# Maternal organophosphate pesticide exposure, low birth weight and placental injury

> **NIH NIH R01** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2021 · $254,112

## Abstract

PROJECT SUMMARY/ABSTRACT
 Background/Significance: The global burden of low birth weight (LBW, <2500 grams) has not
changed significantly with interventions targeted at traditional risk factors; twenty million infants continue to
be born LBW each year, increasing their risks of newborn mortality, childhood stunting, and chronic adult
disease. To achieve the World Health Organization's ambitious target of reducing LBW by 30% by 2025,
novel risk factors must be identified, particularly in low/middle income countries where >95% of LBW
infants are born. Prenatal environmental exposures are potential modifiable contributors to LBW but have
been underexplored in LMICs.
 Objectives/Aims: We will evaluate exposure to organophosphate pesticides (OPs) during pregnancy
and determine its association with LBW in rural sub-Saharan Africa where one in six newborns is LBW. We
propose three aims: 1) To characterize exposure to OPs and identify predictors of high exposure that may
be targeted in future exposure reduction efforts; 3) To determine the association of OP exposure with
newborn weight and gestational age at birth, the two contributors to LBW; and, 3) To evaluate the
association between OP exposure and placental injury, a potential target organ for OP toxicity that may
mediate the effect of OP exposure on birth outcomes.
 Methods: We will leverage an existing birth cohort derived from the Ghana Randomized Air Pollution
and Health Study (GRAPHS) in which 1,414 pregnant women were enrolled prior to 28 weeks gestation
and assigned to distinct prenatal cooking strategies. The cooking interventions had no impact on birth
weight, gestational age at birth, or other obstetric outcomes; however, an extensive biobank of maternal
urine specimens and placental tissue was created and, in combination with detailed covariate data and
rigorously collected birth outcomes, provides a rich platform to address our questions about OP exposure
and LBW. We will measure concentrations of specific OP biomarkers in repeated maternal urine samples
(4 per pregnancy) to evaluate our hypotheses. Our exposure-response analysis will be augmented with
evaluation of placental tissue to highlight potential mechanisms of prenatal OP injury.
 Innovation: This study is the first to evaluate prenatal OP exposure and LBW in rural Africa, where
pesticide exposure is high and one in six newborns is LBW. We will overcome methodologic limitations of
prior literature from industrialized settings with access to repeated prenatal urine samples to better
characterize exposure, a large sample size and extensive covariate data and will employ innovative
statistical approaches to address mixtures of pesticide exposures and estimate windows of susceptibility.
Our study will also be the first to integrate evaluation of the placenta into investigation of the impacts of
prenatal OP exposure.
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## Key facts

- **NIH application ID:** 10166846
- **Project number:** 5R01ES028688-04
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Michele Renee Hacker
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $254,112
- **Award type:** 5
- **Project period:** 2018-08-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10166846

## Citation

> US National Institutes of Health, RePORTER application 10166846, Maternal organophosphate pesticide exposure, low birth weight and placental injury (5R01ES028688-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10166846. Licensed CC0.

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