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PEDIATRICS Vol. 111 No. 5 May 2003, pp. e580-e585

ELECTRONIC ARTICLE

Breastfeeding, Exposure to Organochlorine Compounds, and Neurodevelopment in Infants

Núria Ribas-Fitó, MD^*, Esther Cardo, MD, PhD^*, Maria Sala, MD, PhD^*, M. Eulàlia de Muga, MD^*, Carlos Mazón, MD, Antoni Verdú, MD, Manolis Kogevinas, MD, PhD^*, Joan O. Grimalt, PhD^|| and Jordi Sunyer, MD, PhD^*

^* Environmental and Respiratory Research Unit, Institut Municipal d’Investigació Mèdica, Barcelona, Spain
Primary Health Care Center of Flix, Tarragona, Spain
Department of Pediatrics, Hospital de Móra d’Ebre, Tarragona, Spain
^|| Department of Environmental Chemistry, CID-CSIC, Barcelona, Spain.

--> Objective. Exposure to organochlorine compounds (OCs) occurs both in utero and through breastfeeding. Levels of hexachlorobenzene (HCB) found in the cord serum of newborns from a population located in the vicinity of an electrochemical factory in Spain were among the highest ever reported. We studied the association between exposure to OCs and breastfeeding on neurodevelopment in the 1-year-old infants of this population.

Methods. A birth cohort including 92 mother-infant pairs was recruited between 1997 and 1999 in 5 neighboring villages (84% of possible recruits). The mental and psychomotor development of each infant was assessed at 13 months using the Bayley and the Griffiths Scales of Infant Development. OCs were measured in cord serum.

Results. Dichlorodiphenyl dichloroethylene (p,p'DDE) cord serum levels were negatively associated with both mental and psychomotor development. For each doubling of a dose of p,p'DDE, we found a resultant decrease of 3.50 points (standard error: 1.39) on the mental scale and 4.01 points (standard error: 1.37) on the psychomotor scale. Exposure to polychlorinated biphenyls was only marginally associated with psychomotor development. Prenatal exposure to HCB had no effect on child neurodevelopment. Long-term breastfeeding was associated with better performance on both the mental and motor scales. Short-term breastfed infants with higher p,p'DDE levels in cord serum were associated with the lowest scores on both the mental and the psychomotor scales.

Conclusions. Prenatal exposure to p,p'DDE was associated with a delay in mental and psychomotor development at 13 months. No association was found for exposure to HCB. Long-term breastfeeding was found to be beneficial to neurodevelopment, potentially counterbalancing the impact of exposure to these chemicals through breast milk.

Key Words: hexachlorobenzene • dichlorodiphenyl dichloroethylene • polychlorinated biphenyls • breastfeeding • neurodevelopment • PCB, polychlorinated biphenyl • OC, organochlorine compound • HCB, hexachlorobenzene • MDI, Mental, Development Index • PDI, Psychomotor Developmental Index • p,p'DDE, dichlorodiphenyl dichloroethylene • SE, standard error

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Received for publication Jun 13, 2002; Accepted Dec 20, 2002.

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