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Pesticide Residue Intake in Pregnancy Outcomes

JAMA Intern Med; ePub 2017 Oct 30; Chiu, et al

Publish date:: November 14, 2017

Higher consumption of high-pesticide residue from fruits and vegetables (FVs) was associated with lower probabilities of pregnancy and live birth from treatment with assisted reproductive technologies (ART), a recent study found. The analysis included 325 women who completed a diet assessment and subsequently underwent 541 ART cycles in the Environmental and Reproductive Health (EARTH) prospective cohort study from 2007 to 2016 at a fertility center. Researchers found:

In 325 study participants (mean age 35 years, BMI, 24.1), mean (SD) intakes of high- and low-pesticide residue FVs were 1.7 (1.0) and 2.8 (1.6) servings/day, respectively.
Greater intake of high-pesticide residue FVs was associated with a lower probability of clinical pregnancy and live birth.
Compared with women in the lowest quartile of high-pesticide FV intake (<1.0 servings/day), women in the highest quartile (>2.3 servings/day) had 18% lower probability of clinical pregnancy and 26% lower probability of live birth.

Citation:

Chiu Y, Williams PL, Gillman MW, et al; for the EARTH study team. Association between pesticide residue intake from consumption of fruits and vegetables and pregnancy outcomes among women undergoing infertility treatment with assisted reproductive technology. [Published online ahead of print October 30, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.5038.

Commentary:

Exposure to pesticides is ubiquitous, with over 90% of the US population having detectable levels of pesticide in urine and blood samples.¹ The largest source of human exposure to pesticides is through fruits and vegetables in the diet.² Women with occupational exposure to pesticides have increased risk of infertility and adverse pregnancy outcomes. This study is startling in that it shows an adverse effect of ordinary exposure on fertility outcomes. The role of pesticides on human health and disease continues to be uncovered, and is quite alarming. A recent article in Diabetes showed an effect of persistent organic pollutants (POPs) as a new risk factor for type 2 diabetes, suggesting that chronic exposure to low-dose POPs leads to pancreatic beta-cell dysfunction.³ —Neil Skolnik, MD

Centers for Disease Control and Prevention. National Report on Human Exposure to Environmental Chemicals, updated tables, January 2017. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention. https://www.cdc.gov/exposurereport. Accessed September 10, 2015.
Lu C, Barr DB, Pearson MA, Waller LA. Dietary intake and its contribution to longitudinal organophosphorus pesticide exposure in urban/suburban children. Environ Health Perspect. 2008;116(4):537-542. doi:10.1289/ehp.10912.
Lee YM, Ha CM, Kim SA, et al. Persistent organic pollutants impair insulin secretory function of pancreatic beta-cells: Human and in vitro evidence. Diabetes. 2017;66(10):2669-2680. doi:10.2337/db17-0188.

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