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Pélagie Cohort, Brittany, France
The Pélagie cohort has included almost 3500 pregnant women between 2002 and 2006 from three departments in the Brittany region, particularly concerned by agricultural activities (Ille et Vilaine, Finistère and Côtes d’Armor). Women were enrolled by gynaecologists or ultrasonographers during their medical consultation at their beginning of pregnancy (<19 weeks of amenorrhea). They were informed of the purpose and protocol of the study and they were asked to participate by providing informed consent. During the medical consultation, participants were provided with a questionnaire and material to collect first-morning urine samples. Women completed at home the questionnaire that asked about social and demographic characteristics of the family, obstetric history, occupational activity, nutrition and lifestyle, and sent it with urine samples to our laboratory witha provided pre-stamped letter. At birth, medical information about pregnancy, delivery and the newborn's health was obtained from midwives, pediatricians and hospital medical records and a piece of placenta, cord blood and maternal hair were collected.
A total of 3421 pregnant women were included (64% from Ille-et-Vilaine). Urinary samples were collected for 95% of the cohort. Placenta, cord blood and maternal hair samples were collected respectively for 63%, 62% and 58% of the cohort. Only 22 women (0.6%) could not be followed at birth. Among the liveborn singletons (n=3322), we observed 126 premature births (<37WA; 3.7%), 180 children with intrauterine growth restriction (5%) using definition taking into account anthropometric parameters of the mother and 105 children with small-head for gestational-age (3.2%). The prevalence of prematurity is comparable to that observed from the national survey organised in 1998 in the Brittany region, and is lower than the national prevalence. At the age of 2 and 4-year, questionnaires were sent to participants. They collected data on growth, health and cognitive and motor development of the children as well as data on activities of the child and lifestyles of families. A total of 70% of the cohort with a known residential address (n=1506) participated to the 2-year-old follow-up. The follow-up at 4-year old was realized only in the Ille-et-Vilaine department from preschool medical examinations.
Our first results related to fish and shellfish consumption during pregnancyshowed opposite associations for these two categories of seafood with duration of gestation and birth weight (Guldner et al. 2007). Occupational exposure to solvents during pregnancy was also investigated and we showed an increased risk of major congenital malformations, especially oral clefts, urinary tract defects, musculoskeletal anomalies and male genital birth defects, in association with this exposure (Garlantezec et al., 2009). Urinary metabolites of solvents are also measured. Pesticide exposure assessment was realised from questionnaire (domestic use, organic diet, residence history), environmental data (surveys on land crop use; estimates of air drifts). Biological makers were analyzed in urine for 52 main compounds and metabolites (triazines, amide herbicides, organophosphorous insecticides, propoxur)(Chevrier et al., 2009) and in serum for quantification of organochlorine insecticides (DDT, lindane, …), polychlorobiphenyls and brominated flame retardants. All biomarkers determinations were performed according to a nested case-control design. Assessment of exposure to water disinfection by-products during pregnancy is on going.
e erences - Guldner L, Monfort C, Rouget F, Garlantezec R, Cordier S. Maternal fish and shellfish intake and pregnancy outcomes: a prospective cohort study in Brittany, France. Environmental Health 2007, 6:33 http://www.ehpjournal.net/content/6/1/33 - Garlantézec R, Monfort C, Rouget F, Cordier S. Maternal occupational exposure to solvents and congenital malformations: a prospective study in the general population. Occupational Environmental Medicine(in press) - Chevrier C, Petit C, Limon G, Monfort C, Durand G, Cordier S. Urinary biomarkers for pesticide exposure in pregnant women of the Pelagie cohort study conducted in Brittany (2002-2006). Bulletin épidémiologique hebdomadaire BEH special edition, june 2009
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