Combined Effects of Prenatal Exposures to Environmental Chemicals on Birth Weight

Eva Govarts, Sylvie Remy, Liesbeth Bruckers, Elly Den Hond, Isabelle Sioen, Vera Nelen, Willy Baeyens, Tim Nawrot, Ilse Loots, Nicolas Van Larebeke, Greet Schoeters

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71 Citations (Scopus)


Prenatal chemical exposure has been frequently associated with reduced fetal growth by single pollutant regression models although inconsistent results have been obtained. Our study estimated the effects of exposure to single pollutants and mixtures on birth weight in 248 mother-child pairs. Arsenic, copper, lead, manganese and thallium were measured in cord blood, cadmium in maternal blood, methylmercury in maternal hair, and five organochlorines, two perfluorinated compounds and diethylhexyl phthalate metabolites in cord plasma. Daily exposure to particulate matter was modeled and averaged over the duration of gestation. In single pollutant models, arsenic was significantly associated with reduced birth weight. The effect estimate increased when including cadmium, and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) co-exposure. Combining exposures by principal component analysis generated an exposure factor loaded by cadmium and arsenic that was associated with reduced birth weight. MECPP induced gender specific effects. In girls, the effect estimate was doubled with co-exposure of thallium, PFOS, lead, cadmium, manganese, and mercury, while in boys, the mixture of MECPP with cadmium showed the strongest association with birth weight. In conclusion, birth weight was consistently inversely associated with exposure to pollutant mixtures. Chemicals not showing significant associations at single pollutant level contributed to stronger effects when analyzed as mixtures.
Original languageEnglish
Number of pages19
JournalInternational Journal of Environmental Research and Public Health
Issue number5
Publication statusPublished - 12 May 2016


  • Endocrine disruptors
  • Mixtures
  • Principal Component Analysis
  • Regression analysis
  • Birth outcome
  • Epidemiology
  • Biomonitoring
  • Cord blood


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