Hypertensive disorders of pregnancy and gestational diabetes mellitus among French Caribbean women chronically exposed to chlordecone

Abstract

Few studies have explored the consequences of environmental exposure to organochlorine pesticides for gestational hypertension (GH), preeclampsia (PE) and gestational diabetes mellitus (GDM). Chlordecone is a persistent organochlorine pesticide that was used intensively, and almost exclusively, in the French West Indies until 1993. We investigated the impact of prenatal exposure to chlordecone on the occurrence of GDM, GH and PE by studying 779 pregnant women enrolled in a prospective mother-child cohort (Timoun Study) in Guadeloupe between 2004 and 2007. Chlordecone exposure was determined by assaying maternal plasma and information about pregnancy complications was obtained from midwives, pediatricians and hospital medical records after delivery. The risks of GH (n=65), PE (n=31) and GDM (n=71) were estimated by multiple logistic regression including potential confounders. Levels of chlordecone plasma concentration in the third (OR=0.2; 95% confidence interval (CI): 0.1, 0.5) and fourth quartiles (OR=0.3; 95% CI: 0.2, 0.7) were associated with a statistically significant decrease in the risk of GH. A log10 increase in chlordecone concentration was significantly associated with lower risk of GH (OR=0.4; 95% CI: 0.2, 0.6). No significant associations were observed between the chlordecone exposure and the risk of PE or GDM. This study suggests an inverse association between chlordecone exposure during pregnancy and GH. Further studies are required to determine the underlying mechanism, or the potential unknown confounding factors, resulting in this association.

Association of serum concentrations of persistent organic pollutants (POPs) and risk of pre-eclampsia: a case–control study

“…The authors reported no evidence of association between preeclampsia and Chlordecone as an organochlorine insecticide that has endocrine activities among pregnant women chronically exposed to this chemical [2]. …”

“…PCB have been widely used in heat exchange fluids, in electronic transformers and capacitors and used as an additive in paint, carbonless copy paper, sealants and plastics [2]. PBDEs are synthetic chemicals used as flame retardants in a variety of consumer products such as computer circuit boards and casings, television and radios, furniture, textiles, automobiles and construction materials [3].…”

“…Few studies investigated association of chemical pollutants and risk of hypertensive disorders during pregnancy [2, 18–22] and magnitude of such effects remains largely unknown. Evidence suggested defective vascular remodelling of the spiral arteries in the first half of pregnancy causes pre-eclampsia [23] and Dubey et al study manifested the environmental oestrogens such as synthetic xenoestrogens that are widely used in industrial compounds like PCBs may induce abnormalities in vascular function and structure by mimicking or antagonizing the vascular effects of oestardiol, leading to pre-eclampsia [24].…”

Review Article. Organochlorine pesticides, their toxic effects on living organisms and their fate in the environment

“…A recent study reported that POP exposure is a risk factor contributing to insulin resistance (Arrebola et al ., 2015). Chronic exposure to chlordecone was found to cause hypertensive disorders in pregnancy and gestational diabetes mellitus among French Caribbean women (Saunders et al ., 2014). In a study conducted in Slovakia, highly increased blood levels of diabetes (fasting glucose and insulin) and obesity markers (BMI, triglyceride and cholesterol) were found in large groups of males and females in highly polluted areas.…”

Perinatal exposure to chlordecone and infant growth

“…The children included in the survey were born at term, were of normal weight, and had no birth defects. They were therefore free from conditions related to chlordecone exposure Saunders et al, 2014) that might also have influenced growth. The assessment of prenatal exposure to chlordecone based on cord blood determination at birth can be considered representative of exposure during pregnancy, because chlordecone has a long halflife (Cohn et al, 1978) and chronic maternal exposure occurs principally through dietary intake.…”