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Title: The socioeconomic landscape of the exposome during pregnancy
Authors: Sum, Ka Kei
Tint, Mya Thway
Aguilera, Rosana
Dickens, Borame Sue Lee
Choo, Sue
Ang, Li Ting
Phua, Desiree
Law, Evelyn C.
Ng, Sharon
Tan, Karen Mei-Ling
Benmarhnia, Tarik
Karnani, Neerja
Eriksson, Johan G.
Chong, Yap-Seng
Yap, Fabian
Tan, Kok Hian
Lee, Yung Seng
Chan, Shiao-Yng
Chong, Mary F. F.
Huang, Jonathan
Keywords: Science::Medicine
Issue Date: 2022
Source: Sum, K. K., Tint, M. T., Aguilera, R., Dickens, B. S. L., Choo, S., Ang, L. T., Phua, D., Law, E. C., Ng, S., Tan, K. M., Benmarhnia, T., Karnani, N., Eriksson, J. G., Chong, Y., Yap, F., Tan, K. H., Lee, Y. S., Chan, S., Chong, M. F. F. & Huang, J. (2022). The socioeconomic landscape of the exposome during pregnancy. Environment International, 163, 107205-.
Project: NMRC/TCR/004-NUS/2008 
Journal: Environment International
Abstract: Background: While socioeconomic position (SEP) is consistently related to pregnancy and birth outcome disparities, relevant biological mechanisms are manifold, thus necessitating more comprehensive characterization of SEP-exposome associations during pregnancy. Objectives: We implemented an exposomic approach to systematically characterize the socioeconomic landscape of prenatal exposures in a setting where social segregation was less distinct in a hypotheses-generating manner. Methods: We described the correlation structure of 134 prenatal exogenous and endogenous sources (e.g., micronutrients, hormones, immunomodulatory metabolites, environmental pollutants) collected in a diverse, population-representative, urban, high-income longitudinal mother-offspring cohort (N = 1341; 2009–2011). We examined the associations between maternal, paternal, household, and areal level SEP indicators and 134 exposures using multiple regressions adjusted for precision variables, as well as potential effect measure modification by ethnicity and nativity. Finally, we generated summary SEP indices using Multiple Correspondence Analysis to further explore possible curved relationships. Results: Individual and household SEP were associated with anthropometric/adiposity measures, folate, omega-3 fatty acids, insulin-like growth factor-II, fasting glucose, and neopterin, an inflammatory marker. We observed paternal education was more strongly and consistently related to maternal exposures than maternal education. This was most apparent amongst couples discordant on education. Analyses revealed additional non-linear associations between areal composite SEP and particulate matter. Environmental contaminants (e.g., per- and polyfluoroalkyl substances) and micronutrients (e.g., folate and copper) showed opposing associations by ethnicity and nativity, respectively. Discussion: SEP-exposome relationships are complex, non-linear, and context specific. Our findings reinforce the potential role of paternal contributions and context-specific modifiers of associations, such as between ethnicity and maternal diet-related exposures. Despite weak presumed areal clustering of individual exposures in our context, our approach reinforces subtle non-linearities in areal-level exposures.
ISSN: 0160-4120
DOI: 10.1016/j.envint.2022.107205
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: Duke–NUS Medical School
KK Women’s and Children’s Hospital
Rights: © 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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