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Meta-Analysis
. 2023 Jun 9;18(6):e0287089.
doi: 10.1371/journal.pone.0287089. eCollection 2023.

Pregnancy pesticide exposure and child development in low- and middle-income countries: A prospective analysis of a birth cohort in rural Bangladesh and meta-analysis

Lilia Bliznashka  1   2 , Aditi Roy  3 , David C Christiani  4 , Antonia M Calafat  5 , Maria Ospina  5 , Nancy Diao  4 , Maitreyi Mazumdar  4   6 , Lindsay M Jaacks  2   3
Affiliations
Meta-Analysis

Pregnancy pesticide exposure and child development in low- and middle-income countries: A prospective analysis of a birth cohort in rural Bangladesh and meta-analysis

Lilia Bliznashka et al. PLoS One. .

Abstract

Background: Despite considerable evidence on a negative association between pregnancy pesticide exposure and child development in high-income countries, evidence from low- and middle-income countries (LMICs) is limited. Therefore, we assessed associations between pregnancy pesticide exposure and child development in rural Bangladesh and summarised existing literature in a systematic review and meta-analysis.

Methods: We used data from 284 mother-child pairs participating in a birth cohort established in 2008. Eight urinary pesticide biomarkers were quantified in early pregnancy (mean gestational age 11.6±2.9 weeks) as an index of pesticide exposure. The Bayley Scales of Infant and Toddler Development, Third Edition were administered at 20-40 months of age. Associations between creatinine-adjusted urinary pesticide biomarker concentrations and child development scores were estimated using multivariable generalised linear models. We searched ten databases up to November 2021 to identify prospective studies on pregnancy pesticide exposure and child development conducted in LMICs. We used a random-effects model to pool similar studies, including our original analysis. The systematic review was pre-registered with PROSPERO: CRD42021292919.

Results: In the Bangladesh cohort, pregnancy 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY) concentrations were inversely associated with motor development (-0.66 points [95% CI -1.23, -0.09]). Pregnancy 3,5,6-trichloro-2-pyridinol (TCPY) concentrations were inversely associated with cognitive development, but the association was small: -0.02 points (-0.04, 0.01). We observed no associations between 4-nitrophenol and 3-phenoxybenzoic acid (3-PBA) concentrations and child development. The systematic review included 13 studies from four LMICs. After pooling our results with one other study, we found consistent evidence that pregnancy 3-PBA concentrations were not associated with cognitive, language, or motor development.

Conclusion: Evidence suggests that pregnancy exposure to some organophosphate pesticides is negatively associated with child development. Interventions to reduce in-utero pesticide exposure in LMICs may help protect child development.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram of search results and included articles.
Fig 2
Fig 2. Pooled association between creatinine-adjusted pregnancy 3-PBA concentrations (μg/g creatinine) and child cognitive development composite scores at 20-to-40 months of age.
Abbreviations: 3-PBA, 3-phenoxybenzoic acid; MD, mean difference; CI, confidence interval.
Fig 3
Fig 3. Pooled association between creatinine-adjusted pregnancy 3-PBA concentrations (μg/g creatinine) and child language development composite scores at 20-to-40 months of age.
Abbreviations: 3-PBA, 3-phenoxybenzoic acid; MD, mean difference; CI, confidence interval.
Fig 4
Fig 4. Pooled association between creatinine-adjusted pregnancy 3-PBA concentrations (μg/g creatinine) and child motor development composite scores at 20-to-40 months of age.
Abbreviations: 3-PBA, 3-phenoxybenzoic acid; MD, mean difference; CI, confidence interval.
See this image and copyright information in PMC

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