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Prenatal Exposure to Phthalates and Bisphenols and Childhood Kidney Function: A Prospective Cohort Study

Sol, Chalana M.; Santos, Susana; Kannan, Kurunthachalam; Jaddoe, Vincent W.V.; Trasande, Leonardo
Fetal exposure to phthalates and bisphenols could be associated with kidney function. We aim to assess the association between maternal urine concentrations of phthalates and bisphenols during pregnancy and kidney function and size during childhood. In 1366 pregnant women from a prospective population-based cohort, we measured urine concentrations of phthalates, more specifically phthalic acid and metabolites of low molecular weight phthalates (LMWP) and high molecular weight phthalates (HMWP), with its subgroups of di-2-ethylhexylphthalate (DEHP) and di-n-octylphthalate (DNOP) metabolites, and bisphenol A, S and F during first, second and third trimester. We explored three methods of adjustment for maternal hydration status: creatinine standardization, covariate adjustment for creatinine and covariate-adjusted creatinine standardization plus covariate adjustment. We measured kidney size, calculated estimated glomerular filtration rate (eGFR) and the albumin/creatinine ratio in urine and assessed microalbuminuria at 6 years old. When applying creatinine standardization, we found some associations of higher maternal second trimester urine phthalic acid and overall mean phthalic acid and LMWP concentrations with higher eGFR. These associations were lessened when applying other methods of creatinine adjustment. The associations found when we applied the covariate adjustment for creatinine method were also lessened when applying other methods of creatinine adjustment. Only the association of higher second trimester phthalic acid maternal urine concentrations with higher eGFR at 6 years old remained significant irrespective of the method of creatinine adjustment. There were no consistent associations of maternal bisphenol A, S and F urine concentrations with childhood kidney function. There were no associations of maternal phthalate or bisphenol urine concentrations with kidney volume in children at 6 years old. Concluding, no consistent associations of maternal phthalate or bisphenol urine concentrations with childhood kidney function or volume could be found. Furthermore, the method of adjusting maternal urine phthalate and bisphenol concentrations for urinary dilution had a substantial effect on the associations with childhood kidney function, as it changed the conclusions about the directionality of the associations. Future studies including maternal kidney function are needed to further elucidate these association in humans.
SCOPUS:85141694048
ISSN: 2451-9766
CID: 5370112

Maternal Perceived Stress During the COVID-19 Pandemic: Pre-Existing Risk Factors and Concurrent Correlates in New York City Women

Ghassabian, Akhgar; Jacobson, Melanie H; Kahn, Linda G; Brubaker, Sara G; Mehta-Lee, Shilpi S; Trasande, Leonardo
PMCID:9035490
PMID: 35479764
ISSN: 1661-8564
CID: 5217012

Correction: Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts

Dunlop, Anne L; Essalmi, Alicynne Glazier; Avalos, Lyndsay; Breton, Carrie; Camargo, Carlos A; Cowell, Whitney J; Dabelea, Dana; Dager, Stephen R; Duarte, Cristiane; Elliott, Amy; Fichorova, Raina; Gern, James; Hedderson, Monique M; Thepaksorn, Elizabeth Hom; Huddleston, Kathi; Karagas, Margaret R; Kleinman, Ken; Leve, Leslie; Li, Ximin; Li, Yijun; Litonjua, Augusto; Ludena-Rodriguez, Yunin; Madan, Juliette C; Nino, Julio Mateus; McEvoy, Cynthia; O'Connor, Thomas G; Padula, Amy M; Paneth, Nigel; Perera, Frederica; Sathyanarayana, Sheela; Schmidt, Rebecca J; Schultz, Robert T; Snowden, Jessica; Stanford, Joseph B; Trasande, Leonardo; Volk, Heather E; Wheaton, William; Wright, Rosalind J; McGrath, Monica; ,
[This corrects the article DOI: 10.1371/journal.pone.0245064.].
PMID: 35522645
ISSN: 1932-6203
CID: 5678962

Prenatal Exposure to Nonpersistent Chemical Mixtures and Offspring IQ and Emotional and Behavioral Problems

van den Dries, Michiel A; Ferguson, Kelly K; Keil, Alexander P; Pronk, Anjoeka; Spaan, Suzanne; Ghassabian, Akhgar; Santos, Susana; Jaddoe, Vincent W V; Trasande, Leonardo; Tiemeier, Henning; Guxens, Mònica
Prenatal exposure to nonpersistent chemicals such as phthalates, bisphenols, and organophosphate (OP) pesticides is ubiquitous and occurs in mixtures. So far, epidemiological studies investigating neurodevelopmental consequences of these exposures have mainly been restricted to single-pollutant models. Thus, we studied the association between prenatal exposure to nonpersistent chemical mixtures and child IQ and emotional and behavioral problems. Data came from 782 mother-child pairs. Eleven phthalate, one bisphenol, and five OP pesticide urinary exposure biomarkers were measured three times during pregnancy and averaged. Nonverbal IQ, internalizing and attention problems, aggressive behavior, and autistic traits were assessed at child age 6 years. We used quantile g-computation to estimate the change in each outcome per quartile increase in all chemicals within the mixture. Higher exposure to the mixture was associated with lower nonverbal IQ (-4.0 points (95%CI = -7.0, -1.0), -5.5 points (95%CI = -10.2, -0.9), and -4.6 points (95%CI = -10.8, 1.5) for the second, third, and fourth quartile, respectively, compared to the first quartile). These results were mainly driven by the phthalate mixture. No association was observed with emotional and behavioral problems. Prenatal exposure to nonpersistent chemical mixtures was associated with lower nonverbal IQ in children. Exposure to chemical mixtures during gestation is universal and may impact neurodevelopment.
PMID: 34878787
ISSN: 1520-5851
CID: 5084942

COVID-19 Symptoms and Diagnoses among a Sociodemographically Diverse Cohort of Children from New York City: Lessons from the First Wave, Spring 2020

Kahn, Linda G; Ghassabian, Akhgar; Jacobson, Melanie H; Yu, Keunhyung; Trasande, Leonardo
Early in the pandemic, in the North American epicenter, we investigated associations between sociodemographic factors and rates of pediatric COVID-19 diagnoses in a non-clinical setting and whether symptoms varied by child age. From 20 April-31 August 2020, COVID-19-related data were collected on 2694 children aged ≤ 18 years living in households participating in the New York University Children's Health and Environment Study. We examined differences in rates of subjective and objective diagnoses according to sociodemographic characteristics and differences in reported symptoms by child age. Children of women who were non-Hispanic White, had private health insurance, higher income, or more education were more likely to be diagnosed via WHO criteria or healthcare provider. Children of women who were Hispanic or Asian, reported low income, had less education, or were/lived with an essential worker were more likely to test positive. Older children were less likely to experience cough or runny nose and more likely to experience muscle/body aches, sore throat, headache, and loss of smell or taste than younger children. In conclusion, relying on subjective disease ascertainment methods, especially in the early stage of an outbreak when testing is not universally available, may misrepresent the true prevalence of disease among sociodemographic subgroups. Variations in symptoms by child age should be considered when determining diagnostic criteria.
PMCID:8623025
PMID: 34831640
ISSN: 1660-4601
CID: 5063892

Exposure to environmental chemicals and perinatal psychopathology

Jacobson, Melanie H; Ghassabian, Akhgar; Gore, Andrea C; Trasande, Leonardo
Women are nearly twice as likely to develop mood disorders compared with men, and incidence is greatest during reproductive transitions, including pregnancy and postpartum. Because these periods are characterized by dramatic hormonal and physiologic changes, there is heightened susceptibility to external factors, such as exposure to environmental toxicants, which may play a role in maternal psychopathology. The purpose of this scoping review was to provide an overview of studies conducted in humans and animal models on the effects of nonoccupational exposure to environmental chemicals on maternal psychopathology during the perinatal period. The largest number of studies examined exposure to environmental tobacco smoke and antenatal depression and showed consistently positive findings, although more prospective studies using biomarkers for exposure assessment are needed. The few studies examining persistent organic pollutants such as polybrominated diphenyl ethers and perinatal depression were consistent in showing associations with increased depressive symptoms. Results were mixed for exposure to heavy metals and non-persistent chemicals, but a strong literature in animal models supported an association between bisphenols and phthalates and reduced maternal behavior and care of pups after parturition. Biological mechanisms may include endocrine disruption, neurotransmitter system impairment, alterations in gene expression, and immune activation and inflammation. Additional longitudinal studies that include biospecimen collection are essential to furthering the understanding of how environmental toxicants during pregnancy may affect perinatal psychopathology and the underlying mechanisms of action. Future work should also leverage the parallels between animal and human maternal behavior, thereby highlighting the opportunity for multidisciplinary work in this avenue.
PMID: 34774531
ISSN: 1873-2968
CID: 5048822

Occurrence of Polyethylene Terephthalate and Polycarbonate Microplastics in Infant and Adult Feces

Zhang, Junjie; Wang, Lei; Trasande, Leonardo; Kannan, Kurunthachalam
Although human exposure to microplastics (MPs) and the health effects thereof are a global concern, little is known about the magnitude of exposure. In this study, we quantitatively determined the concentrations of polyethylene terephthalate (PET) and polycarbonate (PC) MPs in three meconium and six infant and 10 adult feces samples collected from New York State. PET and PC MPs were found in some meconium samples (at concentration ranges from below the limit of quantification [<LOQ] to 12,000 and <LOQ-110 ng/g dry weight, respectively) and all infant stool specimens (PET: 5700-82,000 ng/g, median, 36,000 ng/g; PC: 49-2100 ng/g, median, 78 ng/g). They were also found in most (PET) or all (PC) adult stool samples but at concentrations an order of magnitude lower than in infants for PET MPs (<LOQ-16,000 ng/g, median, 2600 ng/g). The estimated mean daily exposures from the diet of infants to PET and PC MPs were 83,000 and 860 ng/kg body weight per day, respectively, which were significantly higher than those of adults (PET: 5800 ng/kg-bw/day; PC: 200 ng/kg-bw/d). Our study suggests that infants are exposed to higher levels of MPs than adults.
SCOPUS:85116699646
ISSN: 2328-8930
CID: 5055812

Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy

Sauder, Katherine A; Harte, Robyn N; Ringham, Brandy M; Guenther, Patricia M; Bailey, Regan L; Alshawabkeh, Akram; Cordero, José F; Dunlop, Anne L; Ferranti, Erin P; Elliott, Amy J; Mitchell, Diane C; Hedderson, Monique M; Avalos, Lyndsay A; Zhu, Yeyi; Breton, Carrie V; Chatzi, Leda; Ran, Jin; Hertz-Picciotto, Irva; Karagas, Margaret R; Sayarath, Vicki; Hoover, Joseph; MacKenzie, Debra; Lyall, Kristen; Schmidt, Rebecca J; O'Connor, Thomas G; Barrett, Emily S; Switkowski, Karen M; Comstock, Sarah S; Kerver, Jean M; Trasande, Leonardo; Tylavsky, Frances A; Wright, Rosalind J; Kannan, Srimathi; Mueller, Noel T; Catellier, Diane J; Glueck, Deborah H; Dabelea, Dana
BACKGROUND:Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. OBJECTIVE:The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy BMI. METHODS:Fifteen observational cohorts in the US Environmental influences on Child Health Outcomes (ECHO) Consortium assessed participant dietary intake with 24-h dietary recalls (n = 1910) or food-frequency questionnaires (n = 7891) from 1999-2019. We compared the distributions of usual intake of 19 micronutrients from food alone (15 cohorts; n = 9801) and food plus dietary supplements (10 cohorts with supplement data; n = 7082) to estimate the proportion with usual daily intakes below their age-specific daily Estimated Average Requirement (EAR), above their Adequate Intake (AI), and above their Tolerable Upper Intake Level (UL), overall and within sociodemographic and anthropometric subgroups. RESULTS:Risk of inadequate intake from food alone ranged from 0% to 87%, depending on the micronutrient and assessment methodology. When dietary supplements were included, some women were below the EAR for vitamin D (20-38%), vitamin E (17-22%), and magnesium (39-41%); some women were above the AI for vitamin K (63-75%), choline (7%), and potassium (37-53%); and some were above the UL for folic acid (32-51%), iron (39-40%), and zinc (19-20%). Highest risks for inadequate intakes were observed among participants with age 14-18 y (6 nutrients), non-White race or Hispanic ethnicity (10 nutrients), less than a high school education (9 nutrients), or obesity (9 nutrients). CONCLUSIONS:Improved diet quality is needed for most pregnant females. Even with dietary supplement use, >20% of participants were at risk of inadequate intake of ≥1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities.
PMCID:8564697
PMID: 34494118
ISSN: 1541-6100
CID: 5061252

Prenatal Exposure to Nonpersistent Chemical Mixtures and Fetal Growth: A Population-Based Study

van den Dries, Michiel A; Keil, Alexander P; Tiemeier, Henning; Pronk, Anjoeka; Spaan, Suzanne; Santos, Susana; Asimakopoulos, Alexandros G; Kannan, Kurunthachalam; Gaillard, Romy; Guxens, Mònica; Trasande, Leonardo; Jaddoe, Vincent W V; Ferguson, Kelly K
BACKGROUND:Prenatal exposure to mixtures of nonpersistent chemicals is universal. Most studies examining these chemicals in association with fetal growth have been restricted to single exposure models, ignoring their potentially cumulative impact. OBJECTIVE:We aimed to assess the association between prenatal exposure to a mixture of phthalates, bisphenols, and organophosphate (OP) pesticides and fetal measures of head circumference, femur length, and weight. METHODS: RESULTS: DISCUSSION/CONCLUSIONS:Higher exposure to a mixture of phthalates, bisphenols, and OP pesticides was associated with lower EFW in the midpregnancy period. In late pregnancy, these differences were similar but less pronounced. At birth, the only associations observed appeared when comparing individuals from Q1 and Q4. This finding suggests that even low levels of exposure may be sufficient to influence growth in early pregnancy, whereas higher levels may be necessary to affect birth weight. Joint exposure to nonpersistent chemicals may adversely impact fetal growth, and because these exposures are widespread, this impact could be substantial. https://doi.org/10.1289/EHP9178.
PMCID:8612241
PMID: 34817287
ISSN: 1552-9924
CID: 5063642

Timing of Toenail Collection and Concentrations of Metals in Pancreatic Cancer. Evidence Against Disease Progression Bias

Pumarega, José; Camargo, Judit; Gasull, Magda; Olshan, Andrew F; Soliman, Amr; Chen, Yu; Richardson, David; Alguacil, Juan; Poole, Charles; Trasande, Leonardo; Porta, Miquel
Trace elements such as cadmium, arsenic, zinc or selenium increase or decrease risk of a wide range of human diseases. Their levels in toenails may provide a measure of mid-term intake of trace elements for studies in humans. However, in biologically and clinically aggressive diseases as pancreatic cancer, the progression of the disease could modify such concentrations and produce reverse causation bias. The aim was to analyze the influence of specific time intervals between several clinical events and the collection of toenails upon concentrations of trace elements in patients with pancreatic cancer. Subjects were 118 incident cases of pancreatic adenocarcinoma prospectively recruited in eastern Spain. Toenails were collected at cancer diagnosis, and soon thereafter interviews were conducted. Information on cancer signs and symptoms was obtained from medical records and patient interviews. Levels of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. General linear models adjusting for potential confounders were applied to analyze relations between log concentrations of trace elements and the time intervals, including the interval from first symptom of cancer to toenail collection (iST). Toenail concentrations of the 12 trace elements were weakly or not influenced by the progression of the disease or the diagnostic procedures. Concentrations of aluminum were slightly higher in subjects with a longer iST (age, sex and stage adjusted geometric means: 11.44 vs. 7.75 µg/g for iST > 120 days vs. ≤ 40 days). There was a weak inverse relation of iST with concentrations of zinc and selenium (maximum differences of about 20 and 0.08 µg/g, respectively). Conclusions: concentrations of the trace elements were weakly or not influenced by the development of the disease before toenail collection. Only concentrations of aluminum increased slightly with increasing iST, whereas levels of zinc and selenium decreased weakly. Even in an aggressive disease as pancreatic cancer, toenail concentrations of trace elements may provide a valid measure of mid-term intake of trace elements, unaffected by clinical events and disease progression.
PMCID:8533671
PMID: 34722949
ISSN: 2451-9766
CID: 5037802