's Plaza, Box 157, Chicago, IL 60614 (e-mail: xbwang{at}childrensmemorial.org).

Previous studies of pregnancy losses and 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) were limited because they did not include losses prior to clinical detection of pregnancy and because exposures were measured after the pregnancies of interest. The authors examined the association of preconception serum total DDT (sum of DDT isomers and metabolites) concentration and subsequent pregnancy losses in 388 newly married, nonsmoking, female textile workers in China between 1996 and 1998. Upon stopping contraception, subjects provided daily urine specimens and records of vaginal bleeding for up to 1 year or until clinical pregnancy. Daily urinary human chorionic gonadotropin was assayed to detect conception and early pregnancy losses, and pregnancies were followed to detect clinical spontaneous abortions. There were 128 (26%) early pregnancy losses in 500 conceptions and 36 (10%) spontaneous abortions in 372 clinical pregnancies. Subjects were grouped in tertiles by preconception serum total DDT concentration (group 1: 5.5–22.9 ng/g; group 2: 23.0–36.5 ng/g; group 3: 36.6–113.3 ng/g). Compared with group 1, group 2 had adjusted relative odds of early pregnancy losses of 1.23 (95% confidence interval (CI): 0.72, 2.10), and group 3 had adjusted odds of 2.12 (95% CI: 1.26, 3.57). The relative odds of early pregnancy losses associated with a 10-ng/g increase in serum total DDT were 1.17 (95% CI: 1.05, 1.29). The small number of spontaneous abortions following clinical detection of pregnancy were not associated with serum total DDT. In this population, there was a positive, monotonic, exposure-response association between preconception serum total DDT and the risk of subsequent early pregnancy losses.

abortion, spontaneous; chorionic gonadotropin; DDT; dichlorodiphenyldichloroethane; dichlorodiphenyl dichloroethylene; hormone antagonists

Abbreviations: CI, confidence interval; DDD, 1,1-dichloro-2,2-bis(p-chlorophenyl)ethane; DDE, 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene; DDT, 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane; hCG, human chorionic gonadotropin; OR, odds ratio; SD, standard deviation

Editor's note: A related article appears on page 717, and an invited commentary on these two articles is published on page 726.


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