Kim, JoanneYang, SeungmiMoodie, Erica EM.Obida, MuvhulawaBornman, Maria S. (Riana)Eskenazi, BrendaChevrier, Jonathan2022-07-202022-07-202022-04Kim, Joannea; Yang, Seungmia; Moodie, Erica EMa; Obida, Muvhulawab; Bornman, Rianab; Eskenazi, Brendac; Chevrier, Jonathana,* Prenatal exposure to insecticides and child cardiometabolic risk factors in the VHEMBE birth cohort, Environmental Epidemiology: April 2022 - Volume 6 - Issue 2 - p e196, doi: 10.1097/EE9.0000000000000196.2474-7882 (online)10.1097/EE9.0000000000000196https://repository.up.ac.za/handle/2263/86339BACKGROUND : As part of malaria control programs, many countries spray dichlorodiphenyltrichloroethane (DDT) or pyrethroid insecticides inside dwellings in a practice called indoor residual spraying that results in high levels of exposure to local populations. Gestational exposure to these endocrine- and metabolism-disrupting chemicals may influence child cardiometabolic health. METHODS : We measured the serum concentration of DDT and dichlorodiphenyldichloroethylene (DDE) and urinary concentration of pyrethroid metabolites (cis-DBCA, cis-DCCA, trans-DCCA, 3-PBA) in peripartum samples collected between August 2012 and December 2013 from 637 women participating in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), a birth cohort study based in Limpopo, South Africa. We applied marginal structural models to estimate the relationship between biomarker concentrations and child-size (height and weight), adiposity (body mass index [BMI], body fat percentage, waist circumference) and blood pressure at 5 years of age. RESULTS : Maternal concentrations of all four pyrethroid metabolites were associated with lower adiposity including reduced BMI z-scores, smaller waist circumferences, and decreased body fat percentages. Reductions in BMI z-score were observed only among children of mothers with sufficient energy intake during pregnancy (βcis-DCCA, trans-DCCA=−0.4, 95% confidence interval (CI) = −0.7,−0.1; pinteraction=0.03 and 0.04, respectively) but there was no evidence of effect modification for the other measures of adiposity. Maternal p,p’-DDT concentrations were associated with a reduction in body fat percentage (β = −0.4%, 95% CI = −0.8,−0.0). CONCLUSIONS : Gestational exposure to pyrethroids may reduce adiposity in children at 5 years of age.en© 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Environmental Epidemiology. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND).Indoor residual sprayingInsecticidesPyrethroidsCardiometabolic healthAdiposityDichlorodiphenyltrichloroethane (DDT)Dichlorodiphenyldichloroethylene (DDE)Venda health examination of mothers, babies and their environment (VHEMBE)Article