Published online July 3, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. 233-241 (doi:10.1542/10.1542/peds.2005-3117)
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In Utero Exposure to Dichlorodiphenyltrichloroethane (DDT) and Dichlorodiphenyldichloroethylene (DDE) and Neurodevelopment Among Young Mexican American Children

Brenda Eskenazi, PhDa, Amy R. Marks, MPHa, Asa Bradman, PhDa, Laura Fenster, PhDb, Caroline Johnson, PhDa, Dana B. Barr, PhDc and Nicholas P. Jewell, PhDa

a Center for Children's Environmental Health Research, School of Public Health, University of California, Berkeley, Berkeley, California
b California Department of Health Services, Division of Environmental and Occupational Disease Control, Richmond, California
c National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia

OBJECTIVE. We investigated the relationship between prenatal exposure to dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenyldichloroethylene (DDE) and neurodevelopment of Mexican farm-workers' children in California.

METHODS. Participants from the Center for the Health Assessment of Mothers and Children of Salinas study, a birth cohort study, included 360 singletons with maternal serum measures of p,p'-DDT, o,p'-DDT, and p,p'-DDE. Psychomotor development and mental development were assessed with the Bayley Scales of Infant Development at 6, 12, and 24 months.

RESULTS. We found a ~2-point decrease in Psychomotor Developmental Index scores with each 10-fold increase in p,p'-DDT levels at 6 and 12 months (but not 24 months) and p,p'-DDE levels at 6 months only. We found no association with mental development at 6 months but a 2- to 3-point decrease in Mental Developmental Index scores for p,p'-DDT and o,p'-DDT at 12 and 24 months, corresponding to 7- to 10-point decreases across the exposure range. Even when mothers had substantial exposure, breastfeeding was usually associated positively with Bayley scale scores.

CONCLUSIONS. Prenatal exposure to DDT, and to a lesser extent DDE, was associated with neurodevelopmental delays during early childhood, although breastfeeding was found to be beneficial even among women with high levels of exposure. Countries considering the use of DDT should weigh its benefit in eradicating malaria against the negative associations found in this first report on DDT and human neurodevelopment.

Key Words: dichlorodiphenyltrichloroethane • dichlorodiphenyldichloroethylene • organochlorine • pesticides • neurodevelopment • Bayley Scales of Infant Development

Abbreviations: CHAMACOS—Center for the Health Assessment of Mothers and Children of Salinas • DAP—dialkyl phosphates • HCB—hexachlorobenzene • HOME—Home Observation for Measurement of the Environment • LOD—limit of detection • MDI—Mental Developmental Index • DDT—dichlorodiphenyltrichloroethane • PDI—Psychomotor Developmental Index • DDE—dichlorodiphenyldichloroethylene • PCB—polychlorinated biphenyl • ß-HCCH—ß-hexachlorocyclohexane • PPVT—Peabody Picture Vocabulary Test • CI—confidence interval

Accepted Feb 15, 2006.


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eLetters:

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DDT and neurodevelopment: results inconclusive to effect policy change
Ameena E Goga
Pediatrics Online, 7 Aug 2006 [Full text]
Dichlorodiphenyltrichloroethane. Implications of Eskenazi et al study to malaria control in Africa
BARNABAS N KAHIIRA
Pediatrics Online, 15 Aug 2006 [Full text]
Re: Dichlorodiphenyltrichloroethane. Implications of Eskenazi et al study to malaria control in Afri
Brenda Eskenazi, et al.
Pediatrics Online, 24 Aug 2006 [Full text]
Re: DDT and neurodevelopment: results inconclusive to effect policy change
Brenda Eskenazi, et al.
Pediatrics Online, 22 Sep 2006 [Full text]