Persistent organic pollutants and haematological markers in Greenlandic pregnant women: the ACCEPT sub-study

Figures & data

Figure 1. Map of Greenland showing the six selected town regions for the ACCEPT sub-study in 2010-11. Participants were enrolled in Qaanaaq, Ilulissat, Aasiaat, Maniitsoq, Nuuk, and Paamiut [18, 19].

Figure 2. The total number (N = 189) of participants’ data stratified by gestation week and trimester groups at inclusion time.

Table 1. Baseline characteristics for study population (N = 189).

Parameters
Age at inclusion (years)	27.00 (18–42)
Pre-pregnancy BMI^a (kg/m^2)	24.24 (16.38–46.57)
Parity^b, n (%)	189 (100)
0	69 (36.5)
1–2	94 (49.7)
≥3	26 (13.8)
Smoking status, n (%)^c	188 (100)
Current	87 (46.3)
Non-current	101 (53.7)
P-cotinine^d (ng/ml)	0.500 (0.500–190.5)
Current (median)	75.7
Non-current (median)	0.5
Alcohol during pregnancy, n (%)^c	185 (100)
No (<1 a month)	179 (97)
Yes (>1 a month)	6 (3)
Iron substitution, n (%)	189 (100)
No	32 (16.9)
Yes	157 (83.1)
n-3/n-6 fatty acid ratio	0.22 (0.08–0.87)
Collection site, n (%)	189 (100)
Nuuk	92 (48.7)
Maniitsoq	39 (20.6)
Ilulissat	33 (17.5)
Aasiaat	18 (9.5)
Paamiut	4 (2.1)
Qaanaaq	3 (1.6)
Level of POPs^e
sumPCBs^f (μg/kg lipid)	189.2 (55.70–2714)
sumOCPs^g (μg/kg lipid)	240.5 (41.10–2198)
sumPFASs^h (ng/mL)	18.5 (6.14–96.43)

N: total number of participants in the study population.

n (%): number and per cent of participants in the groups and with the corresponding answer.

^aBMI: Body mass index in kg/m².

^bParity: number of full term pregnancies.

^cMissing answer(s), not included in the per cent calculation.

^dP-cotinine: plasma-cotinine in ng/ml.

^ePOPs: persistent organic pollutants.

^fsumPCBs: sum of 14 polychlorinated biphenyls.

^gsumOCPs: sum of 11 organochlorine pesticides.

^hsumPFASs: sum of 15 perfluoroalkylated substances.

For single POP congeners and the sum of n-3 and n-6 fatty acids, see reference 19.

Data are presented as median (min – max), unless otherwise indicated.

Table 2. Baseline information of the haematological markers for the study population (N = 189).

Parameter	Abbreviation	SI unit	n	Median	Min – Max	General reference range
Haemoglobin	Hgb	mmol/L	168	7.2	5.6–8.8	7.0–9.4^a
Haematocrit	Hct	ratio (%)^f	168	0.39	0.27–0.49	0.35–0.47^a
Glycated haemoglobin A1c	HbA1c	mmol/mol	148	25.5	13.8–44.6	31–44^a
Basophil count	BASO	10^9/L	168	0.02	0.01–0.16	0.0–0.20 ^b
Eosinophil count	EO	10^9/L	162	0.10	0.00–0.81	0.0–0.50 ^b
Lymphocyte count	LYMPH	10^9/L	160	1.57	0.26–3.14	0.70–4.80 ^b
Monocyte count	MONO	10^9/L	162	0.39	0.02–1.22	0.0–1.10 ^b
Neutrophil count	NEU	10^9/L	160	5.43	0.71–11.70	1.80–7.40 ^b
Mean corpuscular haemoglobin	MCH	fmol/L	168	1.9	1.4–2.1	1.7–2.1^a
Mean corpuscular haemoglobin concentration	MCHC	mmol/L	168	18.4	15.8–22.3	18.6–22.3^a
Mean erythrocyte corpuscular volume	MCV	fL^g	168	100	78–119	81–109^a
Mean platelet volume	MPV	fL^g	168	10.3	7.4–13.3	6.4–11.00^c
Platelet distribution width	PDW	fL^g	168	11.8	7.4–18.5	8.9–15.5^d
Plateletcrit	PCT	ratio (%)^h	168	0.27	0.09–0.66	0.13–0.34^d
Platelet count (thrombocyte count)	PLT	10^9/L	168	258	85–653	135–400^a
Platelet – larger cell ratio	P-LCR	ratio (%)^i	168	0.272	0.07–0.497	–
Red blood cell count	RBC	10^12/L	168	3.89	2.89–5.20	3.66–5.10^a
Red cell distribution width (standard deviation)	RDW-SD	fL^g	168	49.9	38.7–98.3	39.0–46.0 ^5
Red cell distribution width (cell volume)	RDW-CV	ratio(%)^j	168	0.142	0.118–0.262	0.116–0.146^e
White blood cell count (leukocyte count)	WBC	10^9/L	168	7.5	1.6–15.1	3.0–8.5^a
Thyroid stimulating hormone	TSH	mIU/L	132	0.84	0.01–4.41	0.4–3.8^a
Thyroxine (total)	TT4	nmol/L	131	120	81–240	60–140^a
Triiodothyronine (total)	TT3	nmol/L	130	2.40	1.54–4.11	1.10–2.38^a
Uric acid	URIC	mmol/L	169	0.23	0.11–0.40	0.15–0.35^a

N: total number of participants in the study population. n: number of participants with data to the corresponding parameter.

Missing data: N – n.

General reference range listed with reference to: ^alocal recommendation for the Central Laboratory at Queen Ingrid Hospital, Greenland,

^b[22], ^c[23], ^d[24], ^e[25].

^fHct ratio: volume fraction of MCV and RBC in %.

^gfL: 10–15 L.

^hPCT ratio: platelet count in the blood as a percentage to the whole blood volume.

ⁱP-LCR ratio: the percentage of the platelets with a size of more than 12 fL.

^jRDW-CV ratio: RDW-SD/MCV.

“–“: no given reference range.

Table 3. The association between haematological markers and serum level of sumPCBs (N = 189).

	Crude			Adjusted^a			Adjusted^b
Parameter	β	(95%CI)	p	β	(95%CI)	p	β	(95%CI)	p
Hgb (mmol/L)	0.02	(−0.11;0.16)	0.73	0.05	(−0.09;0.18)	0.51	0.03	(−0.12;0.18)	0.69
Hct (ratio)	0.00	(−0.01;0.01)	0.81	0.00	(−0.01;0.01)	0.94	0.00	(−0.01;0.01)	0.88
HbA1c(mmol/mol)^c	−0.03	(−0.07;0.02)	0.21	−0.03	(−0.08;0.01)	0.12	−0.04	(−0.08;0.01)	0.13
BASO (10^9/L)^c	0.09	(−0.04;0.23)	0.18	0.07	(−0.07;0.22)	0.32	0.09	(−0.08;0.25)	0.30
EO (10^9/L)^c	−0.24	(−0.39;-0.08)	<0.01	−0.20	(−0.36;-0.04)	0.01	−0.17	(−0.34;0.01)	0.06*
LYMPH (10^9/L)	−0.12	(−0.23;-0.02)	0.02	−0.13	(−0.24;-0.01)	0.03	−0.11	(−0.24;0.01)	0.08*
MONO (10^9/L)^c	−0.09	(−0.21;0.03)	0.14	−0.09	(−0.20;0.03)	0.13	−0.11	(−0.24;0.01)	0.07*
NEU (10^9/L)^c	−0.19	(−0.30;-0.07)	<0.01	−0.18	(−0.29;-0.07)	<0.01	−0.17	(−0.29;-0.04)	0.01
MCH (fmol/L)	0.02	(−0.01;0.04)	0.16	0.01	(−0.01;0.04)	0.30	0.01	(−0.02;0.04)	0.59
MCHC (mmol/L)	0.00	(−0.35;0.35)	0.99	0.09	(−0.28;0.45)	0.64	0.03	(−0.37;0.43)	0.88
MCV (fL)	0.87	(−1.24;2.99)	0.41	0.16	(−2.01;2.34)	0.88	0.09	(−2.29;2.47)	0.94
MPV (fL)	−0.04	(−0.28;0.20)	0.72	−0.17	(−0.41;0.08)	0.17	−0.23	(−0.50;0.04)	0.09*
PDW (fL)	−0.18	(−0.68;0.32)	0.47	−0.41	(−0.93;0.11)	0.12	−0.54	(−1.11;0.02)	0.06*
PCT (ratio)^c	−0.02	(−0.07;0.04)	0.54	0.00	(−0.07;0.06)	0.89	0.02	(−0.04;0.09)	0.49
PLT (10^9/L)^c	−0.02	(−0.09;0.05)	0.53	0.00	(−0.07;0.08)	0.94	0.04	(−0.04;0.11)	0.37
P-LCR (ratio)	0.00	(−0.02;0.02)	0.78	−0.01	(−0.03;0.01)	0.23	−0.02	(−0.04;0.00)	0.11
RBC (10^12/L)	−0.02	(−0.10;0.06)	0.58	0.00	(−0.08;0.08)	0.96	0.00	(−0.08;0.09)	0.93
RDW-SD (fL)^c	0.00	(−0.04;0.04)	0.93	−0.01	(−0.05;0.03)	0.62	0.00	(−0.04;0.04)	0.99
RDW-CV (ratio)^c	−0.01	(−0.04;0.01)	0.25	−0.01	(−0.04;0.01)	0.29	0.00	(−0.03;0.03)	0.84
WBC (10^9/L)	−0.76	(−1.33;-0.18)	0.01	−0.79	(−1.38;-0.20)	0.01	−0.72	(−1.37;-0.08)	0.03
TSH (mIU/L)^c	−0.06	(−0.22;0.11)	0.50	−0.05	(−0.22;0.13)	0.59	−0.09	(−0.28;0.10)	0.36
TT4 (nmol/L)^c	−0.01	(−0.06;0.04)	0.65	−0.02	(−0.08;0.03)	0.36	−0.03	(−0.08;0.03)	0.36
TT3 (nmol/L)^c	−0.01	(−0.06;0.04)	0.64	−0.03	(−0.08;0.02)	0.25	−0.03	(−0.09;0.02)	0.21
URIC(mmol/L)	0.01	(−0.01;0.02)	0.27	0.00	(−0.01;0.02)	0.47	0.01	(−0.01;0.02)	0.50

N: total number of participants in the study population. sumPCBs: ln-transformed data with the sum of 14 polychlorinated biphenyls.

For single POP congeners, see Ref. 19.

^aLinear regression model adjusted for: age, pre-pregnancy BMI, parity, gestation week (GW), P-cotinine and alcohol intake during pregnancy.

^bLinear regression model adjusted for: age, pre-pregnancy BMI, parity, gestation week (GW), P-cotinine, alcohol intake during pregnancy and n-3/n-6 ratio.

^cln-transformed haematological marker in the statistical analysis.

*borderline significant.

β: linear regression coefficient.

CI: confidence interval.

Table 4. The association between haematological markers and serum level of sumOCPs (N = 189).

	Crude			Adjusted^a			Adjusted^b
Parameter	β	(95%CI)	p	β	(95%CI)	p	β	(95%CI)	p
Hgb (mmol/L)	0.06	(−0.06;0.18)	0.33	0.06	(−0.05;0.18)	0.28	0.06	(−0.07;0.19)	0.35
Hct (ratio)	0.00	(0.00;0.01)	0.30	0.00	(−0.01;0.01)	0.53	0.00	(−0.01;0.01)	0.43
HbA1c(mmol/mol)^c	−0.01	(−0.05;0.03)	0.58	−0.02	(−0.06;0.01)	0.21	−0.02	(−0.06;0.02)	0.24
BASO (10^9/L)^c	0.05	(−0.07;0.17)	0.41	0.05	(−0.07;0.18)	0.42	0.06	(−0.08;0.20)	0.41
EO (10^9/L)^c	−0.19	(−0.32;-0.05)	0.01	−0.14	(−0.28;-0.01)	0.04	−0.11	(−0.26;0.04)	0.17
LYMPH (10^9/L)	−0.11	(−0.20;-0.01)	0.02	−0.11	(−0.21;-0.01)	0.03	−0.10	(−0.21;0.01)	0.08*
MONO (10^9/L)^c	−0.08	(−0.18;0.02)	0.13	−0.06	(−0.16;0.04)	0.25	−0.08	(−0.18;0.03)	0.17
NEU (10^9/L)^c	−0.14	(−0.24;-0.04)	0.01	−0.13	(−0.23;-0.03)	0.01	−0.11	(−0.22;0.00)	0.05
MCH (fmol/L)	0.01	(−0.02;0.03)	0.59	0.00	(−0.02;0.03)	0.71	0.00	(−0.03;0.02)	0.86
MCHC (mmol/L)	−0.06	(−0.36;0.24)	0.71	0.03	(−0.28;0.34)	0.86	−0.03	(−0.37;0.31)	0.93
MCV (fL)	0.52	(−1.32;2.35)	0.58	−0.03	(−1.89;1.83)	0.98	−0.14	(−2.18;1.90)	0.90
MPV (fL)	0.01	(−0.19;0.22)	0.90	−0.10	(−0.31;0.11)	0.35	−0.14	(−0.37;0.09)	0.23
PDW (fL)	−0.06	(−0.50;0.37)	0.77	−0.27	(−0.71;0.18)	0.24	−0.36	(−0.85;0.12)	0.14
PCT (ratio)^c	−0.02	(−0.07;0.03)	0.45	−0.01	(−0.07;0.04)	0.58	0.01	(−0.05;0.06)	0.68
PLT (10^9/L)^c	−0.03	(−0.08;0.03)	0.39	−0.01	(−0.07;0.05)	0.73	0.01	(−0.05;0.08)	0.43
P-LCR (ratio)	0.00	(−0.01;0.02)	0.83	−0.01	(−0.02;0.01)	0.44	−0.01	(−0.03;0.01)	0.27
RBC (10^12/L)	0.02	(−0.05;0.09)	0.52	0.03	(−0.04;0.09)	0.42	0.04	(−0.03;0.12)	0.28
RDW-SD (fL)^c	0.00	(−0.04;0.03)	0.82	−0.01	(−0.04;0.02)	0.54	0.00	(−0.04;0.03)	0.90
RDW-CV (ratio)^c	−0.01	(−0.03;0.01)	0.24	−0.01	(−0.04;0.01)	0.25	0.00	(−0.03;0.02)	0.75
WBC (10^9/L)	−0.61	(−1.11;-0.11)	0.02	−0.61	(−1.12;-0.11)	0.02	−0.54	(−1.10;-0.01)	0.06*
TSH (mIU/L)^c	−0.07	(−0.21;0.08)	0.36	−0.05	(−0.20;0.10)	0.51	−0.09	(−0.25;0.07)	0.27
TT4 (nmol/L)^c	0.00	(−0.05;0.04)	0.82	−0.01	(−0.06;0.03)	0.56	−0.02	(−0.07;0.03)	0.51
TT3 (nmol/L)^c	0.00	(−0.04;0.04)	0.94	−0.02	(−0.06;0.03)	0.45	−0.02	(−0.07;0.03)	0.38
URIC(mmol/L)	0.00	(−0.01;0.01)	0.36	0.00	(−0.01;0.01)	0.44	0.00	(−0.01;0.02)	0.45

N: total number of participants in the study population. sumOCPs: ln-transformed data with the sum of 11 organochlorine pesticides.

For single POP congeners, see [19].

^aLinear regression model adjusted for: age, pre-pregnancy BMI, parity, gestation week (GW), P-cotinine and alcohol intake during pregnancy.

^bLinear regression model adjusted for: age, pre-pregnancy BMI, parity, gestation week (GW), P-cotinine, alcohol intake during pregnancy and n-3/n-6 ratio.

^cln-transformed haematological marker in the statistical analysis.

*borderline significant.

β: linear regression coefficient.

CI: confidence interval.

Table 5. The association between haematological markers and serum level of sumPFASs (N = 189).

	Crude			Adjusted^a			Adjusted^b
Parameter	β	(95%CI)	p	β	(95%CI)	p	β	(95%CI)	p
Hgb(mmol/L)	−0.02	(−0.20;0.17)	0.87	0.01	(−0.18;0.21)	0.88	−0.02	(−0.24;0.18)	0.80
Hct(ratio)	0.01	(0.00;0.03)	0.02	0.01	(0.00;0.03)	0.04	0.02	(0.00;0.03)	0.04
HbA1c(mmol/mol)^c	−0.02	(−0.07;0.04)	0.62	−0.01	(−0.06;0.05)	0.86	0.00	(−0.07;0.06)	0.97
BASO(10^9/L)^c	0.07	(−0.10;0.25)	0.41	0.05	(−0.15;0.25)	0.60	0.07	(−0.15;0.29)	0.53
EO(10^9/L)^c	−0.32	(−0.53;-0.12)	<0.01	−0.22	(−0.44; 0.01)	0.06*	−0.16	(−0.40;0.09)	0.21**
LYMPH(10^9/L)^c	−0.26	(−0.40;-0.12)	<0.01	−0.28	(−0.44;-0.13)	<0.01	−0.30	(−0.47;-0.13)	<0.01
MONO(10^9/L)^c	−0.24	(−0.40;-0.09)	<0.01	−0.27	(−0.42;-0.11)	<0.01	−0.29	(−0.46;-0.13)	<0.01
NEU(10^9/L)^c	−0.27	(−0.42;-0.12)	<0.01	−0.25	(−0.41;-0.09)	<0.01	−0.21	(−0.39;-0.04)	0.02
MCH(fmol/L)	0.01	(−0.02;0.05)	0.44	0.00	(−0.03;0.04)	0.85	−0.01	(−0.05;0.03)	0.54
MCHC(mmol/L)	−0.78	(−1.22;-0.34)	<0.01	−0.70	(−1.18;-0.23)	<0.01	−0.87	(−1.39;-0.35)	<0.01
MCV(fL)	4.74	(2.04;7.44)	<0.01	3.79	(0.89;6.68)	0.01	3.73	(0.56;6.90)	0.02
MPV(fL)	0.41	(0.10;0.72)	<0.01	0.22	(−0.11;0.56)	0.19**	0.16	(−0.21;0.52)	0.40**
PDW(fL)	0.71	(0.07;1.36)	0.03	0.36	(−0.35;1.07)	0.32**	0.25	(−0.53;1.03)	0.52**
PCT(ratio)^c	−0.14	(−0.21;-0.07)	<0.01	−0.13	(−0.21;-0.05)	<0.01	−0.10	(−0.19;-0.01)	0.03
PLT(10^9/L)^c	−0.18	(−0.26;-0.09)	<0.01	−0.15	(−0.25;-0.05)	<0.01	−0.11	(−0.21;-0.004)	0.04
P-LCR(ratio)	0.03	(0.01;0.05)	0.01	0.02	(−0.01;0.04)	0.19**	0.01	(−0.02;0.04)	0.42
RBC(10^9/L)^c	−0.04	(−0.14;0.07)	0.50	0.00	(−0.11;0.11)	0.99	0.01	(−0.11;0.13)	0.83
RDW-SD(fL)^c	0.05	(0.01;0.10)	0.03	0.04	(−0.01;0.10)	0.10**	0.06	(0.00;0.12)	0.04
RDW-CV(ratio)^c	0.00	(−0.03;0.03)	0.88	0.00	(−0.03;0.04)	0.88	0.02	(−0.02;0.06)	0.31
WBC(10^9/L)^c	−1.56	(−2.30;-0.83)	<0.01	−1.63	(−2.40;-0.86)	<0.01	−1.56	(−2.41;-0.70)	<0.01
TSH(mIU/L)^c	−0.12	(−0.39;0.16)	0.41	−0.26	(−0.56;0.04)	0.08	−0.35	(−0.67;-0.03)	0.03
TT4(nmol/L)	−0.01	(−0.08;0.06)	0.72	−0.03	(−0.11;0.05)	0.43	−0.04	(−0.12;0.05)	0.39
TT3(nmol/L)	−0.02	(−0.08;0.05)	0.65	−0.03	(−0.11;0.04)	0.41	−0.04	(−0.12;0.05)	0.39
URIC(mmol/L)	0.01	(−0.002;0.03)	0.09*	0.01	(−0.01;0.03)	0.30**	0.01	(−0.01;0.03)	0.39**

N: total number of participants in the study population. sumPFASs: ln-transformed data with the sum of 15 perfluoroalkylated substances. For single POP congeners, see Ref. 19.

^aLinear regression model adjusted for: age, pre-pregnancy BMI, parity, gestation week (GW), P-cotinine and alcohol intake during pregnancy.

^bLinear regression model adjusted for: age, pre-pregnancy BMI, parity, gestation week (GW), P-cotinine, alcohol intake during pregnancy and n-3/n-6 ratio.

^cln-transformed haematological marker in the statistical analysis.

*borderline significant.

**p-value significant in crude data material, but non-significant after adjustment.

β: linear regression coefficient.

CI: confidence interval.

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