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Early life environmental exposures and children's growth: A longitudinal study evaluating prenatal exposure for endocrine disrupting chemicals and nutrition in relation to children's growth up to seven years of age
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0002-4330-9193
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Endocrine disrupting chemicals (EDCs) have the potential to disrupt the endocrine system in humans and animals with importance for health and development. Additionally, optimal nutrition during pregnancy is critical for fetal growth and pregnancy outcomes. However, further knowledge on the importance of EDC mixtures and nutrition, on birthweight and growth during childhood is needed. 

The overall aim of this thesis was to evaluate the associations between prenatal exposure to EDC mixtures and nutrition respectively, with birthweight, growth and body composition in early- and mid-childhood, and to determine if these associations differed by sex. Data from mother-child pairs in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study was analyzed, including 26 EDCs in prenatal urine and serum samples, children’s anthropometric and body composition measures up to seven years of age, and sociodemographic data from questionnaires and registers.

Results suggest that higher prenatal exposure to EDC mixtures were associated with lower birthweight, and slower weight gain in early childhood, including a later peak growth velocity among girls. At 5.5 and 7 years of age, EDC mixtures were associated with lower BMI, less odds of overweight and less body fat among girls, but more body fat among boys at 7 years of age. Chemicals of concern in the mixtures were e.g., phthalates, bisphenols, perfluorinated alkyl substances (PFASs) and pesticides. Finally, maternal nutrition during pregnancy, i.e., better adherence to nutritional guidelines, was associated with more body fat for boys but less body fat for girls.

In conclusion, prenatal exposure to both EDC mixtures and nutrition suggests to have an influence on birthweight, and children´s growth. Several of the found associations also differed by sex. 

Abstract [en]

Early life is an important period for growth and development and therefore, sensitive to environmental exposures, such as chemicals and nutrition. Endocrine disrupting chemicals (EDCs) are man-made chemicals, common in everyday population exposure, and have been associated with unfavorable health effects and development. Additionally, optimal nutrition during pregnancy is important for both maternal and fetal health. But we need more knowledge on how these environmental exposures may influence children’s growth and if there are sex specific effects.

Twenty-six EDCs were measured in the urine and serum of pregnant women and their children’s growth was measured up to 7 years of age, including birthweight, height, weight, and body fat. Results show that higher levels of EDC mixtures were associated with lower birthweight, slower weight gain, and sex-specific effects on body fat. Also, better nutrition was associated with greater height and sex-specific effects on body fat.

The associations were small and not of concern for the individual, but from a population perspective it is an opportunity for improvement. Regulation of EDCs, both persistent and non-persistent, as well as adherence to nutritional guidelines, may be beneficial to promote healthy environments for children’s growth. 

 

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2023. , p. 111
Series
Karlstad University Studies, ISSN 1403-8099 ; 2023:30
Keywords [en]
Endocrine disrupting chemicals, EDC, Nutrition, Pregnancy, Children, Growth, Birthweight, Body composition, Body Fat, BMI, Overweight
National Category
Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
URN: urn:nbn:se:kau:diva-97115ISBN: 978-91-7867-410-7 (print)ISBN: 978-91-7867-411-4 (electronic)OAI: oai:DiVA.org:kau-97115DiVA, id: diva2:1806361
Public defence
2023-12-08, 1B364 (Frödingsalen), Karlstad, 13:00 (English)
Opponent
Supervisors
Available from: 2023-11-14 Created: 2023-10-20 Last updated: 2023-11-14Bibliographically approved
List of papers
1. Prenatal exposures to mixtures of endocrine disrupting chemicals and children's weight trajectory up to age 5.5 in the SELMA study
Open this publication in new window or tab >>Prenatal exposures to mixtures of endocrine disrupting chemicals and children's weight trajectory up to age 5.5 in the SELMA study
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2021 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 11036Article in journal (Refereed) Published
Abstract [en]

Exposure to endocrine disrupting chemicals (EDCs) may impact early growth, although information is limited on exposure to combination of multiple EDCs. We aimed to evaluate the effect of prenatal exposure to EDC mixtures on birthweight z-scores and childhood weight trajectories. Twenty-six proven and suspected EDCs, were analyzed in prenatal urine and blood samples from 1118 mothers participating in the Swedish Environmental Longitudinal Mother and child Asthma and allergy (SELMA) study. Two growth parameters were estimated from each child's weight trajectory from birth to 5.5 years of age: infant growth spurt rate and age at infant peak growth velocity (PGV). Weighted quantile sum (WQS) regression was used to estimate the mixture effect and identify chemicals of concern. A one-unit increase in the EDC mixture WQS index, was associated with decreased birthweight z-scores of 0.11 (95% CI - 0.16, - 0.06), slower infant growth spurt rate of 0.01 (95% CI - 0.03, - 0.01, on the log(10) scale), and delayed age at infant PGV of 0.15 months (95% CI 0.07, 0.24) after adjusting for potential confounders. Stratified analysis by sex, showed that delayed age at infant PGV was mostly observed in girls with 0.51 months (95% CI 0.26, 0.76). Identified chemicals of concern included perfluorinated alkyl substances (PFAS), Triclosan, phthalates, non-phthalate plasticizers, bisphenols, polycyclic aromatic hydrocarbons, pesticides and PCBs. Prenatal exposure to EDC mixtures was associated with lower birthweight and altered infant weight gain trajectories.

Place, publisher, year, edition, pages
Nature Publishing Group, 2021
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-85306 (URN)10.1038/s41598-021-89846-5 (DOI)000659148400028 ()34040006 (PubMedID)2-s2.0-85106870282 (Scopus ID)
Available from: 2021-07-02 Created: 2021-07-02 Last updated: 2023-10-20Bibliographically approved
2. Prenatal exposures to mixtures of endocrine disrupting chemicals and sex-specific associations with children’s BMI and overweight at 5.5 years of age in the SELMA study
Open this publication in new window or tab >>Prenatal exposures to mixtures of endocrine disrupting chemicals and sex-specific associations with children’s BMI and overweight at 5.5 years of age in the SELMA study
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2023 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 179, article id 108176Article in journal (Refereed) Published
Abstract [en]

Background: Prenatal exposure to mixtures of endocrine disrupting chemicals (EDC) has the potential to disrupt human metabolism. Prenatal periods are especially sensitive as many developmental processes are regulated by hormones. Prenatal exposure to EDCs has inconsistently been associated with children’s body mass index (BMI) and obesity. The objective of this study was to investigate if prenatal exposure to a mixture of EDCs was associated with children’s BMI and overweight (ISO-BMI ≥ 25) at 5.5 years of age, and if there were sex-specific effects. Methods: A total of 1,105 mother–child pairs with complete data on prenatal EDCs concentrations (e.g., phthalates, non-phthalate plasticizers, phenols, PAH, pesticides, PFAS, organochlorine pesticides, and PCBs), children’s measured height and weight, and selected covariates in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study were included in this analysis. The mixture effect of EDCs with children’s BMI and overweight was assessed using WQS regression with 100 repeated holdouts. A positively associated WQS index with higher BMI and odds of overweight was derived. Models with interaction term and stratified weights by sex was applied in order to evaluate sex-specific associations. Results: A significant WQS*sex interaction term was identified and associations for boys and girls were in opposite directions. Higher prenatal exposure to a mixture of EDCs was associated with lower BMI (Mean β = -0.19, 95%CI: −0.40, 0.01) and lower odds of overweight (Mean OR = 0.72, 95%CI: 0.48, 1.04) among girls with borderline significance. However, the association among boys did not reach statistical significance. Among girls, the possible chemicals of concern were MEP, 2-OHPH, BPF, BPS, DPP and PFNA. Conclusion: Prenatal exposure to a mixture of EDCs was associated with lower BMI and overweight among girls, and non-significant associations among boys. Chemicals of concern for girls included phthalates, non-phthalate plasticizers, bisphenols, PAHs, and PFAS.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Association reactions, Endocrine disrupters, Phenols, Plasticizers, Polychlorinated biphenyls, Polycyclic aromatic hydrocarbons, Solvents, Body mass, Body mass index, Child, Endocrine disrupting chemicals, Mass index, Overweight, Pregnancy, Prenatal exposure
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology Pediatrics
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-96758 (URN)10.1016/j.envint.2023.108176 (DOI)001078491500001 ()37672941 (PubMedID)2-s2.0-85169918152 (Scopus ID)
Funder
Landstinget i Värmland
Available from: 2023-09-19 Created: 2023-09-19 Last updated: 2023-11-02Bibliographically approved
3. EDC mixtures during pregnancy and body fat at 7 years of age in a Swedish cohort, the SELMA study
Open this publication in new window or tab >>EDC mixtures during pregnancy and body fat at 7 years of age in a Swedish cohort, the SELMA study
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-97114 (URN)
Available from: 2023-10-20 Created: 2023-10-20 Last updated: 2024-01-12Bibliographically approved
4. Maternal nutrition during mid-pregnancy and children’s body composition at seven years of age in the SELMA study
Open this publication in new window or tab >>Maternal nutrition during mid-pregnancy and children’s body composition at seven years of age in the SELMA study
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2023 (English)In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 130, no 11, p. 1982-1992Article in journal (Refereed) Published
Abstract [en]

Optimal nutrition during pregnancy is vital for both maternal and child health. Our objective was to explore if prenatal diet is associated with children’s height and body fat. Nutrient intake was assessed through a food-frequency questionnaire from 808 pregnant women and summarized to a nutrition index, "My Nutrition Index"(MNI). The association with children’s height and body fat (bioimpedance) was assessed with linear regression models. Secondary analysis was performed with BMI, trunk fat and skinfolds. Overall, higher MNI score was associated with greater height (β=0.47; (95% CI: 0.00, 0.94), among both sexes. Among boys, higher MNI was associated with 0.15 higher BMI z-scores, 0.12 body fat z-scores, 0.11 trunk fat z-scores, and larger triceps, and triceps + subscapular skinfolds (β=0.05 and β=0.06; on the log2 scale) (p-value<0.05). Among girls, the opposite associations were found with 0.12 lower trunk fat z-scores, and smaller subscapular and suprailiac skinfolds (β= -0.07 and β= -0.10; on the log2 scale) (p-value<0.05). For skinfold measures this would represent a ±1.0 millimeters difference. Unexpectedly, a prenatal diet in line with recommended nutrient intake was associated with higher measures of body fat for boys and opposite to girls at a pre-pubertal stage of development. 

Place, publisher, year, edition, pages
Cambridge University Press, 2023
Keywords
adult, article, body composition, body fat, body mass, child, female, food frequency questionnaire, human, linear regression analysis, major clinical study, maternal nutrition, nutrient intake, pregnancy, pregnant woman, school child, secondary analysis, skinfold, triceps brachii muscle, trunk
National Category
Pediatrics Nutrition and Dietetics
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-95208 (URN)10.1017/S0007114523000983 (DOI)001007759800001 ()37232113 (PubMedID)2-s2.0-85160806932 (Scopus ID)
Available from: 2023-06-12 Created: 2023-06-12 Last updated: 2023-12-11Bibliographically approved

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