The association between prenatal exposure to dichlorodiphenyltrichloroethane(DDT) or polychlorinated biphenyls (PCBs) and the risk of congenital anomalies: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LIN Yu ¹ , ZHANG Xiaofen ¹ , HE Jie ² , ZHAO Benhua ¹ , LAI Zhenbin ² , ZHAO Zeyu ¹ , YU Xiaoshan ¹ , CHEN Jianghui ¹ , LIN Xiuyu ¹ ,  SU Yanhua ¹ ,  LIU GANG ¹

1. Department of Preventive Medicine, School of Public Health, Xiamen University; National Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen, 361002, P.R.China;
2. Department of Gastroenterology, The 2^nd Hospital of Xiamen City, Xiamen, 361021, P.R.China;

Corresponding author：

SU Yanhua, Email: suyanhua813@xmu.edu.cn; LIU GANG, Email: gangliu.cmitm@xmu.edu.cn

Keywords：

Dichlorodiphenyltrichloroethane; Polychlorinated biphenyls; Prenatal exposure; Congenital anomalies; Systematic review; Meta-analysis; Case-control study

DOI：

10.7507/1672-2531.201707129

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the association between prenatal exposure to dichlorodiphenyltrichloroethane (DDT) or polychlorinated biphenyls (PCBs) and the risk of congenital anomalies. Methods PubMed, EMbase, WanFang Data, VIP and CNKI databases were electronically searched to collect case-control studies on the relationship between prenatal exposure to DDT or PCBs and congenital anomalies from inception to February 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 13.0 software. Results A total of 14 studies involving 2 238 infants with defect and 2 335 infants without defect were included. The results of meta-analysis showed that: the prenatal exposure to high level of DDT increased the incidence of cryptorchidism (OR=1.12, 95% CI 1.09 to 1.15, P<0.001). However, DDT exposure had no correlation to hypospadias and neural tube defects. The associations between prenatal exposure to PCBs and cryptorchidism, hypospadias, neural tube defects were not discovered. Conclusion Prenatal exposure to high levels of DDT may be a risk factor for cryptorchidism. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.

Citation： LIN Yu, ZHANG Xiaofen, HE Jie, ZHAO Benhua, LAI Zhenbin, ZHAO Zeyu, YU Xiaoshan, CHEN Jianghui, LIN Xiuyu, SU Yanhua, LIU GANG. The association between prenatal exposure to dichlorodiphenyltrichloroethane(DDT) or polychlorinated biphenyls (PCBs) and the risk of congenital anomalies: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2018, 18(4): 365-372. doi: 10.7507/1672-2531.201707129 Copy

1.	Yu HY, Bao LJ, Liang Y, et al. Field validation of anaerobic degradation pathways for dichlorodiphenyltrichloroethane (DDT) and 13 metabolites in marine sediment cores from China. Environ Sci Technol, 2011, 45(12): 5245-5252.
2.	Magulova K, Priceputu A. Global monitoring plan for persistent organic pollutants (POPs) under the Stockholm Convention: Triggering, streamlining and catalyzing global POPs monitoring. Environ Pollut, 2016, 217: 82-84.
3.	Krauthacker B, Alebić-Kolbah T, Buntić A, et al. DDT residues in samples of human milk, and in mothers' and cord blood serum, in a continental town in Croatia (Yugoslavia). Int Arch Occup Environ Health, 1980, 46(3): 267-273.
4.	Koepke R, Warner M, Petreas M, et al. Serum DDT and DDE levels in pregnant women of Chiapas, Mexico. Arch Environ Health, 2004, 59(11): 559-565.
5.	Lubick N. DDT levels in Antarctic penguins present a complex mystery. Environ Sci Technol, 2008, 42(11): 3909.
6.	WHO. WHO gives indoor use of DDT a clean bill of health for controlling malaria. Available at: http://www.who.int/mediacentre/news/releases/2006/pr50/en/.
7.	Afful S, Anim AK, Serfor-Armah Y. Spectrum of organochlorine pesticide residues in fish samples from the Densu Basin. Res J Environ Earth, 2010, 2(3): 133-138.
8.	Gaspari L, Sampaio DR, Paris F, et al. High prevalence of micropenis in 2710 male newborns from an intensive-use pesticide area of Northeastern Brazil. Int J Androl, 2012, 35(3): 253-264.
9.	Longnecker MP, Klebanoff MA, Dunson DB, et al. Maternal serum level of the DDT metabolite DDE in relation to fetal loss in previous pregnancies. Environ Res, 2005, 97(2): 127-133.
10.	Bornman R, de Jager C, Worku Z, et al. DDT and urogenital malformations in newborn boys in a malarial area. BJU Int, 2010, 106(3): 405-411.
11.	Govarts E, Nieuwenhuijsen M, Schoeters G, et al. Birth weight and prenatal exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (DDE): a meta-analysis within 12 European Birth Cohorts. Environ Health Perspect, 2012, 120(2): 162-170.
12.	Krysiak-Baltyn K, Toppari J, Skakkebaek NE, et al. Association between chemical pattern in breast milk and congenital cryptorchidism: modelling of complex human exposures. Int J Androl, 2012, 35(3): 294-302.
13.	Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA, 2000, 283(15): 2008-2012.
14.	Han Y, Xia Z, Guo S, et al. Laparoscopically assisted anorectal pull-through versus posterior sagittal anorectoplasty for high and intermediate anorectal malformations: a systematic review and meta-analysis. PLoS One, 2017, 12(1): e0170421.
15.	Rignell-Hydbom A, Lindh CH, Dillner J, et al. A nested case-control study of intrauterine exposure to persistent organochlorine pollutants and the risk of hypospadias. PLoS One, 2012, 7(9): e44767.
16.	Suarez L, Gilani Z, Felkner M, et al. Exposure to polychlorinated biphenyls and risk of neural-tube defects in a Mexican American population. Int J Occup Environ Health, 2005, 11(3): 233-237.
17.	Bhatia R, Shiau R, Petreas M, et al. Organochlorine pesticides and male genital anomalies in the child health and development studies. Environ Health Perspect, 2005, 113(2): 220-224.
18.	Longnecker MP, Klebanoff MA, Brock JW, et al. Maternal serum level of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene and risk of cryptorchidism, hypospadias, and polythelia among male offspring. Am J Epidemiol, 2002, 155(4): 313-322.
19.	Carmichael SL, Herring AH, Sjödin A, et al. Hypospadias and halogenated organic pollutant levels in maternal mid-pregnancy serum samples. Chemosphere, 2010, 80(6): 641-646.
20.	Koskenniemi JJ, Virtanen HE, Kiviranta H, et al. Association between levels of persistent organic pollutants in adipose tissue and cryptorchidism in early childhood: a case-control study. Environ Health, 2015, 14: 78.
21.	Brucker-Davis F, Wagner-Mahler K, Delattre I, et al. Cryptorchidism at birth in Nice area (France) is associated with higher prenatal exposure to PCBs and DDE, as assessed by colostrum concentrations. Hum Reprod, 2008, 23(8): 1708-1718.
22.	Fernandez MF, Olmos B, Granada A, et al. Human exposure to endocrine-disrupting chemicals and prenatal risk factors for cryptorchidism and hypospadias: a nested case-control study. Environ Health Perspect, 2007, 115 Suppl 1: 8-14.
23.	McGlynn KA, Guo X, Graubard BI, et al. Maternal pregnancy levels of polychlorinated biphenyls and risk of hypospadias and cryptorchidism in male offspring. Environ Health Perspect, 2009, 117(9): 1472-1476.
24.	Giordano F, Abballe A, De Felip E, et al. Maternal exposures to endocrine disrupting chemicals and hypospadias in offspring. Birth Defects Res A Clin Mol Teratol, 2010, 88(4): 241-250.
25.	Waliszewski SM, Infanzon RM, Arroyo SG, et al. Persistent organochlorine pesticides levels in blood serum lipids in women bearing babies with undescended testis. Bull Environ Contam Toxicol, 2005, 75(5): 952-959.
26.	Ren A, Qiu X, Jin L, et al. Association of selected persistent organic pollutants in the placenta with the risk of neural tube defects. Proc Natl Acad Sci U S A, 2011, 108(31): 12770-12775.
27.	Ma J, Qiu X, Ren A, et al. Using placenta to evaluate the polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) exposure of fetus in a region with high prevalence of neural tube defects. Ecotoxicol Environ Saf, 2012, 86: 141-146.
28.	Wang B, Yi D, Jin L, et al. Organochlorine pesticide levels in maternal serum and risk of neural tube defects in offspring in Shanxi Province, China: a case-control study. Sci Total Environ, 2014, 490: 1037-1043.
29.	Needham LL, Gerthoux PM, Patterson DG Jr, et al. Exposure assessment: serum levels of TCDD in Seveso, Italy. Environ Res, 1999, 80(2 Pt 2): S200-S206.
30.	Arrebola JP, Cuellar M, Claure E, et al. Concentrations of organochlorine pesticides and polychlorinated biphenyls in human serum and adipose tissue from Bolivia. Environ Res, 2012, 112: 40-47.
31.	Lv QX, Wang W, Li XH, et al. Polychlorinated biphenyls and polybrominated biphenyl ethers in adipose tissue and matched serum from an E-waste recycling area (Wenling, China). Environ Pollut, 2015, 199: 219-226.
32.	Weidner IS, Møller H, Jensen TK, et al. Risk factors for cryptorchidism and hypospadias. J Urol, 1999, 161(5): 1606-1609.
33.	Kelce WR, Stone CR, Laws SC, et al. Persistent DDT metabolite p,p'-DDE is a potent androgen receptor antagonist. Nature, 1995, 375(6532): 581-585.
34.	Bowerman WW, Giesy JP, Best DA, et al. A review of factors affecting productivity of bald eagles in the Great Lakes region: implications for recovery. Environ Health Perspect, 1995, 103 Suppl 4: 51-59.
35.	Brender JD, Felkner M, Suarez L, et al. Maternal pesticide exposure and neural tube defects in Mexican Americans. Ann Epidemiol, 2010, 20(1): 16-22.
36.	Shaw GM, Wasserman CR, O'Malley CD, et al. Maternal pesticide exposure from multiple sources and selected congenital anomalies. Epidemiology, 1999, 10(1): 60-66.

1. Yu HY, Bao LJ, Liang Y, et al. Field validation of anaerobic degradation pathways for dichlorodiphenyltrichloroethane (DDT) and 13 metabolites in marine sediment cores from China. Environ Sci Technol, 2011, 45(12): 5245-5252.
2. Magulova K, Priceputu A. Global monitoring plan for persistent organic pollutants (POPs) under the Stockholm Convention: Triggering, streamlining and catalyzing global POPs monitoring. Environ Pollut, 2016, 217: 82-84.
3. Krauthacker B, Alebić-Kolbah T, Buntić A, et al. DDT residues in samples of human milk, and in mothers' and cord blood serum, in a continental town in Croatia (Yugoslavia). Int Arch Occup Environ Health, 1980, 46(3): 267-273.
4. Koepke R, Warner M, Petreas M, et al. Serum DDT and DDE levels in pregnant women of Chiapas, Mexico. Arch Environ Health, 2004, 59(11): 559-565.
5. Lubick N. DDT levels in Antarctic penguins present a complex mystery. Environ Sci Technol, 2008, 42(11): 3909.
6. WHO. WHO gives indoor use of DDT a clean bill of health for controlling malaria. Available at: http://www.who.int/mediacentre/news/releases/2006/pr50/en/.
7. Afful S, Anim AK, Serfor-Armah Y. Spectrum of organochlorine pesticide residues in fish samples from the Densu Basin. Res J Environ Earth, 2010, 2(3): 133-138.
8. Gaspari L, Sampaio DR, Paris F, et al. High prevalence of micropenis in 2710 male newborns from an intensive-use pesticide area of Northeastern Brazil. Int J Androl, 2012, 35(3): 253-264.
9. Longnecker MP, Klebanoff MA, Dunson DB, et al. Maternal serum level of the DDT metabolite DDE in relation to fetal loss in previous pregnancies. Environ Res, 2005, 97(2): 127-133.
10. Bornman R, de Jager C, Worku Z, et al. DDT and urogenital malformations in newborn boys in a malarial area. BJU Int, 2010, 106(3): 405-411.
11. Govarts E, Nieuwenhuijsen M, Schoeters G, et al. Birth weight and prenatal exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (DDE): a meta-analysis within 12 European Birth Cohorts. Environ Health Perspect, 2012, 120(2): 162-170.
12. Krysiak-Baltyn K, Toppari J, Skakkebaek NE, et al. Association between chemical pattern in breast milk and congenital cryptorchidism: modelling of complex human exposures. Int J Androl, 2012, 35(3): 294-302.
13. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA, 2000, 283(15): 2008-2012.
14. Han Y, Xia Z, Guo S, et al. Laparoscopically assisted anorectal pull-through versus posterior sagittal anorectoplasty for high and intermediate anorectal malformations: a systematic review and meta-analysis. PLoS One, 2017, 12(1): e0170421.
15. Rignell-Hydbom A, Lindh CH, Dillner J, et al. A nested case-control study of intrauterine exposure to persistent organochlorine pollutants and the risk of hypospadias. PLoS One, 2012, 7(9): e44767.
16. Suarez L, Gilani Z, Felkner M, et al. Exposure to polychlorinated biphenyls and risk of neural-tube defects in a Mexican American population. Int J Occup Environ Health, 2005, 11(3): 233-237.
17. Bhatia R, Shiau R, Petreas M, et al. Organochlorine pesticides and male genital anomalies in the child health and development studies. Environ Health Perspect, 2005, 113(2): 220-224.
18. Longnecker MP, Klebanoff MA, Brock JW, et al. Maternal serum level of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene and risk of cryptorchidism, hypospadias, and polythelia among male offspring. Am J Epidemiol, 2002, 155(4): 313-322.
19. Carmichael SL, Herring AH, Sjödin A, et al. Hypospadias and halogenated organic pollutant levels in maternal mid-pregnancy serum samples. Chemosphere, 2010, 80(6): 641-646.
20. Koskenniemi JJ, Virtanen HE, Kiviranta H, et al. Association between levels of persistent organic pollutants in adipose tissue and cryptorchidism in early childhood: a case-control study. Environ Health, 2015, 14: 78.
21. Brucker-Davis F, Wagner-Mahler K, Delattre I, et al. Cryptorchidism at birth in Nice area (France) is associated with higher prenatal exposure to PCBs and DDE, as assessed by colostrum concentrations. Hum Reprod, 2008, 23(8): 1708-1718.
22. Fernandez MF, Olmos B, Granada A, et al. Human exposure to endocrine-disrupting chemicals and prenatal risk factors for cryptorchidism and hypospadias: a nested case-control study. Environ Health Perspect, 2007, 115 Suppl 1: 8-14.
23. McGlynn KA, Guo X, Graubard BI, et al. Maternal pregnancy levels of polychlorinated biphenyls and risk of hypospadias and cryptorchidism in male offspring. Environ Health Perspect, 2009, 117(9): 1472-1476.
24. Giordano F, Abballe A, De Felip E, et al. Maternal exposures to endocrine disrupting chemicals and hypospadias in offspring. Birth Defects Res A Clin Mol Teratol, 2010, 88(4): 241-250.
25. Waliszewski SM, Infanzon RM, Arroyo SG, et al. Persistent organochlorine pesticides levels in blood serum lipids in women bearing babies with undescended testis. Bull Environ Contam Toxicol, 2005, 75(5): 952-959.
26. Ren A, Qiu X, Jin L, et al. Association of selected persistent organic pollutants in the placenta with the risk of neural tube defects. Proc Natl Acad Sci U S A, 2011, 108(31): 12770-12775.
27. Ma J, Qiu X, Ren A, et al. Using placenta to evaluate the polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) exposure of fetus in a region with high prevalence of neural tube defects. Ecotoxicol Environ Saf, 2012, 86: 141-146.
28. Wang B, Yi D, Jin L, et al. Organochlorine pesticide levels in maternal serum and risk of neural tube defects in offspring in Shanxi Province, China: a case-control study. Sci Total Environ, 2014, 490: 1037-1043.
29. Needham LL, Gerthoux PM, Patterson DG Jr, et al. Exposure assessment: serum levels of TCDD in Seveso, Italy. Environ Res, 1999, 80(2 Pt 2): S200-S206.
30. Arrebola JP, Cuellar M, Claure E, et al. Concentrations of organochlorine pesticides and polychlorinated biphenyls in human serum and adipose tissue from Bolivia. Environ Res, 2012, 112: 40-47.
31. Lv QX, Wang W, Li XH, et al. Polychlorinated biphenyls and polybrominated biphenyl ethers in adipose tissue and matched serum from an E-waste recycling area (Wenling, China). Environ Pollut, 2015, 199: 219-226.
32. Weidner IS, Møller H, Jensen TK, et al. Risk factors for cryptorchidism and hypospadias. J Urol, 1999, 161(5): 1606-1609.
33. Kelce WR, Stone CR, Laws SC, et al. Persistent DDT metabolite p,p'-DDE is a potent androgen receptor antagonist. Nature, 1995, 375(6532): 581-585.
34. Bowerman WW, Giesy JP, Best DA, et al. A review of factors affecting productivity of bald eagles in the Great Lakes region: implications for recovery. Environ Health Perspect, 1995, 103 Suppl 4: 51-59.
35. Brender JD, Felkner M, Suarez L, et al. Maternal pesticide exposure and neural tube defects in Mexican Americans. Ann Epidemiol, 2010, 20(1): 16-22.
36. Shaw GM, Wasserman CR, O'Malley CD, et al. Maternal pesticide exposure from multiple sources and selected congenital anomalies. Epidemiology, 1999, 10(1): 60-66.

Chinese Journal of Evidence-Based Medicine

The association between prenatal exposure to dichlorodiphenyltrichloroethane(DDT) or polychlorinated biphenyls (PCBs) and the risk of congenital anomalies: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content