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Dichlorodiphenyldichloroethylene Exposure during the First Trimester of Pregnancy Alters the Anal Position in Male Infants


Address for correspondence: Dr. Lizbeth Lopez-Carrillo, Instituto Nacional de Salud Publica. Av. Universidad 655, Col Sta. Maria Ahuacatitlan. CP:62508. Cuernavaca, Morelos, Mexico.


Anogenital distance (AGD) at birth is regarded as a useful measurement that reflects the prenatal androgenic status in rodents. However, the impact of xenoantiandrogens on human development is largely unknown. The aim of this study was to evaluate the potential antiandrogenic impact of prenatal DDT metabolites (p,p′-DDE and p,p′-DDT) exposure on infant AGD, using a non-age–dependent anal position index (API). As part of an ongoing perinatal cohort study on the effects of organochlorine pesticides in children's neurodevelopment, we conducted a cross-sectional study in 71 infants (37 males and 34 females). Maternal serum levels of DDT metabolites (p,p′-DDE and p,p′-DDT) before and during each trimester of pregnancy were determined by electron capture gas–liquid chromatography. During postnatal home visits at 3, 6, and 12 or 18 months of age, the children's weight and API were evaluated. Multiple lineal regression models were used to estimate the potential endocrine disruptor activity of prenatal p,p′-DDE exposure. Boys had significantly higher API values than girls (0.6 versus 0.5; P < 0.001). Only among boys, a doubling increase of maternal p,p′-DDE serum levels during the first trimester of pregnancy, were associated with a significant reduction of API (β=−0.02; P= 0.02). No effect of p,p′-DDT on AGD was observed. Evidence of the effect of prenatal p,p′-DDE on external genital differentiation is scarce and not consistent in the literature. Further studies are needed to confirm a hormonal disruptive effect on the development of external genitalia, due not only to p,p′-DDE but also due to other antiandrogenic persistent compounds.