Effects of Gestational Exposures to Chemical Mixtures on Birth Weight Using Bayesian Factor Analysis in the Health Outcome and Measures of Environment (HOME) Study

Background: Studying the effects of gestational exposures to chemical mixtures on infant birth weight is inconclusive due to several challenges. One of the challenges is which statistical methods to rely on. Bayesian factor analysis (BFA), which has not been utilized for chemical mixtures, has advantages in variance reduction and model interpretation.Methods: We analyzed data from a cohort of 384 pregnant women and their newborns using urinary biomarkers of phthalates, phenols, and organophosphate pesticides (OPs) and serum biomarkers of polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), perfluoroalkyl substances (PFAS), and organochlorine pesticides (OCPs). We examined the association between exposure to chemical mixtures and birth weight using BFA and compared with multiple linear regression (MLR) and Bayesian kernel regression models (BKMR).Results: For BFA, a 10-fold increase in the concentrations of PCB and PFAS mixtures was associated with an 81 g (95% confidence intervals [CI] = −132 to −31 g) and 57 g (95% CI = −105 to −10 g) reduction in birth weight, respectively. BKMR results confirmed the direction of effect. However, the 95% credible intervals all contained the null. For single-pollutant MLR, a 10-fold increases in the concentrations of multiple chemicals were associated with reduced birth weight, yet the 95% CI all contained the null. Variance inflation from MLR was apparent for models that adjusted for copollutants, resulting in less precise confidence intervals.Conclusion: We demonstrated the merits of BFA on mixture analysis in terms of precision and interpretation compared with MLR and BKMR. We also identified the association between exposure to PCBs and PFAS and lower birth weight.