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Abstract
Background: Organophosphates (OP) and pyrethroids (PYR) are insecticides used worldwide in large scale farming, home applications, and insect repellents. Studies suggest that OP and PYR exposure during pregnancy are associated poor birth. The aims of this project are to 1) Compare OP and PYR metabolite levels among a diverse cohort of pregnant persons residing in Brazil, Guatemala, Nicaragua, and Puerto Rico and examine demographics that associate with OP exposure levels 2) Identify changes in metabolite exposure levels across gestation 3) Examine associations between organophosphate and pyrethroid pesticide biomarker levels and preterm birth (PTB). Methods: 1,326 pregnant persons were recruited from ZIP research sites in Puerto Rico, Nicaragua, Brazil, and Guatemala. Participants were first interviewed about demographic characteristics and followed throughout pregnancy until delivery. Urine samples were collected at regular visits and analyzed for pesticide biomarker concentrations. We measured six organophosphate biomarkers (DEDP, DETP, DMDP, DMP, and DMTP) and four pyrethroid biomarkers (PBA, FPBA, PNP), and TCP) Results: Aim 1) Analysis revealed significant differences in for metabolite levels by site with the highest percentages of detection in Brazil. Analysis also revealed significant differences in OP levels by primary water source (higher in bottle/delivery vs city) and BMI category (lower in obese vs healthy weight). The geometric DEP an DETP mean levels in our study were higher than some previous studies conducted in the same regions, which could be explained by possible higher use of pesticides due to the Zika outbreak in 2015-2016. Aim 2) Among the five metabolites examined in this study, TCP was the only analyte that appeared to be increasing on average in the sample throughout gestation. Aim 3) Pyrethroid exposure displayed a protective association against preterm birth, while organophosphate exposure did not show a significant association. Conclusions: Our analysis adds to the growing body of knowledge on pesticide exposure during pregnancy. We found elevated levels in Brazil, higher levels than previous studies in the Americas, and identified public drinking water as an exposure route to be further studied. Our analysis did not reveal OP or PYR exposure to be a risk factor for preterm birth.