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Stijn L. Verhulst,¹ Vera Nelen,² Elly Den Hond,^3,4 Gudrun Koppen,^3,4 Caroline Beunckens,⁵ Carl Vael,⁶Greet Schoeters,^3,4 and Kristine Desager¹

¹Department of Pediatrics, University of Antwerp, Antwerp, Belgium; ²Provincial Institute for Hygiene, Antwerp, Belgium; ³VITO (Flemish Institute of Technological Research), Mol, Belgium; ⁴Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; ⁵Center for Statistics, Hasselt University, Hasselt, Belgium; ⁶Department of Microbiology, University of Antwerp, Antwerp, Belgium

Abstract
Objective: We investigated the association between body mass index (BMI) standard deviation score (SDS) and prenatal exposure to hexachlorobenzene, dichlorodiphenyldichloroethylene (DDE) , dioxin-like compounds, and polychlorinated biphenyls (PCBs) .

Methods: In this prospective birth cohort study, we assessed a random sample of mother–infant pairs (n = 138) living in Flanders, Belgium, with follow-up until the children were 3 years of age. We measured body mass index as standard deviation scores (BMI SDS) of children 1–3 years of age as well as pollutants measured in cord blood.

Results: DDE correlated with BMI SDS, with effect modification by maternal smoking and the child’s age. At 1 year, children of smoking mothers had higher BMI SDS than did children of nonsmoking mothers. At 3 years, this difference was reduced because of the faster rate of decline in BMI SDS in the former group. This relationship held except for children with high levels of DDE. DDE had a small effect on BMI SDS at 3 years of age in children of nonsmoking mothers (difference in BMI SDS for DDE concentrations between the 90th and 10th percentiles = 0.13) . On the other hand, smoking enhanced the relation between DDE and BMI SDS at 3 years (difference in BMI SDS for DDE concentrations between the 90th and 10th percentiles = 0.76) . Increasing concentrations of PCBs were associated with higher BMI SDS values at all ages (parameter estimate = 0.003 ± 0.001 ; p = 0.03) .

Conclusion: In this study we demonstrated that intrauterine exposure to DDE and PCBs is associated with BMI during early childhood. Future studies are warranted to confirm our findings and to assess possible mechanisms by which these pollutants could alter energy metabolism.

Key words: body mass index, childhood, dichlorodiphenyldichloroethylene, dioxin-like compounds, hexachlorobenzene, obesity, polychlorinated biphenyls. Environ Health Perspect 117:122–126 (2009) . doi:10.1289/ehp.0800003 available via http://dx.doi.org/ [Online 8 October 2008]

Address correspondence to S. Verhulst, University of Antwerp, Department of Pediatrics, Universiteitsplein 1, 2610 Wilrijk, Belgium. Telephone: 32475391944. Fax: 3238214447. E-mail: stijn.verhulst@ua.ac.be

The study was commissioned, financed, and steered by the Ministry of the Flemish Community (Department of Science, Department of Public Health, and Department of Environment) , without any responsibility for the scientific content.

The authors declare they have no competing financial interests.

Received 16 July 2008 ; accepted 8 October 2008.