Multiple maternal occupational exposures during pregnancy and intrauterine growth: analysis of the French Longitudinal Study of Children - ELFE cohort, using data-driven approaches

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OBJECTIVE: To use data-driven approaches to investigate maternal multi-occupational exposures during pregnancy and their effects on intrauterine growth. METHODS: Maternal occupational exposure to 47 factors during pregnancy was evaluated with job-exposure matrices in the French ELFE cohort. The outcomes of interest were birthweight (BW), small for gestational age (SGA) and head circumference (HC). Occupational exposures associated with these outcomes were identified by EWAS, LASSO, and random forest. The five exposures with the strongest effects selected with these approaches were included in a final multivariate model with significant interactions. RESULTS: We included 12,851 women. The most important occupational factors predictive of SGA were endocrine disruptors, high strain, kneeling/squatting, job demands, physical effort. No significant associations were detected when these variables were combined in a final model. For BW, the most important variables were leaning forward/sideways, using a computer screen, ultrafine particles, physical effort, airborne germs, repetitive actions. The use of a computer screen significantly decreased BW and, for women not exposed to airborne germs, leaning forward/sideways significantly increased BW. For HC, repetitive actions, oxygenated solvents, kneeling/squatting, airborne germs, working outdoors were the most important predictive factors. Repetitive actions and working outdoors significantly decreased HC. HC also decreased in women exposed to both airborne germs, and oxygenated solvents. Similar results were found for women who worked during the third trimester. CONCLUSION: Our findings highlight potential roles of chemical, biological and postural factors and their interactions in determining intrauterine growth. These results highlight the importance of considering multiple exposures in occupational health studies.

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