Objective: To evaluate associations between early pregnancy 25-hydroxyvitamin D (25[OH]D) concentrations and antepartum depression and anxiety symptoms and potential modifiers thereof. Materials and Methods: In a pregnancy cohort (N = 498), we examined cross-sectional associations of early pregnancy (mean = 15.4 weeks gestation) serum 25[OH]D concentrations and depression and anxiety symptoms. Symptoms were measured using Depression, Anxiety, and Stress Scales (DASS-21) and Patient Health Questionnaire Depression Module (PHQ-9) instruments. Regression models were fit and effect modification by prepregnancy body mass index and leisure-time physical activity (LTPA) were assessed using interaction terms and stratified analyses. ( < 28.9 ng/mL) had 1.11 higher PHQ-9 scores than those in the highest quartile ( ‡ 39.5 ng/mL, p < 0.05). However, associations were attenuated and statistically insignificant in fully adjusted models. Inverse associations of 25[OH]D with depression symptoms were significant among participants who reported no LTPA, but not among women who reported any LTPA (interaction p = 0.018). Conclusions: Our study provides modest evidence for inverse cross-sectional associations of early pregnancy maternal vitamin D concentrations with antepartum depression symptoms. We also observed that these associations may be modified by physical activity.

Background While associations of vitamin D deficiency with Type 2 diabetes have been well demonstrated, investigations of vitamin D and risk of gestational diabetes mellitus (GDM) reported inconsistent findings. We examined associations of vitamin D status with GDM. Methods In a nested case-cohort study (135 GDM cases and 517 non-GDM controls), we measured maternal serum Vit-D status (total 25[OH]D and 25[OH]D3) in early pregnancy (16 weeks on average) using liquid chromatography-tandem mass spectroscopy. GDM was diagnosed according to the ADA guidelines. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (CI) using logistic regression models. Results GDM cases had lower mean total 25[OH]D (27.3 vs. 29.3ng/ml) and 25[OH]D3 (23.9 vs. 26.7ng/ml) concentrations compared with women who did not develop GDM (both P-values<0.05). Overall, 25[OH]D3 concentrations, but not total 25[OH]D concentrations, were significantly associated with GDM risk. A 5ng/ml increase in 25[OH]D3 concentration was associated with a 14% decrease in GDM risk (P-value=0.02). Women in the lowest quartile for 25[OH]D3 concentration had a 2-fold (95%CI 1.15-3.58) higher risk of GDM compared with women in the highest quartile (P-value for trend<0.05). Conclusions Early pregnancy vitamin D status, particularly 25[OH]D3, is inversely associated with GDM risk.

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Background:Racial/ethnic disparities in preterm birth (PTB) are well documented in the epidemiological literature, but little is known about the relative contribution of different social and environmental determinants of such disparities in birth outcome. Furthermore, increased focus has recently turned toward modifiable aspects of the environment, including physical characteristics, such as neighborhood air pollution, to reduce disparities in birth outcomes.Objectives:To apply decomposition methods to understand disparities in preterm birth (PTB) prevalence between births of non-Hispanic black individuals and births of non-Hispanic white individuals in California, according to individual demographics, neighborhood socioeconomic environment, and neighborhood air pollution.Methods:We used all live singleton births in California spanning 2005 to 2010 and estimated PTBs and other adverse birth outcomes for infants borne by non-Hispanic black mothers and white mothers. To compare individual-level, neighborhood-level, and air pollution [Particulate Matter, 2.5 micrometers or less (PM2.5) and nitrogen dioxide (NO2)] predictors, we conducted a nonlinear extension of the Blinder–Oaxaca method to decompose racial/ethnic disparities in PTB.Results:The predicted differences in probability of PTB between black and white infants was 0.056 (95% CI: 0.054, 0.058). All included predictors explained 37.8% of the black–white disparity. Overall, individual (17.5% for PTB) and neighborhood-level variables (16.1% for PTB) explained a greater proportion of the black–white difference in birth outcomes than air pollution (5.7% for PTB).Conclusions:Our results suggest that, although the role of individual and neighborhood factors remains prevailing in explaining black–white differences in birth outcomes, the individual contribution of PM2.5 is comparable in magnitude to any single individual- or neighborhood-level factor. https://doi.org/10.1289/EHP490

Assisted reproductive technologies (ART) are increasingly used, however little is known about the long-term health of ART-conceived offspring. Weak selection of comparison groups and poorly characterized mechanisms impede current understanding. In a prospective cohort (Growing Up in Singapore Towards healthy Outcomes; GUSTO; Clinical Trials ID: NCT01174875) including 83 ART-conceived and 1095 spontaneously-conceived singletons, we estimate effects of ART on anthropometry, blood pressure, serum metabolic biomarkers, and cord tissue DNA methylation by emulating a pragmatic trial supported by machine learning-based estimators. We find ART-conceived children to be shorter (−0.5 SD [95% CI: −0.7, −0.2]), lighter (−0.6 SD [−0.9, −0.3]) and have lower skinfold thicknesses (e.g. −14% [−24%, −3%] suprailiac), and blood pressure (−3 mmHg [−6, −0.5] systolic) at 6-6.5 years, with no strong differences in metabolic biomarkers. Differences are not explained by parental anthropometry or comorbidities, polygenic risk score, breastfeeding, or illnesses. Our simulations demonstrate ART is strongly associated with lower NECAB3 DNA methylation, with negative control analyses suggesting these estimates are unbiased. However, methylation changes do not appear to mediate observed differences in child phenotype.

Grandmaternal education may be related to grandchild birth weight (GBW) through maternal early-life development; however, conventional regression models may be endogenously confounded. Alternative models employing explicit structural assumptions may provide incrementally clearer evidence. We used data from the US National Longitudinal Study of Adolescent to Adult Health (1995-2009; 1,681 mother-child pairs) to estimate "direct effects" of grandmaternal educational level (less than high school, high school diploma or equivalent, or college degree) at the time of the mother's birth on GBW, adjusted for maternal life-course factors: maltreatment as a child, education and income as an adult, prepregnancy overweight, and prenatal smoking. Using conventional and marginal structural model (MSM) approaches, we estimated 54-g (95% confidence interval: -14.0, 122.1) and 87-g (95% confidence interval: 10.9, 162.5) higher GBWs per increase in educational level, respectively. The MSM allowed simultaneous mediation by and adjustment for prepregnancy overweight. Estimates were insensitive to alternate structural assumptions and mediator parameterizations. Bias analysis suggested that a single unmeasured confounder would have to have a strong influence on GBW (approximately 150 g) or be greatly imbalanced across exposure groups (approximately 25%) to completely explain the findings. Coupling an MSM with sensitivity analyses provides some evidence that maternal early-life socioeconomic environment is directly associated with offspring birth weight.

This cohort study investigates the life experiences, outdoor activity level, and adiposity changes in children in Singapore 1 year after COVID-19–related lockdown.

Background: Pyrethroids are the most widely used insecticides globally for domestic, agricultural, and malaria vector control. In 10 countries, dichlorodiphenyl trichloroethane (DDT) is also used for the latter. Thus, high exposure to pyrethroids and DDT have been reported among women and children from rural and/or malaria-endemic areas. Experimental studies suggest that fetal exposure to pyrethroids, particularly cypermethrin, and DDT may have sex-specific growth effects. However, epidemiologic investigations are scarce and inconsistent and have not considered postnatal environment or susceptibility factors. Methods: In 665 mother–child dyads participating in the Venda Health Examination of Mothers, Babies, and their Environment (VHEMBE), a rural South African birth cohort with high insecticide exposure, we examined associations of maternal peripartum uri-nary pyrethroid metabolites and serum DDT concentrations with child anthropometrics at 3.5 years using multivariable linear regression. We investigated effect modification by child sex, maternal nutrition and HIV status, and household poverty. Results: Pyrethroid metabolites cis -3-(2,2-dibromovinyl)-2,2-dimethyl-cyclopropane carboxylic acid ( cis -DBCA), cis -3-(2,2,-dicholorvinyl)-2,2-dimethyl-cyclopropane carboxylic acid ( cis -DCCA), trans -DCCA, and 3-phenoxybenzoic acid (3-PBA) were quantified in nearly all mothers. A 10-fold increase in cis -DCCA concentration was associated with 0.21 kg/m 2 lower body mass index (95% confidence interval = −0.41, −0.01), with similar estimates for other cypermethrin or permethrin metabolites ( trans -DCCA and 3-phenoxybenzoic acid). In stratified analyses, stronger associations were observed with lower weight, body mass index, arm circumference, and weight-for-height among boys relative to girls. Associations with cis -3-(2,2-dibromovinyl)-2,2-dimethyl-cyclopropane carboxylic acid, a metabolite specific to deltamethrin, were weaker or absent. No substantial associations were observed with DDT. Discussion: In a population with ubiquitous pyrethroid exposure, maternal concentrations of metabolites of cypermethrin and permethrin were associated with thinness at 3.5 years.