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The Cumulative Risk of Chemical and Nonchemical Exposures on Birth Outcomes in Healthy Women: The Fetal Growth Study

Author

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  • Leah Zilversmit Pao

    (Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA)

  • Emily W. Harville

    (Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA)

  • Jeffrey K. Wickliffe

    (Department of Global Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA)

  • Arti Shankar

    (Global Biostatistics and Data Science, Department of Global Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA)

  • Pierre Buekens

    (Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA)

Abstract

Metals, stress, and sociodemographics are commonly studied separately for their effects on birth outcomes, yet often jointly contribute to adverse outcomes. This study analyzes two methods for measuring cumulative risk to understand how maternal chemical and nonchemical stressors may contribute to small for gestational age (SGA). SGA was calculated using sex-specific fetal growth curves for infants of pregnant mothers ( n = 2562) enrolled in the National Institute of Child Health and Human Development (NICHD) Fetal Growth Study. The exposures (maternal lead, mercury, cadmium, Cohen’s perceived stress, Edinburgh depression scores, race/ethnicity, income, and education) were grouped into three domains: metals, psychosocial stress, and sociodemographics. In Method 1 we created cumulative risk scores using tertiles. Method 2 employed weighted quantile sum (WQS) regression. For each method, logistic models were built with three exposure domains individually and race/ethnicity, adjusting for age, parity, pregnancy weight gain, and marital status. The adjusted effect of overall cumulative risk with three domains, was also modeled using each method. Sociodemographics was the only exposure associated with SGA in unadjusted models ((odds ratio) OR: 1.35, 95% (confidence interval) CI: 1.08, 1.68). The three cumulative variables in adjusted models were not significant individually, but the overall index was associated with SGA (OR: 1.17, 95% CI: 1.02, 1.35). In the WQS model, only the sociodemographics domain was significantly associated with SGA. Sociodemographics tended to be the strongest risk factor for SGA in both risk score and WQS models.

Suggested Citation

  • Leah Zilversmit Pao & Emily W. Harville & Jeffrey K. Wickliffe & Arti Shankar & Pierre Buekens, 2019. "The Cumulative Risk of Chemical and Nonchemical Exposures on Birth Outcomes in Healthy Women: The Fetal Growth Study," IJERPH, MDPI, vol. 16(19), pages 1-16, October.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:19:p:3700-:d:272563
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    References listed on IDEAS

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    1. Sarah Alves & Joan Tilghman & Arlene Rosenbaum & Devon C. Payne-Sturges, 2012. "U.S. EPA Authority to Use Cumulative Risk Assessments in Environmental Decision-Making," IJERPH, MDPI, vol. 9(6), pages 1-23, May.
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    Cited by:

    1. Allison A. Appleton & Betty Lin & Elizabeth A. Holdsworth & Beth J. Feingold & Lawrence M. Schell, 2021. "Prenatal Exposure to Favorable Social and Environmental Neighborhood Conditions Is Associated with Healthy Pregnancy and Infant Outcomes," IJERPH, MDPI, vol. 18(11), pages 1-13, June.
    2. Allison A. Appleton & Kevin C. Kiley & Lawrence M. Schell & Elizabeth A. Holdsworth & Anuoluwapo Akinsanya & Catherine Beecher, 2021. "Prenatal Lead and Depression Exposures Jointly Influence Birth Outcomes and NR3C1 DNA Methylation," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    3. Anisma R. Gokoel & Arti Shankar & Firoz Abdoel Wahid & Ashna D. Hindori-Mohangoo & Hannah H. Covert & Jeffrey K. Wickliffe & Emily W. Harville & Wilco C. W. R. Zijlmans & Maureen Y. Lichtveld, 2021. "The Cumulative Risk of Prenatal Exposures to Chemical and Non-Chemical Stressors on Birth Outcomes in Suriname," IJERPH, MDPI, vol. 18(14), pages 1-13, July.

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