TABLE 9-7Selected Epidemiologic Studies—Birth Weight Following Maternal Exposure (Shaded Entries Are New Information for This Update)

ReferencePrimary ExposureSample SizeOutcome/Main FindingsAdjustment Covariates
VIETNAM VETERANS US VA Cohort of Female Vietnam Veterans
H. Kang, personal correspondence, February 27, 2013Military service2,689BW girls = + 0.5 oz BW boys = –0.8 oz (difference in boys comes to –22.7 gUnadjusted differences and major uncontrolled confounders (smoking, parity, race)
Kang et al., 2000Military service4,140LBW (OR = 1.06, 95% CI 0.8–1.5)Maternal age, education, race, marital status, military characteristics, smoking, drinking, average number of hours worked during pregnancy, complications during pregnancy
Seveso, Italy, Women's Health Study—Industrial accident July 10, 1976 (981 women who were between infancy and 40 yrs old, who resided in Zones A or B)
Baccarelli et al., 2008Seveso51No association with LBWNone
Eskenazi et al., 2003 (B. Eskenazi, personal correspondence, January 30, 2013—researchers checked for effect modification by sex but found none)Seveso608 overallBirth weight (nonsignificant negative coefficients). SGA—ORs between 1.2–1.8; none are technically significant. OR = 1.2, 0.8–1.8 is overallGestational age, sex, parity, history of LBW, maternal height, maternal BMI, maternal age, maternal education, smoking
Vietnamese Studies
Nishijo et al., 2012People living around contaminated airbase in Vietnam210At birth no effect, but birth-weight discrepancy grows with months from delivery. Significant at 4 months. Effect only seen in boysParity, maternal age, weight, educational period, alcohol use, family income, family smoking, gestational weeks, infant age on the day of examination
Times Beach and Quail Run Cohorts
Stockbauer et al., 1988TCDD soil contamination in MissouriMatched sets, ~400 (2:1)LBW: 1.5 (95% CI 0.2–2.3)Sex, maternal education, parity, marital status, prepregnancy weight, smoking, history of previous SAB and fetal deaths
Yusho, Japan, Cohort—population exposed to PCDDs, PCDFs, and PCBs in contaminated cooking oil
Tsukimori et al., 2012bYusho190~ –200g birthweight reduction with PCDD TEQ (p = 0.003) in males, also overall effect but driven by effect in boysGestational age, maternal age, parity, smoking, duration breastfeeding, seafood consumption
Kuratsune et al., 1972Yusho11None calculated
Other Environmental Studies
Konishi et al., 2009Sapporo, Japan; contemporary cohort514BW (–220.5 g per 10-fold increase in TEQ, 95% CI –399.2 to –41.9); effect driven by malesGestational age, maternal age, maternal height, maternal weight before pregnancy, parity, smoking, inshore fish intake, blood sampling period, infant sex
Tawara et al., 2009Coastal Japan; contemporary cohort75Some weak negative correlationsUnadjusted; Spearman correlations
Nishijo et al., 2008Breast-milk dioxin levels42Negative correlation for TEQ-PCDD and TEQ, PCDF, but not “significant”Spearman correlations
Vartiainen et al., 1998Random sampling of mother/infant pairs from urban/rural Finland167Birth weight decreased with increasing concentrations of I-TEQ, especially among boysUnadjusted; effect goes away when restricted to primiparas
Patandin et al., 1998Dutch children—PCB 118 exposure (only total)207Birth weight = –119 (53.7); p = 0.03Smoking, alcohol, gestational age, target height, parity
United States
Kezios et al., 2012California Child Health and Human Development Study600No association with birth weightRace, age, smoking status, BMI, sex, length of gestation, lipids
Sagiv et al., 2007PCB 118722Negative birthweight effects with increasing exposure quartile, nonsignificant—0, –18, –72, –69.5Gestational age, infant size, birth year, maternal age, race parity, height, prepregnancy BMI, smoking, local fish consumption

NOTE: BMI, body mass index; BW, birth weight; CI, confidence interval; I-TEQ, international (total) toxic equivalent; LBW, low birth weight; OR, odds ratio; PCB, polychlorinated biphenyls; PCDD, polychlorinated dibenzo-p-dioxin; PCDF, polychlorinated dibenzofurans; SAB, spontaneous abortion; SGA, small for gestational age; TCDD, 2,3,7,8-trichlorodibenzo-p-dioxin; TEQ, (total) toxic equivalent; VA, US Department of Veterans Affairs.

From: 9, Fertility and Gestational Outcomes

Cover of Veterans and Agent Orange
Veterans and Agent Orange: Update 2012.
Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Ninth Biennial Update); Board on the Health of Select Populations; Institute of Medicine.
Washington (DC): National Academies Press (US); 2014 Mar 6.
Copyright 2014 by the National Academy of Sciences. All rights reserved.

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