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Overall, 202 maternal-infant pairs (101 FGR cases and 101 controls) were enrolled in the present study. The population characteristics of FGR cases and healthy newborns were listed and compared (Table 1). The average birth weight and gestational age of FGR cases were (2.29 ± 0.43) kg and (36.4 ± 4.0) weeks, respectively, which were significantly lower than those of the controls (3.31 ± 0.34) kg and (39.1 ± 1.1) weeks, respectively, P < 0.001). The Quetelet index of FGR cases was significantly lower than that of controls [(48.31 ± 7.56) vs. (66.03 ± 6.41), P < 0.001]. In terms of maternal feature, no significant difference was observed in the maternal age, delivery mode, monthly income, and pregnancy syndrome between the FGR cases and healthy controls. Regarding placental growth indicators, differences were detected in the placental length (17.03 vs. 18.37, P < 0.001), breadth (16.68 vs. 18.54, P < 0.001), and surface area (224.21 vs. 270.38, P < 0.001) between the FGR cases and controls.
Demographic characteristic Total (n = 202) FGR (n = 101) Control (n = 101) P-value Gestational age (weeks) 37.8 ± 3.2 36.4 ± 4.0 39.1 ± 1.1 < 0.001* Newborn’s birth weight (kg) 2.81 ± 0.64 2.29 ± 0.43 3.31 ± 0.34 < 0.001* Newborn’s birth length (cm) 48.83 ± 3.79 47.47 ± 5.09 50.09 ± 0.69 < 0.001* Quetelet index 57.49 ± 11.29 48.31 ± 7.56 66.03 ± 6.41 < 0.001* Maternal age (years) 27.8 ± 4.3 27.1 ± 4.9 28.3 ± 3.7 0.097 Placental indicator Length (cm) 17.85 ± 2.26 17.03 ± 1.97 18.37 ± 2.29 < 0.001* Breadth (cm) 17.82 ± 2.25 16.68 ± 2.15 18.54 ± 2.00 < 0.001* Surface area (cm2) 252.39 ± 59.54 224.21 ± 47.32 270.38 ± 59.77 < 0.001* Neonate’s sex 0.778 Male 96 49 47 Female 106 52 54 Delivery mode 0.198 Vaginal delivery 93 71 22 Cesarean delivery 109 79 30 Maternal education level 0.011* Below high school 48 27 21 High school 88 51 37 College and above 66 23 43 Monthly income (Yuan) 0.665 < 5,000 79 38 41 > 5,000 123 63 60 Pregnancy syndrome 0.150 No 149 70 79 Yes 53 31 22 Note. *P-value < 0.05 is statistically significant. Table 1. Demographic characteristic of maternal-newborn pairs
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Table 2 shows the median (interquartile range) concentrations of PBDE congeners in maternal serum between the FGR and control groups. The detection rate of seven PBDE homologues were more than 50% (BDE-17, -47, -66, -153, -207, -208, and -209). The concentration of BDE-209 was the highest in the maternal serum of FGR cases and controls. The maternal serum PBDE concentrations of FGR group, especially BDE-207, -208, -209, and ∑19PBDEs, were significantly higher than those of healthy controls.
PBDE congener Detection rate (%) FGR Control P-value Median (P25, P75) Median (P25, P75) BDE-17 64.4 0.644 (0.154, 1.594) 0.436 (0.090, 1.040) 0.140 BDE-28&33 40.0 0.175 (< LOD, 1.962) 0.313 (< LOD, 1.498) 0.934 BDE-47 56.9 0.524 (< LOD, 1.645) 0.455 (<LOD, 1.255) 0.279 BDE-49 26.7 < LOD (< LOD, 0.322) < LOD (< LOD, 1.286) 0.022* BDE-66 63.9 0.540 (0.158, 3.751) 0.526 (< LOD, 1.793) 0.160 BDE-99 24.8 < LOD (< LOD, 0.205) < LOD (< LOD, 0.435) 0.929 BDE-100 29.2 < LOD (< LOD, 0.298) < LOD (< LOD, 0.320) 0.812 BDE-138 39.1 < LOD (< LOD, 1.839) 0.221 (< LOD, 1.941) 0.371 BDE-153 65.3 2.531 (0.703, 5.348) 1.825 (0.412, 3.122) 0.059 BDE-154 31.2 < LOD (< LOD, 0.391) < LOD (< LOD, 0.724) 0.856 BDE-183 6.9 < LOD (< LOD, < LOD) < LOD (< LOD, < LOD) 0.040* BDE-190 8.9 < LOD (< LOD, < LOD) < LOD (< LOD, <LOD) 0.366 BDE-196 24.3 < LOD (< LOD, 0.704) < LOD (< LOD, 0.862) 0.984 BDE-203 20.3 < LOD (< LOD, 0.439) < LOD (< LOD, < LOD) 0.690 BDE-206 46.0 1.709 (< LOD, 9.007) < LOD (< LOD, 3.379) 0.035* BDE-207 52.0 2.598 (< LOD, 8.449) 0.698 (< LOD, 3.058) 0.002* BDE-208 55.0 1.562 (0.298, 5.259) 1.041 (< LOD, 2.679) 0.012* BDE-209 57.4 7.867 (< LOD, 46.264) 5.908 (< LOD, 18.732) 0.045* ∑19PBDEs 83.7 31.948 (14.119, 93.455) 22.630 (9.204, 43.939) 0.009* Note. LOD: limit of detection.*P-value < 0.05 is statistically significant. Table 2. PBDE level in maternal serum between FGR cases and controls (ng/g)
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Table 3 shows the associations between maternal serum PBDE levels and placental size. A unit increase in BDE-17, -153, -207, -209, and ∑19PBDE concentrations in maternal serum was related to a decrease of 0.19–0.23 cm in placental length. Every unit increase in BDE-17, -153, -207, -208, -209, and ∑19PBDE concentrations was associated with 0.18–0.31 cm decrease in placental breadth. Similarly, concentrations of BDE-17, -153, -207, -208, -209, and ∑19PBDEs were significantly negatively correlated with the placental surface.
PBDE congener Length Breadth Surface area Beta P-value Beta P-value Beta P-value BDE-17 −0.234 0.004* −0.184 0.024* −0.224 0.006* BDE-47 −0.122 0.135 −0.079 0.335 −0.107 0.191 BDE-66 −0.031 0.705 −0.069 0.397 −0.041 0.618 BDE-153 −0.233 0.004* −0.314 < 0.001* −0.283 < 0.001* BDE-207 −0.190 0.019* −0.211 0.009* −0.204 0.012* BDE-208 −0.104 0.201 −0.220 0.007* −0.173 0.034* BDE-209 −0.209 0.010* −0.270 0.001* −0.252 0.002* ∑19PBDEs −0.228 0.005* −0.296 < 0.001* −0.274 0.001* Note. * P-value < 0.05 is statistically significant. Table 3. Correlation between PBDE concentrations and placental indicator
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Table 4 shows the relationships between maternal serum PBDE levels and birth outcome indicators, including birth weight, birth length, gestational age, and Quetelet index. A unit increase in BDE-47, -66, -153, -207, -208, -209, and ∑19PBDE concentrations was related to a decrease of 0.160.27 g in birth weight. Every unit increase in BDE-207, -208, -209, and ∑19PBDE concentrations were associated with 0.18, 0.21, 0.18, and 0.20 cm decreases in birth length, respectively. Meanwhile, gestational age significantly decreased with the increase in BDE-207, -208, -209, and ∑19PBDEs. Likewise, concentrations of BDE-47, -66, -153, -207, -208, -209, and ∑19PBDEs showed a significantly negative association with Quetelet index.
PBDE congener Birth weight Birth length Gestational age Quetelet index Beta P-value Beta P-value Beta P-value Beta P-value BDE-17 −0.127 0.099 −0.041 0.599 −0.054 0.483 −0.126 0.106 BDE-47 −0.162 0.036* −0.058 0.461 −0.122 0.113 −0.173 0.026* BDE-66 −0.228 0.003* −0.102 0.189 −0.086 0.266 −0.228 0.003* BDE-153 −0.183 0.017* −0.139 0.075 −0.105 0.174 −0.180 0.020* BDE-207 −0.268 < 0.001* −0.184 0.018* −0.198 0.010* −0.242 0.002* BDE-208 −0.253 0.001* −0.213 0.006* −0.280 < 0.001* −0.204 0.008* BDE-209 −0.255 0.001* −0.176 0.023* −0.247 0.001* −0.258 0.001* ∑19PBDEs −0.284 < 0.001* −0.201 0.010* −0.261 0.001* −0.277 < 0.001* Note. * P-value < 0.05 is statistically significant. Table 4. Correlation between PBDE concentrations and birth outcome indicator
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The effect of each BDE congener on FGR birth was assessed after adjusting for potential confounders, including gestational age, education, monthly income, and pregnancy syndrome. As shown in Table 5, BDE-66 [odds ratio (OR) = 1.17; 95% confidence interval (CI): 1.04 to 1.32], BDE-153 (OR = 1.12; 95% CI: 1.01 to 1.23), BDE-207 (OR = 1.11; 95% CI: 1.04 to 1.19), BDE-208 (OR = 1.11; 95% CI: 1.03 to 1.20), BDE-209 (OR = 1.02; 95% CI: 1.01 to 1.03), and ∑19PBDEs (OR = 1.11; 95% CI: 1.00 to 1.02) concentrations in maternal serum were significantly associated with the increased risk of FGR. After adjusting for confounders, the association of BDE-207 (OR = 1.10; 95% CI: 1.02 to 1.19) and ∑19PBDE (OR = 1.01; 95% CI: 1.00 to 1.02) concentrations with FGR birth remained statistically significant.
PBDE congener Unadjusted Adjusteda OR ( 95% CI) P-value OR ( 95% CI) P-value BDE-17 1.23 (0.92, 1.63) 0.157 1.21 (0.87, 1.67) 0.254 BDE-47 1.16 (0.99, 1.36) 0.058 1.13 (0.92, 1.38) 0.249 BDE-66 1.17 (1.04, 1.32) 0.010* 1.16 (0.98, 1.39) 0.087 BDE-153 1.12 (1.01, 1.23) 0.027* 1.12 (0.98, 1.27) 0.089 BDE-207 1.11 (1.04, 1.19) 0.001* 1.10 (1.02, 1.19) 0.016* BDE-208 1.11 (1.03, 1.20) 0.006* 1.10 (0.98, 1.23) 0.125 BDE-209 1.02 (1.01, 1.03) 0.003* 1.01 (0.99, 1.03) 0.092 ∑19PBDEs 1.01 (1.00, 1.02) 0.001* 1.01 (1.00, 1.02) 0.037* Note. *P-value < 0.05 is statistically significant;
aAdjusting for gestational age, education, income, and pregnancy syndrome.Table 5. Effects of PBDEs in maternal serum on FGR risk
Concentrations of Polybrominated Diphenyl Ethers in Maternal Blood, Placental Size, and Risk for Fetal Growth Restriction: A Nested Case-control Study
doi: 10.3967/bes2020.112
- Received Date: 2020-02-09
- Accepted Date: 2020-07-22
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Key words:
- Polybrominated diphenyl ethers /
- Fetal growth restriction /
- Maternal serum /
- Birth outcome
Abstract:
Citation: | JIN Yu Ting, DENG Xiao Kai, ZHAO Ying Ya, LI Jia Lin, SONG Qi, ZHANG Yun Hui, YANG Qing, CHEN Shang Qin. Concentrations of Polybrominated Diphenyl Ethers in Maternal Blood, Placental Size, and Risk for Fetal Growth Restriction: A Nested Case-control Study[J]. Biomedical and Environmental Sciences, 2020, 33(11): 821-828. doi: 10.3967/bes2020.112 |