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  1. Article ; Online: Social Vulnerability and Initiation of Pharmacotherapy for Gestational Diabetes Mellitus in a Medicaid Population.

    Pham, Amelie / Wiese, Andrew D / Spieker, Andrew J / Phillips, Sharon E / Adgent, Margaret A / Grijalva, Carlos G / Osmundson, Sarah S

    Women's health issues : official publication of the Jacobs Institute of Women's Health

    2023  Volume 33, Issue 3, Page(s) 273–279

    Abstract: Objective: Our study examines the association between social vulnerability index (SVI) and pharmacotherapy initiation for gestational diabetes mellitus (GDM).: Methods: We studied a retrospective cohort of pregnant patients with GDM, enrolled in ... ...

    Abstract Objective: Our study examines the association between social vulnerability index (SVI) and pharmacotherapy initiation for gestational diabetes mellitus (GDM).
    Methods: We studied a retrospective cohort of pregnant patients with GDM, enrolled in Tennessee Medicaid, who gave birth between 2007 and 2019. Enrollment files were linked to birth and death certificates, state hospitalization registries, and pharmacy claims. SVI, measured at the community level and determined by residential census tract, ranged from 0 to 100 (low to high vulnerability). Multivariable logistic regression assessed the association between SVI and the odds of initiating the most common pharmacotherapies for GDM-insulin, glyburide, or metformin-and adjusted for relevant covariates. SVI was modeled with restricted cubic splines to account for nonlinear associations, using the median Tennessee SVI as a reference. Secondary analysis assessed associations with the SVI subthemes.
    Results: Among 33,291 patients with GDM, 21.7% (7,209) initiated pharmacotherapy during pregnancy. Patients from areas with higher SVI were more likely to be non-Hispanic Black with higher body mass index, whereas those with lower SVI were more likely to be nulliparous. Multivariable modeling demonstrated a complex nonlinear association between SVI and GDM pharmacotherapy initiation, relative to the reference. Higher SVI was associated with elevated odds of GDM pharmacotherapy initiation (e.g., odds ratio 1.11 [95% confidence interval 1.02-1.22] for SVI 80) and low to medium SVI had variable nonsignificant associations with GDM pharmacotherapy initiation, relative to the reference (lower odds of initiation for values 25-50, higher odds of initiation for values < 25). Secondary analysis demonstrated a nonlinear association between subtheme 3 and the odds of GDM pharmacotherapy initiation.
    Conclusion: Social vulnerability is associated with initiation of pharmacotherapy for GDM, highlighting the possible role of social determinants of health in achieving glycemic control.
    MeSH term(s) Pregnancy ; Female ; Humans ; Diabetes, Gestational/drug therapy ; Retrospective Studies ; Social Vulnerability ; Medicaid ; Glyburide/therapeutic use
    Chemical Substances Glyburide (SX6K58TVWC)
    Language English
    Publishing date 2023-01-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1085396-0
    ISSN 1878-4321 ; 1049-3867
    ISSN (online) 1878-4321
    ISSN 1049-3867
    DOI 10.1016/j.whi.2022.12.004
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  2. Article ; Online: Changes in medication initiation and selection patterns for gestational diabetes management.

    Pham, Amelie / Shi, Rena / Wiese, Andrew D / Spieker, Andrew J / Phillips, Sharon E / Adgent, Margaret A / Grijalva, Carlos G / Osmundson, Sarah S

    BJOG : an international journal of obstetrics and gynaecology

    2023  Volume 131, Issue 4, Page(s) 518–520

    MeSH term(s) Pregnancy ; Female ; Humans ; Diabetes, Gestational/drug therapy ; Hypoglycemic Agents/therapeutic use ; Diabetes Mellitus, Type 2/drug therapy
    Chemical Substances Hypoglycemic Agents
    Language English
    Publishing date 2023-09-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2000931-8
    ISSN 1471-0528 ; 0306-5456 ; 1470-0328
    ISSN (online) 1471-0528
    ISSN 0306-5456 ; 1470-0328
    DOI 10.1111/1471-0528.17664
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  3. Article ; Online: Prescription Opioid Exposure During Pregnancy and Risk of Spontaneous Preterm Delivery.

    Bosworth, Olivia M / Padilla-Azain, Maria C / Adgent, Margaret A / Spieker, Andrew J / Wiese, Andrew David / Pham, Amelie / Leech, Ashley A / Grijalva, Carlos G / Osmundson, Sarah S

    JAMA network open

    2024  Volume 7, Issue 2, Page(s) e2355990

    Abstract: Importance: Opioid exposure during pregnancy has been associated with preterm birth, but prior studies have not differentiated between spontaneous and indicated preterm birth or fully investigated these associations as functions of opioid dose.: ... ...

    Abstract Importance: Opioid exposure during pregnancy has been associated with preterm birth, but prior studies have not differentiated between spontaneous and indicated preterm birth or fully investigated these associations as functions of opioid dose.
    Objective: To determine whether prescription opioid use during pregnancy is associated with spontaneous preterm birth and whether the association is dose-dependent.
    Design, setting, and participants: This case-control study examined a retrospective cohort of pregnant patients enrolled in Tennessee Medicaid. Enrollment files were linked to health care encounters, hospital discharge information, birth certificate data, and prescription fills. Eligible participants were pregnant people ages 15 to 44 years without opioid use disorder who experienced birth of a single fetus at 24 weeks gestation or greater between 2007 and 2019 with linked birth certificate data. Cases of spontaneous preterm birth were matched with up to 10 controls based on pregnancy start date, race, ethnicity, age at delivery within 2 years, and history of prior preterm birth. Cases and matched controls were continuously enrolled in TennCare for at least 90 days prior to the index date (case delivery date).
    Exposure: Total opioid MME filled during the 60 days prior to the index date.
    Main outcomes and measures: The primary outcome was spontaneous preterm birth determined by a validated algorithm using birth certificate data. Conditional logistic regression was used to estimate the association between spontaneous preterm birth and total opioid morphine milligram equivalents (MME) dispensed, adjusting for parity, prepregnancy body mass index, education level, tobacco use, hepatitis infections, and pain indications.
    Results: A total of 25 391 cases (median [IQR] age, 23 [20-28] years; 127 Asian [0.5%], 9820 Black [38.7%], 664 Hispanic [2.6%]; 14 748 non-Hispanic White [58.1%]) with spontaneous preterm birth were identified and matched with 225 696 controls (median [IQR] age, 23 [20-27] years; 229 Asian [0.1%], 89 819 Black [39.8%], 3590 Hispanic [1.6%]; 132 002 non-Hispanic White [58.5%]) (251 087 patients total), with 18 702 patients (7.4%) filling an opioid prescription in the 60 days prior to the index date. Each doubling of nonzero opioid MME was associated with a 4% increase in the odds of spontaneous preterm birth compared with no opioid exposure (adjusted odds ratio, 1.04; 95% CI, 1.01-1.08).
    Conclusions and relevance: In this case-control study, a positive association was found between total prescription opioid dose dispensed and the odds of spontaneous preterm birth. These findings support guidance to minimize opioid exposure during pregnancy and prescribe the lowest dose necessary.
    MeSH term(s) Infant, Newborn ; United States ; Female ; Pregnancy ; Humans ; Young Adult ; Adult ; Analgesics, Opioid/adverse effects ; Premature Birth/epidemiology ; Case-Control Studies ; Retrospective Studies ; Opioid-Related Disorders/epidemiology ; Endrin/analogs & derivatives
    Chemical Substances Analgesics, Opioid ; MME (78185-58-7) ; Endrin (OB9NVE7YCL)
    Language English
    Publishing date 2024-02-05
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.55990
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  4. Article ; Online: Triclosan and prescription antibiotic exposures and enterolactone production in adults.

    Adgent, Margaret A / Rogan, Walter J

    Environmental research

    2015  Volume 142, Page(s) 66–71

    Abstract: Background: The gut microbiome plays an important role in the development of disease. The composition of the microbiome is influenced by factors such as mode of delivery at birth, diet and antibiotic use, yet the influence of environmental chemical ... ...

    Abstract Background: The gut microbiome plays an important role in the development of disease. The composition of the microbiome is influenced by factors such as mode of delivery at birth, diet and antibiotic use, yet the influence of environmental chemical exposures is largely unknown. The antimicrobial compound triclosan, found in many personal care products and widely detected in human urine, is an environmental exposure for which systemic microbiotic effects may be of particular interest. To investigate the relationship between triclosan and gut microflora, we assessed the association between triclosan and enterolactone, an intestinal metabolite that is produced via bacterial transformation of dietary lignans (seeds, nuts) and has known susceptibility to oral antibiotics.
    Methods: We examined urinary triclosan and enterolactone for 2005-2008 U.S. National Health and Nutrition Examination Survey subjects, aged ≥20 years (n=3041). We also examined the association between prescription antibiotic use and enterolactone to confirm its susceptibility to changes in bacterial composition of the body. Associations between natural log-transformed enterolactone and (1) detected vs. not detected (<2.3 ng/mL) triclosan, (2) triclosan quintiles (Q1-Q5), and (3) any vs. no antibiotics were estimated with multiple linear regression, adjusting for sex, age, race, body mass index, poverty income ratio, education, fiber intake, bowel movement frequency, cotinine and creatinine (n=2441).
    Results: Triclosan was detected in 80% of subjects (range: <2.3-3620 ng/mL), while enterolactone was detected in >99% of subjects (range: <0.1-122,000 ng/mL). After adjustment, enterolactone was not associated with triclosan (detect vs. non-detect: β= 0.07 (95% CI: -0.15, 0.30); Q5 (≥104.5 ng/mL) vs. Q1 (none): β= 0.06 (95% CI: -0.21, 0.34)). In sex-stratified analyses, triclosan was associated with higher enterolactone in women (detect vs. non-detect: β= 0.31 (95% CI: -0.07, 0.70), but not men β= -0.18 (95% CI: -0.47, 0.11). However, any antibiotic use (n=112), as compared to no antibiotic use, was associated with significantly lower enterolactone (β=-0.78 (95%CI: -1.22, -0.36)), with no sex-specific effects. This association was driven by inverse associations with the following antibiotic classes: macrolide derivatives, quinolones, sulfonamides, and lincomycin derivatives.
    Conclusions: Antibiotics, but not triclosan, are negatively associated with urinary enterolactone. Antibiotics may reduce enterolactone by killing certain gut bacteria. At levels detected in the U.S., triclosan does not appear to be acting similarly, despite broad antimicrobial properties. Additional study of determinants of triclosan exposure and enterolactone production may be needed to better understand positive associations among women.
    MeSH term(s) 4-Butyrolactone/analogs & derivatives ; 4-Butyrolactone/analysis ; 4-Butyrolactone/biosynthesis ; Adult ; Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/urine ; Female ; Gastrointestinal Microbiome/drug effects ; Gastrointestinal Microbiome/physiology ; Humans ; Lignans/analysis ; Lignans/biosynthesis ; Male ; Middle Aged ; Prescription Drugs ; Triclosan/adverse effects ; Triclosan/urine ; Young Adult
    Chemical Substances Anti-Bacterial Agents ; Lignans ; Prescription Drugs ; Triclosan (4NM5039Y5X) ; 4-Butyrolactone (OL659KIY4X) ; 2,3-bis(3'-hydroxybenzyl)butyrolactone (X01E7E1D6H)
    Language English
    Publishing date 2015-06-23
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 205699-9
    ISSN 1096-0953 ; 0013-9351
    ISSN (online) 1096-0953
    ISSN 0013-9351
    DOI 10.1016/j.envres.2015.06.017
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  5. Article ; Online: Risk of Death at 1 Year Following Postpartum Opioid Exposure.

    Horn, Arlyn / Adgent, Margaret A / Osmundson, Sarah S / Wiese, Andrew D / Phillips, Sharon E / Patrick, Stephen W / Griffin, Marie R / Grijalva, Carlos G

    American journal of perinatology

    2022  Volume 41, Issue 7, Page(s) 949–960

    Abstract: Objective:  Opioids are commonly prescribed to women for acute pain following childbirth. Postpartum prescription opioid exposure is associated with adverse opioid-related morbidities but the association with all-cause mortality is not well studied. ... ...

    Abstract Objective:  Opioids are commonly prescribed to women for acute pain following childbirth. Postpartum prescription opioid exposure is associated with adverse opioid-related morbidities but the association with all-cause mortality is not well studied. This study aimed to examine the association between postpartum opioid prescription fills and the 1-year risk of all-cause mortality among women with live births.
    Methods:  In a retrospective cohort study of live births among women enrolled in Tennessee Medicaid (TennCare) between 2007 and 2015, we compared women who filled two or more postpartum outpatient opioid prescriptions (up to 41 days of postdelivery discharge) to women who filled one or fewer opioid prescription. Women were followed from day 42 postdelivery discharge through 365 days of follow-up or date of death. Deaths were identified using linked death certificates (2007-2016). We used Cox's proportional hazard regression and inverse probability of treatment weights to compare time to death between exposure groups while adjusting for relevant confounders. We also examined effect modification by delivery route, race, opioid use disorder, use of benzodiazepines, and mental health condition diagnosis.
    Results:  Among 264,135 eligible births, 216,762 (82.1%) had one or fewer maternal postpartum opioid fills and 47,373 (17.9%) had two or more fills. There were 182 deaths during follow-up. The mortality rate was higher in women with two or more fills (120.5 per 100,000 person-years) than in those with one or fewer (57.7 per 100,000 person-years). The risk of maternal death remained higher in participants exposed to two or more opioid fills after accounting for relevant covariates using inverse probability of treatment weighting (adjusted hazard ratio: 1.46 [95% confidence interval: 1.01, 2.09]). Findings from stratified analyses were consistent with main findings.
    Conclusion:  Filling two or more opioid prescriptions during the postpartum period was associated with a significant increase in 1-year risk of death among new mothers.
    Key points: · Opioid prescribing in the postpartum period is common.. · Prior studies show that >1 postnatal opioid fill is associated with adverse opioid-related events.. · > 1 opioid fill within 42 days of delivery was associated with an increase in 1-year risk of death..
    MeSH term(s) Humans ; Female ; Retrospective Studies ; Analgesics, Opioid/adverse effects ; Adult ; Postpartum Period ; Tennessee/epidemiology ; Pregnancy ; Young Adult ; United States/epidemiology ; Medicaid/statistics & numerical data ; Opioid-Related Disorders/mortality ; Proportional Hazards Models ; Risk Factors
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2022-05-31
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/s-0042-1745848
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  6. Article ; Online: Maternal Opioid Use Disorder and the Risk of Postneonatal Infant Mortality.

    Grossarth, Sarah / Osmundson, Sarah S / Wiese, Andrew D / Phillips, Sharon E / Pham, Amelie / Leech, Ashley A / Patrick, Stephen W / Spieker, Andrew J / Grijalva, Carlos G / Adgent, Margaret A

    JAMA pediatrics

    2023  Volume 177, Issue 7, Page(s) 675–683

    Abstract: Importance: The risk of serious long-term outcomes for infants born to individuals with opioid use disorder (OUD) is not fully characterized, nor is it well understood whether risks are modified by infant diagnosis of neonatal opioid withdrawal syndrome ...

    Abstract Importance: The risk of serious long-term outcomes for infants born to individuals with opioid use disorder (OUD) is not fully characterized, nor is it well understood whether risks are modified by infant diagnosis of neonatal opioid withdrawal syndrome (NOWS).
    Objective: To characterize the risk of postneonatal infant mortality among infants with a NOWS diagnosis or born to individuals with OUD.
    Design, setting, and participants: The study team conducted a retrospective cohort study of 390 075 infants born from 2007 through 2018 to mothers who were enrolled in Tennessee Medicaid from 183 days prior to delivery through 28 days post partum (baseline). Maternal and infant baseline characteristics were measured using administrative claims and birth certificates, and infants were followed up from day 29 post partum through day 365 or death. Deaths were identified using linked death certificates through 2019. These data were analyzed from February 10, 2022, through March 3, 2023.
    Exposure: Infant exposures included birth to an individual with OUD or postnatal diagnosis of NOWS. The study team defined a pregnant individual's OUD status (maternal OUD) as having OUD diagnosis or a maintenance medication prescription fill during baseline; this study defined NOWS as having NOWS diagnosis up to day 28. Groups were categorized by exposures as maternal OUD with NOWS (OUD positive/NOWS positive), maternal OUD without NOWS (OUD positive/NOWS negative), no documented maternal OUD with NOWS (OUD negative/NOWS positive), and no documented maternal OUD or NOWS (OUD negative/NOWS negative, unexposed).
    Main outcome and measures: The outcome was postneonatal infant death, confirmed by death certificates. Cox proportional hazards models were used, adjusting for baseline maternal and infant characteristics, to estimate adjusted hazard ratios (aHRs) and 95% CIs for the association between maternal OUD or NOWS diagnosis with postneonatal death.
    Results: Pregnant individuals in the cohort had a mean (SD) age of 24.5 (5.2) years; 51% of infants were male. The study team observed 1317 postneonatal infant deaths and incidence rates of 3.47 (OUD negative/NOWS negative, 375 718), 8.41 (OUD positive/NOWS positive, 4922); 8.95 (OUD positive/NOWS negative, 7196), and 9.25 (OUD negative/NOWS positive, 2239) per 1000 person-years. After adjustment, the risk of postneonatal death was elevated for all groups, relative to the unexposed: OUD positive/NOWS positive (aHR, 1.54; 95% CI, 1.07-2.21), OUD positive/NOWS negative (aHR, 1.62; 95% CI, 1.21-2.17), and OUD negative/NOWS positive (aHR, 1.64; 95% CI, 1.02-2.65).
    Conclusions and relevance: Infants born to individuals with OUD or with a NOWS diagnosis had an increased risk of postneonatal infant mortality. Future work is necessary to create and evaluate supportive interventions for individuals with OUD during and after pregnancy to reduce adverse outcomes.
    MeSH term(s) Infant ; Infant, Newborn ; Pregnancy ; Female ; Male ; Humans ; Young Adult ; Adult ; Retrospective Studies ; Infant Mortality ; Opioid-Related Disorders/epidemiology ; Mothers ; Neonatal Abstinence Syndrome/epidemiology ; Neonatal Abstinence Syndrome/drug therapy ; Analgesics, Opioid/adverse effects
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2023-05-08
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2701223-2
    ISSN 2168-6211 ; 2168-6203
    ISSN (online) 2168-6211
    ISSN 2168-6203
    DOI 10.1001/jamapediatrics.2023.1047
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  7. Article ; Online: Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: A cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population.

    Ammar, Lin / Tindle, Hilary A / Miller, Angela M / Adgent, Margaret A / Nian, Hui / Ryckman, Kelli K / Mogos, Mulubrhan / Piano, Mariann R / Xie, Ethan / Snyder, Brittney M / Ramesh, Abhismitha / Yu, Chang / Hartert, Tina V / Wu, Pingsheng

    PloS one

    2023  Volume 18, Issue 10, Page(s) e0287348

    Abstract: Background: Research on health effects and potential harms of electronic cigarette (EC) use during pregnancy is limited. We sought to determine the risks of pregnancy EC use on pregnancy-related adverse birth outcomes and assess whether quitting ECs ... ...

    Abstract Background: Research on health effects and potential harms of electronic cigarette (EC) use during pregnancy is limited. We sought to determine the risks of pregnancy EC use on pregnancy-related adverse birth outcomes and assess whether quitting ECs reduces the risks.
    Methods: Women with singleton live births who participated in the US Pregnancy Risk Assessment Monitoring System (PRAMS) survey study 2016-2020 were classified into four mutually exclusive groups, by their use of ECs and combustible cigarettes (CCs) during pregnancy: non-use, EC only use, CC only use, and dual use. We determined the risk of preterm birth, low birth weight, and small-for-gestational-age (SGA) by comparing cigarette users to non-users with a modified Poisson regression model adjusting for covariates. In a subset of women who all used ECs prior to pregnancy, we determined whether quitting EC use reduces the risk of preterm birth, low birth weight, and SGA by comparing to those who continued its use. All analyses were weighted to account for the PRAMS survey design and non-response rate.
    Results: Of the 190,707 women (weighted N = 10,202,413) included, 92.1% reported cigarette non-use, 0.5% EC only use, 6.7% CC only use, and 0.7% dual use during pregnancy. Compared with non-use, EC only use was associated with a significantly increased risk of preterm birth (adjusted risk ratio [aRR]: 1.29, 95% confidence interval [CI]: 1.00, 1.65) and low birth weight (aRR: 1.38, 95%CI: 1.09, 1.75), but not SGA (aRR: 1.04, 95%CI: 0.76, 1.44). Among 7,877 (weighted N = 422,533) women EC users, quitting use was associated with a significantly reduced risk of low birth weight (aRR: 0.76, 95%CI: 0.62, 0.94) and SGA (aRR: 0.77, 95%CI: 0.62, 0.94) compared to those who continued to use ECs during pregnancy.
    Conclusions: Pregnancy EC use, by itself or dual use with CC, is associated with preterm birth and low birth weight. Quitting use reduces that risk. ECs should not be considered as a safe alternative nor a viable gestational smoking cessation strategy.
    MeSH term(s) Pregnancy ; Infant, Newborn ; Humans ; Female ; Premature Birth/epidemiology ; Premature Birth/etiology ; Electronic Nicotine Delivery Systems ; Vaping/adverse effects ; Cross-Sectional Studies ; Risk Assessment ; Arrhythmias, Cardiac/complications ; Fetal Growth Retardation
    Language English
    Publishing date 2023-10-24
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0287348
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  8. Article ; Online: Association between maternal occupational exposure to cleaning chemicals during pregnancy and childhood wheeze and asthma.

    Herrin, Melissa A / Sherris, Allison R / Dearborn, Logan C / Loftus, Christine T / Szpiro, Adam A / Moore, Paul E / Adgent, Margaret A / Barrett, Emily S / Nguyen, Ruby H N / Carroll, Kecia N / Karr, Catherine J

    Frontiers in epidemiology

    2023  Volume 3

    Abstract: Background: Asthma is a leading cause of childhood morbidity in the U.S. and a significant public health concern. The prenatal period is a critical window during which environmental influences, including maternal occupational exposures, can shape child ... ...

    Abstract Background: Asthma is a leading cause of childhood morbidity in the U.S. and a significant public health concern. The prenatal period is a critical window during which environmental influences, including maternal occupational exposures, can shape child respiratory health. Cleaning chemicals are commonly encountered in occupational settings, yet few studies have examined the potential link between prenatal occupational exposures to cleaning chemicals and risk of childhood wheeze and asthma.
    Methods: We evaluated the potential influence of maternal occupational exposure to cleaning chemicals during pregnancy on pediatric asthma and wheeze at child age 4-6 years in 453 mother-child pairs from two longitudinal pregnancy cohorts, TIDES and GAPPS, part of the ECHO prenatal and early childhood pathways to health (ECHO-PATHWAYS) consortium. Maternal occupational exposure to cleaning chemicals was defined based on reported occupation and frequency of occupational use of chemicals during pregnancy. Child current wheeze and asthma outcomes were defined by parental responses to a widely-used, standardized respiratory outcomes questionnaire administered at child age 4-6 years. Multivariable Poisson regression with robust standard errors was used to estimate relative risk (RR) of asthma in models adjusted for confounding. Effect modification by child sex was assessed using product interaction terms.
    Results: Overall, 116 mothers (25.6%) reported occupational exposure to cleaning chemicals during pregnancy, 11.7% of children had current wheeze, and 10.2% had current asthma. We did not identify associations between prenatal exposure to cleaning chemicals and current wheeze [RRadjusted 1.03, 95% confidence interval (CI): 0.56, 1.90] or current asthma (RRadjusted 0.89, CI: 0.46, 1.74) in the overall sample. Analyses of effect modification suggested an adverse association among females for current wheeze (RR 1.82, CI: 0.76, 4.37), compared to males (RR 0.68, CI: 0.29, 1.58), though the interaction p-value was >0.05.
    Conclusion: We did not observe evidence of associations between maternal prenatal occupational exposure to cleaning chemicals and childhood wheeze or asthma in the multi-site ECHO-PATHWAYS consortium. We leveraged longitudinal U.S. pregnancy cohorts with rich data characterization to expand on limited and mixed literature. Ongoing research is needed to more precisely characterize maternal occupational chemical exposures and impacts on child health in larger studies.
    Language English
    Publishing date 2023-04-19
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2674-1199
    ISSN (online) 2674-1199
    DOI 10.3389/fepid.2023.1166174
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  9. Article ; Online: Soy-based infant formula feeding and menstrual pain in a cohort of women aged 23-35 years.

    Upson, Kristen / Adgent, Margaret A / Wegienka, Ganesa / Baird, Donna D

    Human reproduction (Oxford, England)

    2018  Volume 34, Issue 1, Page(s) 148–154

    Abstract: Study question: Is soy formula feeding during infancy associated with menstrual pain in reproductive-age women?: Summary answer: Our data suggest that soy formula feeding during infancy is associated with several indicators of severe menstrual pain ... ...

    Abstract Study question: Is soy formula feeding during infancy associated with menstrual pain in reproductive-age women?
    Summary answer: Our data suggest that soy formula feeding during infancy is associated with several indicators of severe menstrual pain in reproductive-age women.
    What is known already: A prior study observed greater severity of menstrual pain in young women who as infants participated in feeding studies and were assigned to soy-based formula feeding.
    Study design, size, duration: We used data from the Study of Environment, Lifestyle & Fibroids (SELF), a cohort of 1696 African-American women ages 23-35 years at enrollment.
    Participants/materials, settings, methods: Data on infant soy formula feeding was ascertained by self-administered questionnaire for 1553 participants, with 89% of participants receiving assistance from their mothers. Information on menstrual pain indicators was collected by web- and telephone-interview. We estimated the relative risk (RR) and 95% confidence interval (CI) using log-binomial regression, or log-multinomial regression, adjusting for participant age and maternal education.
    Main results and the role of chance: Women ever fed soy formula as infants were more likely than unexposed women to report ever use of hormonal contraception for menstrual pain (RR 1.4, CI: 1.1-1.9) and moderate/severe menstrual discomfort/pain with 'most periods', but not 'every period', during early adulthood (ages 18-22 when not using hormonal contraception) (RR 1.5, CI: 1.1-2.0).
    Limitations, reasons for caution: We relied on retrospective recall to ascertain infant exposure to soy formula feeding and data on menstrual pain indicators.
    Wider implications of the findings: Our observations add to the growing body of literature from animal and human studies on the reproductive health consequences of early-life exposure to soy formula.
    Study funding/competing interest(s): This research was supported by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences and, in part, by funds allocated for health research by the American Recovery and Reinvestment Act. This research was also supported by grant K99NR017191 (KU). None of the authors has a conflict of interest.
    Trial registration number: Not applicable.
    MeSH term(s) Dysmenorrhea/chemically induced ; Dysmenorrhea/diagnosis ; Dysmenorrhea/epidemiology ; Female ; Humans ; Infant ; Infant Formula/adverse effects ; Infant, Newborn ; Retrospective Studies ; Severity of Illness Index ; Soy Milk/administration & dosage ; Surveys and Questionnaires/statistics & numerical data ; Time Factors ; Young Adult
    Keywords covid19
    Language English
    Publishing date 2018-07-10
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Intramural ; Research Support, N.I.H., Extramural
    ZDB-ID 632776-x
    ISSN 1460-2350 ; 0268-1161 ; 1477-741X
    ISSN (online) 1460-2350
    ISSN 0268-1161 ; 1477-741X
    DOI 10.1093/humrep/dey303
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  10. Article: Environmental tobacco smoke and sudden infant death syndrome: a review.

    Adgent, Margaret A

    Birth defects research. Part B, Developmental and reproductive toxicology

    2006  Volume 77, Issue 1, Page(s) 69–85

    Abstract: Environmental tobacco smoke (ETS), containing the developmental neurotoxicant, nicotine, is a prevalent component of indoor air pollution. Despite a strong association with active maternal smoking and sudden infant death syndrome (SIDS), information on ... ...

    Abstract Environmental tobacco smoke (ETS), containing the developmental neurotoxicant, nicotine, is a prevalent component of indoor air pollution. Despite a strong association with active maternal smoking and sudden infant death syndrome (SIDS), information on the risk of SIDS due to prenatal and postnatal ETS exposure is relatively inconsistent. This literature review begins with a discussion and critique of existing epidemiologic data pertaining to ETS and SIDS. It then explores the biologic plausibility of this association, with comparison of the known association between active maternal smoking and SIDS, by examining metabolic and placental transfer issues associated with nicotine, and the biologic responses and mechanisms that may follow exposure to nicotine. Evidence indicates that prenatal and postnatal exposures to nicotine do occur from ETS exposure, but that the level of exposure is often substantially less than levels induced by active maternal smoking. Nicotine also has the capacity to concentrate in the fetus, regardless of exposure source. Experimental animal studies show that various doses of nicotine are capable of affecting a neonate's response to hypoxic conditions, a process thought to be related to SIDS outcomes. Mechanisms contributing to deficient hypoxia response include the ability of nicotine to act as a cholinergic stimulant through nicotinic acetylcholine receptor (nAChR) binding. The need for future research to investigate nicotine exposure and effects from non-maternal tobacco smoke sources in mid to late gestation is emphasized, along with a need to discourage smoking around both pregnant women and infants.
    MeSH term(s) Environmental Exposure/statistics & numerical data ; Female ; Humans ; Infant ; Maternal Exposure ; Nicotine/metabolism ; Sample Size ; Sudden Infant Death/epidemiology ; Sudden Infant Death/etiology ; Tobacco Smoke Pollution/adverse effects
    Chemical Substances Tobacco Smoke Pollution ; Nicotine (6M3C89ZY6R)
    Language English
    Publishing date 2006-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
    ZDB-ID 2104792-3
    ISSN 1542-9733 ; 1542-0752 ; 1542-975X
    ISSN 1542-9733 ; 1542-0752 ; 1542-975X
    DOI 10.1002/bdrb.20068
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