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, 121 (1), 125-30

In Utero Exposure to Dioxins and Dioxin-Like Compounds and Anogenital Distance in Newborns and Infants


In Utero Exposure to Dioxins and Dioxin-Like Compounds and Anogenital Distance in Newborns and Infants

Marina Vafeiadi et al. Environ Health Perspect.


Background: Anogenital distance in animals is used as a measure of fetal androgen action. Prenatal exposure to dioxins and dioxin-like compounds in rodents causes reproductive changes in male offspring and decreases anogenital distance.

Objective: We assessed whether in utero exposure to dioxins and dioxin-like compounds adversely influences anogenital distance in newborns and young children (median age, 16 months; range, 1-31 months).

Methods: We measured anogenital distance among participants of the "Rhea" mother-child cohort study in Crete and the Hospital del Mar (HMAR) cohort in Barcelona. Anogenital distance (AGD; anus to upper penis), anoscrotal distance (ASD; anus to scrotum), and penis width (PW) were measured in 119 newborn and 239 young boys; anoclitoral (ACD; anus to clitoris) and anofourchetal distance (AFD; anus to fourchette) were measured in 118 newborn and 223 young girls. We estimated plasma dioxin-like activity in maternal blood samples collected at delivery with the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR CALUX®) bioassay.

Results: Anogenital distances were sexually dimorphic, being longer in males than females. Plasma dioxin-like activity was negatively associated with AGD in male newborns. The estimated change in AGD per 10 pg CALUX®-toxic equivalent/g lipid increase was -0.44 mm (95% CI: -0.80, -0.08) after adjusting for confounders. Negative but smaller and nonsignificant associations were observed for AGD in young boys. No associations were found in girls.

Conclusions: Male infants may be susceptible to endocrine-disrupting effects of dioxins. Our findings are consistent with the experimental animal evidence used by the Food and Agriculture Organization/World Health Organization to set recommendations for human dioxin intake.

Conflict of interest statement

H.B. is employed by Biodetection Systems B.V., the company that performed the DR CALUX® bioassay. The authors declare they have no actual or potential competing financial interests.


Figure 1
Figure 1
GAMS; adjusted associations (95% CIs) between dioxin-like activity and AGD in newborn (A) and young (B) boys. (A) Adjusted for birth weight, gestational age, cohort, maternal ethnicity, and maternal education. (B) Adjusted for weight and age at examination, examiner, delivery hospital, maternal education, smoking during pregnancy, and residence. ++, observations.

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