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BACKGROUND: Phthalate exposures are ubiquitous during pregnancy and may contribute to racial and ethnic disparities in preterm birth. OBJECTIVES: We investigated race and ethnicity in the relationship between biomarkers of phthalate exposure and preterm birth by examining: a) how hypothetical reductions in racial and ethnic disparities in phthalate metabolites might reduce the probability of preterm birth; and b) exposure-response models stratified by race and ethnicity. METHODS: We pooled individual-level data on 6,045 pregnancies from 16 U.S. cohorts. We investigated covariate- adjusted differences in nine urinary phthalate metabolite concentrations by race and ethnicity [non-Hispanic White (White, 43%), non-Hispanic Black (Black, 13%), Hispanic/Latina (38%), and Asian/Pacific Islander (3%)]. Using g-computation, we estimated changes in the probability of preterm birth under hypothetical interventions to eliminate disparities in levels of urinary phthalate metabolites by proportionally lowering average concentrations in Black and Hispanic/ Latina participants to be approximately equal to the averages in White participants. We also used race and ethnicity- stratified logistic regression to characterize associations between phthalate metabolites and preterm birth. RESULTS: In comparison with concentrations among White participants, adjusted mean phthalate metabolite concentrations were consistently higher among Black and Hispanic/Latina participants by 23%-148% and 4%-94%, respectively. Asian/Pacific Islander participants had metabolite levels that were similar to those of White participants. Hypothetical interventions to reduce disparities in metabolite mixtures were associated with lower probabilities of preterm birth for Black [13% relative reduction; 95% confidence interval (CI): -34%, 8.6%] and Hispanic/Latina (9% relative reduction; 95% CI: -19%, 0.8%) participants. Odds ratios for preterm birth in association with phthalate metabolites demonstrated heterogeneity by race and ethnicity for two individual metabolites (mono-n-butyl and monoisobutyl phthalate), with positive associations that were larger in magnitude observed among Black or Hispanic/Latina participants. CONCLUSIONS: Phthalate metabolite concentrations differed substantially by race and ethnicity. Our results show hypothetical interventions to reduce population-level racial and ethnic disparities in biomarkers of phthalate exposure could potentially reduce the probability of preterm birth. https://doi.org/10.1289/EHP12831, Introduction Preterm birth is a major cause of neonatal mortality and morbidity that may perpetuate impacts on intergenerational health. (1) In the United States, preterm birth rates increased over the [...]

Research suggests that breastfeeding may reduce child maltreatment risk. Alaska has high rates of both breastfeeding initiation and maltreatment reports to Child Protective Services (CPS). The present study assessed any and exclusive breastfeeding duration and child maltreatment reports to CPS among Alaskan mother-infant dyads, controlling for demographics and shared risk factors. We used a prospective, population-representative dataset linking 2009-2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) data with 2009-2016 Alaska CPS and administrative state data (n = 3,459). Breastfeeding duration was derived from PRAMS breastfeeding questions and categorized as never, < 1 weeks, 1-9 weeks, and [greater than or equal to] 10 weeks. Age at first report of maltreatment to Alaska CPS included physical or sexual abuse, neglect, or mental injury. Hazard ratios and 95% confidence intervals (CI) were calculated using Cox proportional hazard models, adjusting for confounders. There was no increase in risk of maltreatment report among children never breastfed compared to those breastfed for [greater than or equal to] 10 weeks. Risk of maltreatment report during the observation period was 1.7 times as high among children breastfed for < 1 week (CI: 1.06, 2.73), and 1.5 times as high among those breastfed for 1-9 weeks (CI: 1.17, 1.80), compared to those breastfed for [greater than or equal to] 10 weeks. Estimates were attenuated for exclusive breastfeeding. Feeding method did not predict maltreatment reports in this population. Among mothers who initiated breastfeeding, shorter duration was associated with elevated risk of maltreatment reports. Addressing factors that facilitate or prohibit sustained breastfeeding may reduce risk of child maltreatment reports., Author(s): Helena J. Hutchins [sup.1] , Kim G. Harley [sup.1] , Jordyn T. Wallenborn [sup.1] , Barbara Abrams [sup.1] [sup.2] , Rebecca Reno [sup.1] , Jared W. Parrish [sup.3] Author [...]

Background: Intimate partner violence (IPV) is the most common form of gender-based violence affecting women and girls worldwide and is exacerbated in humanitarian settings. There is evidence that neighborhood social processes influence IPV. Perceived neighborhood social cohesion (P-NSC)—a measure of community trust, attachment, safety, and reciprocity—may be protective against women's experience of and men's perpetration of IPV and controlling behaviors. Methods: A quantitative social network study, comprised of individual verbally-administered surveys, was conducted in Bokolmayo refugee camp in Dollo Ado, Ethiopia in 2019. In total, 302 Somali refugees (147 women and 155 men), sampled using snowball sampling, participated in the data collection. Logistic regression was used to examine P-NSC and its association with IPV to inform an IPV and HIV prevention intervention. Results: Low P-NSC and men's perpetration of physical IPV in the past month were strongly associated (adjusted AOR = 23.6, 95% CI: 6.2–89.9). Low P-NSC, conversely, was associated with decreased odds of women's experiences of controlling behaviors by an intimate partner in the past year (AOR = 0.1, 95% CI: 0.0–0.5). Women's experiences of other forms of IPV, including physical, sexual, and emotional IPV within the past year, were not associated with P-NSC in adjusted models; P-NSC was significantly associated with all forms of IPV in unadjusted models. Conclusion: Social cohesion programs and other neighborhood approaches to improve P-NSC should be explored as potential avenues to prevent and reduce IPV, with a focus on male IPV and controlling behavior perpetration. [ABSTRACT FROM AUTHOR]

BACKGROUND: The prevalence of liver disorders and metabolic syndrome has increased among youth. Glyphosate, the most widely used herbicide worldwide, could contribute to the development of these conditions. OBJECTIVE: We aimed to assess whether lifetime exposure to glyphosate and its degradation product, aminomethylphosphonic acid (AMPA), is associated with elevated liver transaminases and metabolic syndrome among young adults. METHODS: We conducted a prospective cohort study (n = 480 mother-child dyads) and a nested case-control study (n = 60 cases with elevated liver transaminases and 91 controls) using data from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS). We measured glyphosate and AMPA concentrations in urine samples collected during pregnancy and at child ages 5, 14, and 18 y from cases and controls. We calculated glyphosate residue concentrations: [glyphosate + (1.5 X AMPA)]. We estimated the amount of agricultural-use glyphosate applied within a 1-km radius of every residence from pregnancy to age 5 y for the full cohort using California Pesticide Use Reporting data. We assessed liver transaminases and metabolic syndrome at 18 y of age. RESULTS: Urinary AMPA at age 5 y was associated with elevated transaminases [relative risk (RR) per 2-fold increase = 1.27, 95% confidence interval (CI): 1.06, 1.53] and metabolic syndrome (RR = 2.07, 95% CI: 1.38, 3.11). Urinary AMPA and glyphosate residues at age 14 y were associated with metabolic syndrome [RR= 1.80 (95% CI: 1.10, 2.93) and RR = 1.88 (95% CI: 1.03, 3.42), respectively]. Overall, a 2- fold increase in urinary AMPA during childhood was associated with a 14% and a 55% increased risk of elevated liver transaminases and metabolic syndrome, respectively. Living near agricultural glyphosate applications during early childhood (birth to 5 y of age) was also associated with metabolic syndrome at age 18 y in the case-control group (RR= 1.53, 95% CI: 1.16, 2.02). DISCUSSION: Childhood exposure to glyphosate and AMPA may increase risk of liver and cardiometabolic disorders in early adulthood, which could lead to more serious diseases later in life. https://doi.org/10.1289/EHP11721, Introduction The prevalence of childhood obesity and metabolic syndrome has increased at an alarming rate in the United States, (1,2) particularly among populations of color. (1-3) Accompanying this, has been [...]

Background: Because fine particulate matter [PM, with aerodynamic diameter [less than or equal to]2.5 [micro]m (P[M.sub.2.5])] is a ubiquitous environmental exposure, small changes in cognition associated with P[M.sub.2.5] exposure could have great societal costs. Prior studies have demonstrated a relationship between in utero P[M.sub.2.5] exposure and cognitive development in urban populations, but it is not known whether these effects are similar in rural populations and whether they persist into late childhood. OBJECTIVES: In this study, we tested for associations between prenatal P[M.sub.2.5] exposure and both full-scale and subscale measures of IQ among a longitudinal cohort at age 10.5 y. Methods: This analysis used data from 568 children enrolled in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a birth cohort study in California's agricultural Salinas Valley. Exposures were estimated at residential addresses during pregnancy using state of the art, modeled P[M.sub.2.5] surfaces. IQ testing was performed by bilingual psychometricians in the dominant language of the child. Results: A 3-[micro]g/[m.sup.3] higher average P[M.sub.2.5] over pregnancy was associated with -1.79 full-scale IQ points [95% confidence interval (CI): -2.98, -0.58], with decrements specifically in Working Memory IQ (WMIQ) and Processing Speed IQ (PSIQ) subscales [WMIQ -1.72 (95% CI: -2.98, -0.45) and PSIQ -1.19 (95% CI: -2.54,0.16)]. Flexible modeling over the course of pregnancy illustrated mid-to-late pregnancy (months 5-7) as particularly susceptible times, with sex differences in the timing of susceptible windows and in which subscales were most affected [Verbal Comprehension IQ (VCIQ) and WMIQ in males; and PSIQ in females]. Discussion: We found that small increases in outdoor P[M.sub.2.5] exposure in utero were associated with slightly lower IQ in late childhood, robust to many sensitivity analyses. In this cohort there was a larger effect of P[M.sub.2.5] on childhood IQ than has previously been observed, perhaps due to differences in PM composition or because developmental disruption could alter the cognitive trajectory and thus appear more pronounced as children get older. https://doi.org/10.1289/EHP10812, Introduction Particulate matter (PM) exposure is ubiquitous in the United States, and newly available estimates of PM that combine ground-based measurements with remotely sensed data (1) allow for characterization of [...]

The prevalence of childhood overweight is high in Mexican immigrant communities in the United States. Understanding mother’s perceptions of child weight in immigrants’ country of origin may help to understand this high prevalence. The goal of this study was to examine and compare mothers’ perception of weight in Mexico (MX) and in an immigrant community in California (CA). We assessed perceptions of child weight using a pictorial scale with 314 mothers of 5-year-old children in MX and 60 mothers of 5 year-old-children in CA. We compared maternal reports with children’s objectively measured weight. Using chi-square and Analysis of Variance, we investigated associations of maternal perception of and satisfaction with weight according to socio-demographic characteristics. Mothers were more likely to underestimate their children’s weight in CA than in MX. On average, CA mothers wanted their children to be smaller than they currently were and mothers in MX wanted their children to be bigger than they currently were. This differed by weight status in CA with mothers of normal weight and at-risk-for-overweight children wanting them to be bigger and mothers of overweight children wanting them to be smaller. In order for programs to be effective, mothers must be able to recognize their children as overweight and want to address it. Because underestimation of weight and a desire for a larger size is common in this population, programs to address overweight may be more effective if they focus on alternative benefits of weight control strategies, such as healthy child development.

BACKGROUND: Household cleaning products may be a significant source of chemical exposures, including carcinogens and suspected endocrine disruptors. OBJECTIVES: We characterized exposures during routine household cleaning and tested an intervention to reduce exposures to cleaning product chemicals. Methods: The Lifting Up Communities with Interventions and Research (LUCIR) Study is a youth-led, community-based intervention project. Youth researchers conducted personal air monitoring with 50 Latina women while they cleaned their homes with their regular cleaning products (preintervention visit) and then 1 week later while they used 'green' cleaning products provided by the study (postintervention visit). Air samples were analyzed for volatile and semivolatile organic compounds using gas chromatography-mass spectrometry and high- performance liquid chromatography. We compared pre- and postintervention air concentrations of 47 chemicals of concern, selected because they were on California's Proposition 65 list of carcinogens or reproductive/developmental toxicants or were suspected endocrine disruptors. Youth researchers were integrally involved in the study design, data collection, interpretation, and dissemination of findings. RESULTS: We observed statistically significant decreases in air concentrations of 17 chemicals of concern when participants switched to green cleaning products, including decreases in geometric mean concentrations of 1,4-dioxane (-46.4%), chloroform (-86.7%), benzene (- 24.8%), naphthalene (-40.3%), toluene (-24.2%), and hexane (-35.5%). We observed significant increases in air concentrations of three fragrance compounds: the plantderived terpene, beta-myrcene (221.5%), and the synthetic musks celestolide (31.0%) and galaxolide (79.6%). Almost all participants (98%) said the replacement products worked as well as their original products, and 90% said that they would consider buying the replacement products in the future. DISCUSSION: This study demonstrates that choosing cleaning products that are marketed as green may reduce exposure to several carcinogens and endocrine disruptors. Future studies should determine whether use of unscented green products would further reduce exposure to terpenes and musks. https://doi.org/10.1289/EHP8831, Introduction Household cleaning products can expose consumers to multiple chemicals, including volatile organic compounds (VOCs) that may affect human health. Multiple studies have shown associations of cleaning products with increased [...]

Background: Postpartum depression (PPD) is increasingly common in the United States and poses a significant threat to maternal and neonatal health. Universal screening for postpartum depression is recommended by numerous organizations, including the American College of Obstetricians and Gynecologists, but is not achieved in practice. Methods: A cross‐sectional, weighted, state‐representative study of California residents who gave birth in 2016 using the Listening to Mothers in California 2018 data set. Primary exposure was type of maternity care professional providing care during pregnancy, and the primary outcome was PPD screening. The secondary exposure was self‐reported depression or anxiety during pregnancy, and the secondary outcome was attending a postpartum office visit. Bivariate analyses were conducted using Rao‐Scott chi‐square tests, and multivariate analyses were conducted using logistic regression. Results: Compared to participants cared for by obstetricians, participants cared for by midwives had 2.6 times the odds of reporting being screened for PPD after controlling for covariates (95% CI = 1.5, 4.4). Receiving care from any other practitioner type compared with an obstetrician was not associated with a different rate of postpartum depression screening. Reporting depression or anxiety during pregnancy was associated with 0.7 times the odds (95% CI = 0.5, 1.0) of returning for postpartum care after controlling for covariates. Conclusions: Being cared for by a midwife during pregnancy increases the likelihood of being screened for postpartum depression. In addition, even perfectly implemented universal screening will miss a vulnerable sector of the population that is at high risk for postpartum depression and is less likely to return for postpartum care. [ABSTRACT FROM AUTHOR]

Objective Although previous studies have examined the impact of maternal depression on child overweight and obesity, little is known about the relationship in Latino families, who suffer from high risks of depression and obesity. We prospectively investigated the association between depressive symptoms in women with young children and child overweight and obesity (overweight/obesity) at age 7 years among Latino families. Methods Participants included 332 singletons with anthropometric measures obtained at 7 years from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a birth cohort study. Maternal depression was assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale when the children were 1, 3.5, and 7 years. Overweight and obesity was measured by body mass index (kg/m.sup.2) at age 7 years. Results 63 % of women had CES-D scores consistent with depression in at least one of the 3 given assessments. Compared to children whose mothers were never depressed, children whose mothers were depressed at all three assessments had 2.4 times the adjusted odds of overweight/obesity at age 7 years (95 % CI 1.1-5.6). However, a single positive maternal depression screen was not associated with child overweight/obesity and there was no difference in the odds of overweight/obesity by the age of the child when maternal depression occurred. Conclusion Chronic maternal depression during a child's early life was associated with child overweight/obesity at 7 years. Addressing maternal depression is a critical component of comprehensive obesity prevention and treatment strategies for Latino children., Author(s): Jocelyn Audelo[sup.1] [sup.2] , Katherine Kogut[sup.3] , Kim G. Harley[sup.2] [sup.3] , Lisa G. Rosas[sup.4] [sup.5] , Lauren Stein[sup.3] , Brenda Eskenazi[sup.1] [sup.3] Author Affiliations: (1) Maternal and Child [...]