The median urinary concentrations were 0. However, three pyrethroid metabolite concentrations were highly correlated with each other, with an approximate r of 0. In general, there was no clear evidence or consistent pattern of differences in associations by sex at 1 y of age Table 5. There was a significant interaction of cis -DBCA and sex on Receptive Communication and Language Composite with a negative coefficient in girls and a positive coefficient in boys, although neither sex stratum was significant.

At 2 y of age, we observed that a fold increase in maternal cis -DBCA concentrations was associated with a 0. However, there were significant differences in associations between Motor Composite scores and each of the four metabolites p -Int 0.

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Note: Coefficients show the change in scaled BSID score associated with a fold increase in maternal urinary pyrethroid metabolite concentrations. Note: Coefficients show the change in scaled BSID score associated with a fold increase in in maternal urinary pyrethroid metabolite concentrations. Overall, the trends in associations in this restricted and full sample Table 6 were similar, with some results slightly attenuated e. However, significant inverse associations emerge between cis - and trans -DCCA and 3PBA and fine motor scores at the 1-y visit but were no longer apparent at the 2-y visit, and between trans -DCCA and Language Composite at the 2-y visit, primarily driven by Expressive Communication.

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In other sensitivity analyses, removing the covariate for preterm status from the models see Tables S4—S5 or including variables in the regression models for maternal HIV status see Tables S6—S7 , child lead levels see Tables S8—S11 , or child hemoglobin levels see Tables S12—S15 did not alter the above results. At the 2-y visit, there was no consistent pattern of which set of group PIPs were highest. No associations of the pyrethroid group for the 2-y assessment reached PIP inclusion criterion.

We examined the relationship between in utero exposure to insecticides used in IRS for malaria control in Limpopo, South Africa, and neurodevelopment of children at 1- and 2-y follow-up as assessed on the BSID. Other associations with pyrethroids were less consistent. We did not observe a relationship of maternal pyrethroid exposure and child cognition, but did observe associations of cis -DBCA and language development. Although the children in our study were considerably younger than in previous studies, our finding of a relationship between maternal pyrethroid metabolites cis - and trans -DCCA and 3PBA and poorer socio-emotional development in the 1-y-olds are in line with the results of these two studies.

Unfortunately, we did not administer the Social Emotional subtest at 2 y of age and therefore, cannot confirm this finding at 2 y of age. In the current study, we aimed to collect urine from women when they entered the hospital for admission, but in more than a third the urine sample was collected postdelivery. Women who had the urine sample collected predelivery were more likely to deliver by Cesarean section, but did not differ in any other obvious ways. Because we were concerned that measurements in postdelivery urine samples reflected exposure occurring in the hospital instead of in the home from IRS , we controlled for timing of the sample collection in the main analysis and conducted sensitivity analyses restricting the sample to women who provided specimens predelivery.

Although the findings were not substantially different when restricting analysis to the smaller sample, three of the four pyrethoid metabolite levels were higher in the predelivery samples. Serial urine samples collected over the course of pregnancy would have yielded a more accurate picture of exposure to pyrethroids. Thus, the risk of exposure misclassification of pyrethroids around the critical period of brain development is a limitation of this study. To our knowledge, this is the first study to examine the relationship of insecticides used in IRS and neurodevelopment. Previous studies have considered the neurodevelopmental effects of organochlorine or pyrethroid insecticides, but in populations unlike those that are currently exposed to these pesticides in the context of IRS.

Our population is economically impoverished, food insecure, and has fairly high rates of HIV—all factors that may potentially render this population more vulnerable to chemical exposure. Spraying practices vary between demographically similar villages based largely on minor differences in altitude, which impact malaria transmission risk. This yielded a wide range of exposures in an otherwise relatively demographically homogeneous population.

Associated Data

Another limitation of the study is that we found a lack of consistency between associations at the 1-y and 2-y visits, and hence the longitudinal measures were deemed not relevant. It is possible that the assessment at 1 y of age was less reliable given infant behavior than at 2 y of age. The fact that this finding no longer exists at 2 y of age suggests that it may be due to chance. Data from future visits in this ongoing longitudinal study should give us an indication whether the associations persist over time. Previous studies have not considered the joint effects of the two pesticide classes, although both classes of pesticides are widely used in malaria-endemic areas in South Africa.

A strength of this study is the use of BKMR to consider individual chemical exposure responses with co-occurring insecticides and their interaction without numerous comparison testing. In contrast, pyrethoid exposure measured in the peripartum period was associated with statistically significant decrements in social-emotional and language development in this age range, as well as lower motor function scores in girls but higher motor function scores in boys.

Although IRS has been instrumental in the prevention of malaria in sub-Saharan Africa, these benefits must be considered against possible neurotoxic effects on young children. Ramutangwa and T.

Madzanani, who performed all of the Bayley assessments. We thank D. National Center for Biotechnology Information , U. Journal List Environ Health Perspect v. Environ Health Perspect. Published online Apr 6. Rauch , 1 Eric S. Kogut , 1 Riana Bornman , 2, 3 and Jonathan Chevrier 4. Stephen A. Eric S. Katherine R. Author information Article notes Copyright and License information Disclaimer.

Corresponding author. Address correspondence to B. Telephone: Email: ude. Copyright notice. All content is public domain unless otherwise noted. This article has been corrected. See Environ Health Perspect. This article has been cited by other articles in PMC. Associated Data Supplementary Materials 3.

Abstract Background: Although indoor residual spraying IRS with dichlorodiphenyltrichloroethane DDT and pyrethroids effectively controls malaria, it potentially increases human exposure to these insecticides. Objectives: We aimed to estimate the effects of maternal insecticide exposure and neurodevelopment of toddlers living in a malaria-endemic region currently using IRS.

Conclusions: Prenatal exposure to pyrethroids may be associated at 1 y of age with poorer social-emotional development. Introduction The World Health Organization WHO reported that there were million cases of malaria in , resulting in about , deaths, with most deaths occurring in children under 5 y of age WHO Procedures Shortly after delivery and before leaving the hospital, mothers were queried in TshiVenda by trained bilingual English-TshiVenda interviewers. Pyrethroid Metabolite Measurements We collected a spot urine sample for women prior to delivery and for women postdelivery but before leaving the hospital ; 10 women did not provide a urine sample.

Data Analysis Prenatal DDT and pyrethroid metabolite levels were log 10 -transformed to reduce the influence of outliers. Open in a separate window. For the multivariate model, food security was considered as a continuous variable. Results Almost all mothers were from the Vhavenda people and all were Black African. Note that within a group, the conditional PIPs will total 1. Discussion We examined the relationship between in utero exposure to insecticides used in IRS for malaria control in Limpopo, South Africa, and neurodevelopment of children at 1- and 2-y follow-up as assessed on the BSID.

Supplemental Material 3. Neonatal neurodevelopment and prenatal exposure to dichlorodiphenyldichloroethylene DDE : a cohort study in Mexico. Optimal predictive model selection. Ann Stat 32 3 —, Risk assessment of the use of deltamethrin on bednets for the prevention of malaria. Urinary concentrations of metabolites of pyrethroid insecticides in the general U.

New high-resolution mass spectrometric approach for the measurement of polychlorinated biphenyls and organochlorine pesticides in human serum.

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Endocrine disrupting potential and reproductive dysfunction in male mice exposed to deltamethrin. The effectiveness of a short form of the Household Food Security Scale. Bayesian kernel machine regression for estimating the health effects of multi-pollutant mixtures. Biostatistics 16 3 —, PMID: , Simultaneous presence of DDT and pyrethroid residues in human breast milk from a malaria endemic area in South Africa.

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Measurement of social support in family medicine patients. Detection of postnatal depression. Development of the item Edinburgh Postnatal Depression Scale. Exposure to DDT during a defined period in neonatal life induces permanent changes in brain muscarinic receptors and behaviour in adult mice. In utero exposure to dichlorodiphenyltrichloroethane DDT and dichlorodiphenyldichloroethylene DDE and neurodevelopment among young Mexican American children. Pediatrics 1 —, PMID: , A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants.

Prenatal exposure to pyrethroid pesticides and childhood behavior and executive functioning. Neurotoxicology 62 —, PMID: , Development after exposure to polychlorinated biphenyls and dichlorodiphenyl dichloroethene transplacentally and through human milk. Methods for epidemiologic analyses of multiple exposures: a review and comparative-study of maximum-likelihood, preliminary-testing, and empirical-Bayes regression. Impact of prenatal exposure to piperonyl butoxide and permethrin on month neurodevelopment.

Pediatrics 3 :e—e, PMID: , In-utero exposure to dichlorodiphenyltrichloroethane and cognitive development among infants and school-aged children.

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Epidemiology 23 5 —, PMID: , Indicators of family care for development for use in multicountry surveys. Invited commentary: why DDT matters now. Epidemiologic evaluation of measurement data in the presence of detection limits. Polychlorinated biphenyl and organochlorine pesticide concentrations in maternal mid-pregnancy serum samples: association with autism spectrum disorder and intellectual disability. A culture-sensitive quantitative food frequency questionnaire used in an African population: 1.