Association of DDT with Spontaneous Abortion: A Case-Control Study

Korrick, Susan A; Chen, Changzhong; Damokosh, Andrew I; Ni, Jiatong; Liu, Xue; Cho, Sung-Il; Altshul, Larisa; Ryan, Louise; Xu, Xiping

« Previous Next »Annals of Epidemiology
Volume 11, Issue 7 , Pages 491-496, October 2001

Association of DDT with Spontaneous Abortion:

A Case-Control Study

Susan A Korrick, MD, MPH
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
- Department of Environmental Health, Harvard School of Public Health, Boston, MA USA
- Address reprint requests to: Susan Korrick, MD, MPH, Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115
Changzhong Chen, MD
- Program for Population Genetics, Harvard School of Public Health, Boston, MA USA
Andrew I Damokosh, PhD
- Program for Population Genetics, Harvard School of Public Health, Boston, MA USA
Jiatong Ni, MD
- Anhui Institute of Biomedicine and Environmental Health, Anqing, Anhui, China
Xue Liu, BS
- Anhui Institute of Biomedicine and Environmental Health, Anqing, Anhui, China
Sung-Il Cho, MD, ScD
- Program for Population Genetics, Harvard School of Public Health, Boston, MA USA
Larisa Altshul, MS
- Department of Environmental Health, Harvard School of Public Health, Boston, MA USA
Louise Ryan, PhD
- Department of Biostatistics, Harvard School of Public Health, and the Department of Biostatistical Science, Dana-Farber Cancer Institute, Boston, MA USA
Xiping Xu, MD, PhD
- Department of Environmental Health, Harvard School of Public Health, Boston, MA USA
- Program for Population Genetics, Harvard School of Public Health, Boston, MA USA

Received 17 November 2000; received in revised form 28 February 2001; accepted 19 March 2001.

Abstract

PURPOSE: Spontaneous abortion (SAB), the most common adverse pregnancy outcome, affects ∼15% of clinically recognized pregnancies. Except for advanced maternal age and smoking, there are not well-established risk factors for SAB. Animal models associate increased fetal resorption or abortion with exposure to the pesticide dichlorodiphenyl trichloroethane (DDT), but epidemiologic investigations of DDT and SAB are inconsistent. We undertook a pilot investigation of the hypothesized association of DDT with SAB.

METHODS: Participants in this case-control study were selected from a longitudinal study of reproductive effects of rotating shifts among female Chinese textile workers who were married, ages 22–34, nulliparous without history of SAB or infertility, and planning pregnancy. From 412 pregnancies, 42 of which ended in SAB, 15 SAB cases and 15 full-term controls were randomly selected and phlebotomized. Serum was analyzed for p,p′-DDT, o,p′-DDT, their metabolites (DDE and DDD), and other organochlorines including polychlorinated biphenyls.

RESULTS: Cases and controls were nonsmokers and did not differ in age (mean 25 years), body mass index (BMI), passive smoke exposure, or workplace exposures. Cases had significantly (p < 0.05) higher serum levels of p,p′-DDE (22 vs.12 ng/g) and o,p′-DDE (0.09 vs. 0.05 ng/g) than controls. After adjustment for age and BMI, each ng/g serum increase in p,p′-DDE was associated with a 1.13 (CI, 1.02–1.26) increased odds of SAB. With adjustment of serum DDE levels for excretion via breastfeeding, DDE-associated increased odds of SAB remained significant with up to 7% declines in maternal serum DDE levels for each month of breastfeeding.

CONCLUSIONS: A potential increased risk of SAB is associated with maternal serum DDE levels.

Keywords: Pesticides, Organochlorines, DDT, DDE, PCBs, Spontaneous Abortion