Perinatal & Pediatric
Association between prenatal exposure to chemical and nonchemical stressors and adolescent well-being among extremely low gestational aged newborns (ELGANs) Jenna Frey* Jenna Frey Lauren Eaves T. Michael O’Shea Rebecca C. Fry
Humans are exposed to an array of stressors in their built and social environments throughout the life course. Exposure to chemical and nonchemical stressors—particularly during critical windows of susceptibility such as in utero—have been separately and jointly associated with adverse health outcomes. Aiming to identify associations between prenatal exposure and adolescent health, we hypothesize that higher levels of negative stressors will be associated with lower levels of well-being and increased internalizing/externalizing behaviors.
Participants in this analysis (N=219) were a part of the Extremely Low Gestational Age Newborn (ELGAN) cohort which is made up of individuals born before 28 weeks of completed gestation in three US regions. Chemical stressors (11 metals/metalloids measured in umbilical cord samples) and nonchemical stressors (SES composite variable including <12 years of educational attainment, Medicaid insurance use, “single” marital status, and food stamp use collected by a maternal interview at birth) were assessed. Three outcomes were measured at age 15. Overall wellbeing was measured through the PROMIS Global health self-report measure and internalizing and externalizing behaviors through the Child Behavior Checklist Youth Self-Report form. Metals were natural log-transformed for normality. Regression models were run for each of the 11 metals and the SES variable for each outcome.
In models adjusted for maternal age at birth and smoking status during pregnancy, the metals were positively associated with overall well-being: zinc (β=2.23, p=0.006), strontium (β=1.68, p=0.003), and barium (β=1.25, p=0.007). Adjusted models showed associations between the SES sum and internalizing behaviors (β=1.29, p=0.05) and the SES sum and externalizing behaviors (β=1.05, p=0.02). Next steps include testing for interaction between chemical and nonchemical stressors and evaluating mixtures effects of coexposure to multiple metals through quantile g-computation.