Relationship of prenatal pesticide exposures with prenatal ultrasound and birth growth measures among offspring of women living with HIV.

BACKGROUND

While numerous studies have evaluated the effects of prenatal pesticide exposure on birth weight, few have examined associations with ultrasound measures of fetal growth, and none have focused on women living with HIV (WLHIV). Because children born to WLHIV face health vulnerabilities related to HIV infection and antiretroviral treatment, we conducted this study to determine whether pesticide exposure contributes further risk to fetal growth.

OBJECTIVE

We assessed associations between prenatal exposure to 28 pesticide biomarkers and ultrasound-based fetal growth trajectories and traditional birth outcomes among WLHIV from Brazil and the U.S.

METHODS

We evaluated 153 women living with HIV with prenatal ultrasounds, birth measurements, and urine specimens collected throughout pregnancy. Pesticide biomarkers (including herbicides, insect repellents, neonicotinoids, organophosphate insecticides, and pyrethroids) were quantified using mass spectrometry. Mixed effect linear regression models evaluated associations of geometric mean concentrations with fetal growth outcomes, and linear and logistic regression models assessed associations with birth outcomes.

RESULTS

Most pesticides were not associated with meaningful decrements in fetal growth measures or birth outcomes. However, seven pesticides were linked to reductions in fetal growth measures persisting through birth. These included associations with smaller fetal and birth measurements, including head circumference, biparietal diameter, femur length, abdominal circumference, and birth weight Z-score. Two of these pesticides were also associated with increased odds of being small for gestational age.

CONCLUSIONS

We found that certain pesticides increased the risk of suboptimal growth during pregnancy among WLHIV, highlighting possible additional health risks among children exposed to HIV and related treatments.