The Cumulative Risk of Prenatal Exposures to Chemical and Non-Chemical Stressors on Birth Outcomes in Suriname

Abstract

The cumulative exposure to chemical and non-chemical stressors may have an impact on birth outcomes. The aim of this study is to examine the cumulative exposure of a mixture of chemicals (mercury, lead, selenium and tin) and non-chemical stressors (social support, perceived stress, probable depression and BMI) on birth outcomes (birthweight, gestational age at birth, and Apgar score at 5 min). The study population is a subset (n = 384) of the Caribbean Consortium for Research in Environmental and Occupational Health–MeKiTamara prospective cohort study. Associations between the latent chemical construct, non-chemical stressors and birth outcomes were assessed using path models. The results showed a significant direct relationship between perceived stress and birthweight (β = −0.17), however even though the relationship between perceived stress and depression was significant in all three path models (β = 0.61), the association between depression and birth outcomes was not significant. Perceived stress was significantly associated with community engagement (β = −0.12) and individual resilience (β = −0.12). BMI (β = 0.12) was also significantly directly associated with birthweight. The latent chemical construct did not show an association with the birth outcomes. Our data indicate the need for the development of a support system for pregnant women by involving them in prenatal care programs to reduce maternal stress, which may also influence depression and (in)directly improve the birth outcomes. Interventions regarding weight management for women of childbearing age are necessary to halt obesity and its negative effects on birth outcomes.

Risk Factors for Working Pregnant Women and Potential Adverse Consequences of Exposure: A Systematic Review

“…In order to examine whether psychosocial work stress during pregnancy was related to the risk of giving birth to a preterm baby or a baby small for the gestational age, a study was conducted in Denmark by Larsen et al ( 13 ), but the association between work stress and preterm birth was not confirmed. However, this association was indeed found in the study by Gokoel et al ( 42 ). Likewise, Trocado et al ( 16 ) found a possible association between low birth weight and day and night rotating shifts.…”

Prenatal PFAS and psychosocial stress exposures in relation to fetal growth in two pregnancy cohorts: Applying environmental mixture methods to chemical and non-chemical stressors

“…We also acknowledge that results from our study may not be directly comparable to the NICHD Fetal Growth study, as the chemical exposures differed. An additional study of pregnant people in the Caribbean utilized a path analysis, a subset of structural equation modeling ( Gokoel et al, 2021 ). In that study, the chemical construct (comprised of mercury, lead, selenium, and tin measured in maternal whole blood) and increasing PSS and depression scores were associated with lower birthweight and gestational age ( Gokoel et al, 2021 ), which supports our findings that there is a joint effect of chemical and non-chemical stressors on fetal growth.…”

“…An additional study of pregnant people in the Caribbean utilized a path analysis, a subset of structural equation modeling ( Gokoel et al, 2021 ). In that study, the chemical construct (comprised of mercury, lead, selenium, and tin measured in maternal whole blood) and increasing PSS and depression scores were associated with lower birthweight and gestational age ( Gokoel et al, 2021 ), which supports our findings that there is a joint effect of chemical and non-chemical stressors on fetal growth. Other studies using stratified single pollutant models have shown that the relationships between increasing chemical exposures and adverse pregnancy outcomes are stronger in the presence of stress ( Padula et al, 2020 ; Aker et al, 2020 ; Ferguson et al, 2019 ; Ashrap et al, 2021 ).…”