Pregnancy pesticide exposure and child development in low- and middle-income countries: A prospective analysis of a birth cohort in rural Bangladesh and meta-analysis

BACKGROUND

Despite considerable evidence on a negative association between pregnancy pesticide exposure and child development in high-income countries, evidence from low- and middle-income countries (LMICs) is limited. Therefore, we assessed associations between pregnancy pesticide exposure and child development in rural Bangladesh and summarised existing literature in a systematic review and meta-analysis.

METHODS

We used data from 284 mother-child pairs participating in a birth cohort established in 2008. Eight urinary pesticide biomarkers were quantified in early pregnancy (mean gestational age 11.6±2.9 weeks) as an index of pesticide exposure. The Bayley Scales of Infant and Toddler Development, Third Edition were administered at 20-40 months of age. Associations between creatinine-adjusted urinary pesticide biomarker concentrations and child development scores were estimated using multivariable generalised linear models. We searched ten databases up to November 2021 to identify prospective studies on pregnancy pesticide exposure and child development conducted in LMICs. We used a random-effects model to pool similar studies, including our original analysis. The systematic review was pre-registered with PROSPERO: CRD42021292919.

RESULTS

In the Bangladesh cohort, pregnancy 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY) concentrations were inversely associated with motor development (-0.66 points [95% CI -1.23, -0.09]). Pregnancy 3,5,6-trichloro-2-pyridinol (TCPY) concentrations were inversely associated with cognitive development, but the association was small: -0.02 points (-0.04, 0.01). We observed no associations between 4-nitrophenol and 3-phenoxybenzoic acid (3-PBA) concentrations and child development. The systematic review included 13 studies from four LMICs. After pooling our results with one other study, we found consistent evidence that pregnancy 3-PBA concentrations were not associated with cognitive, language, or motor development.

CONCLUSION

Evidence suggests that pregnancy exposure to some organophosphate pesticides is negatively associated with child development. Interventions to reduce in-utero pesticide exposure in LMICs may help protect child development.

Uncertainty of pesticides in foodstuffs, associated environmental and health risks to humans-a critical case of Bangladesh with respect to global food policy

The uncertain fate and transport pathways of applied pesticides are the key hidden threats with respect to the safety and quality evaluation of foodstuffs in Bangladesh. The risk assessment of and uncertainty about applied pesticides are poorly explored due to weak regulatory systems, farmer ignorance, intensive agricultural practices, and lack of available research data on improper handling of pesticides on farming lands with poor phytosanitary management. However, increasing evidence suggests that the prevalence of pesticides in common foodstuffs is due to their uptake by crops and improper management of crop protection practices. Besides, the biotransformation of pesticides in common Bangladeshi food products is poorly understood. Several studies have reported higher concentrations of pesticides than allowed by European Union guidelines in Bangladeshi foodstuffs. However, to date, no systematic review with critical discussion on current research findings and knowledge gaps concerning fate, uncertainty, and health risks of pesticides in the foodstuffs of Bangladesh is published. Therefore, this review summarizes the findings of existing literature on pesticide residue in foodstuffs and points out the weaknesses in the regulatory system and risk assessments for highlighting the critical challenges to food safety in Bangladesh as compared to global food policy. In addition, strategies for the sustainable management of residual pesticides are also discussed.