Prenatal exposure to persistent organic pollutants in Wuhan, China: associations with birth outcomes and breastfeeding safety

Abstract

Infants are particularly vulnerable to the adverse effects of persistent organic pollutants (POPs) due to their developing physiological systems and relatively high exposure per unit body weight. This study quantified legacy POPs in breast milk samples collected from 99 lactating mothers in Wuhan, China, and evaluated their associations with neonatal birth outcomes. The predominant organochlorine pesticides (OCPs) detected were 1,2,3,4,5,6-hexachlorocyclohexanes (HCHs) and dichlorodiphenyltrichloroethane (DDT) metabolites. Among polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs), PCB-52 and BDE-154 were the most abundant congeners. Maternal factors, including parity, body mass index, and dietary patterns, significantly influenced POP concentrations in breast milk. Our results revealed significant associations between specific POPs and birth outcomes. For instance, β-HCH was positively correlated with birth weight, whereas heptachlor exhibited a negative correlation. Additionally, PCB-170 was inversely correlated with infant head circumference, while BDE-28 and BDE-99 showed positive correlations. Our health risk assessment demonstrated that, despite elevated POP levels in a subset of samples, the estimated daily intake for most breastfed infants remained below established safety thresholds. These findings reaffirm that the established nutritional and immunological benefits of breastfeeding far outweigh the potential risks from background POP exposure. Nevertheless, the persistent and widespread detection of these contaminants underscores the need for ongoing biomonitoring and public health interventions to reduce maternal body burdens by mitigating environmental and dietary sources.

Keywords

Breast milk / breastfeeding safety / toxicants / maternal body burden / persistent organic pollutants / infant health risk assessment

References

[1] Jiang L.,Gao W.,Ma X..et al. Long-term investigation of the temporal trends and gas/particle partitioning of short- and medium-chain chlorinated paraffins in ambient air of King George Island, Antarctica Environ. Sci. Technol. 2021 55 230 9

[2] Sun H.,Li Y.,Hao Y..et al. Bioaccumulation and trophic transfer of polybrominated diphenyl ethers and their hydroxylated and methoxylated analogues in polar marine food webs Environ. Sci. Technol. 2020 54 15086 96

[3] Tang C.,Chen Z.,Huang Y..et al. Occurrence and potential harms of organochlorine pesticides (OCPs) in environment and their removal by periphyton Crit. Rev. Environ. Sci. Technol. 2023 53 1957 81

[4] Gabryszewska M.. How are polychlorinated biphenyls currently being produced, despite the production ban, and do they pose a risk to the environment? Environ. Prot. Nat. Resour. 2022 33 29 34

[5] An J.,Li S.,Zhong Y..et al. The cytotoxic effects of synthetic 6-hydroxylated and 6-methoxylated polybrominated diphenyl ether 47 (BDE47) Environ. Toxicol. 2011 26 591 9

[6] Domingo J. L.,Souza M. C. O.,Nadal M.,Barbosa F.. A One Health approach to polybrominated diphenyl ethers (PBDEs): Integrating human, animal, and environmental health perspectives Chemosphere 2025 386 144644

[7] Abafe O. A.,Harrad S.,Abdallah M. A.. Novel insights into the dermal bioaccessibility and human exposure to brominated flame retardant additives in microplastics Environ. Sci. Technol. 2023 57 10554 62 PMC10373483

[8] He X.,Wu R.,Jiang W.,Tian Y.,Zhang J.,Huang Y.. Shanghai birth cohort. prenatal exposure to per- and polyfluoroalkyl substances and childhood executive function and behavioral difficulties at age 7: evidence from the Shanghai birth cohort study Environ. Int. 2025 202 109687

[9] Holme J. A.,Myhre O.,Øvrevik J.. Adverse neurodevelopment in children associated with prenatal exposure to fine particulate matter (PM_2.5) - possible roles of polycyclic aromatic hydrocarbons (PAHs) and mechanisms involved Reprod. Toxicol. 2024 130 108718

[10] Wu D.,Li Y.,Chen L..et al. Maternal gestational weight gain and offspring’s neurodevelopmental outcomes: a systematic review and meta-analysis Neurosci. Biobehav. Rev. 2023 153 105360

[11] Xu Y.,Zhao X.,Ding Z.,Jiang S.,Yu R.. Hidden heroes in breast milk: the dual roles of phospholipids and sphingolipids in infant immunity and brain development Early Hum. Dev. 2025 211 106409

[12] Acharya N.,Gautam B.,Subbiah S.,Rogge M. M.,Anderson T. A.,Gao W.. Polycyclic aromatic hydrocarbons in breast milk of obese vs normal women: Infant exposure and risk assessment Sci. Total Environ. 2019 668 658 67

[13] Hu L.,Luo D.,Wang L..et al. Levels and profiles of persistent organic pollutants in breast milk in China and their potential health risks to breastfed infants: a review Sci. Total Environ. 2021 753 142028

[14] Serreau R.,Terbeche Y.,Rigourd V.. Pollutants in breast milk: a scoping review of the most recent data in 2024 Healthcare. 2024 12 680 PMC10970666

[15] Massart F.,Gherarducci G.,Marchi B.,Saggese G.. Chemical biomarkers of human breast milk pollution Biomark. Insights 2008 3 159 69 PMC2688366

[16] Li J.,Zhang X.,Kahil T..et al. From regional imbalances to latecomer advantage: phosphorus pollution and economic development in the Yangtze economic belt Ecological Indicators 2025 173 113423

[17] Zhu S.,Jin Y.,Deng W..et al. Determining factors and future trajectory of volatile organic compounds emissions in the Yangtze River Delta region of China Environ. Impact Assess. Rev. 2025 112 107793

[18] Luo J.,Xing X.,Wu Y.,Zhang W.,Chen R. S.. Spatio-temporal analysis on built-up land expansion and population growth in the Yangtze River Delta Region, China: from a coordination perspective Appl. Geogr. 2018 96 98 108

[19] De Klerk L.,Smit N.,Yohannes Y..et al. Persistent organic pollutants in South African coastal ecosystems: Analysing the evileye blaasop Amblyrhynchote honckenii (Bloch, 1785) for PCB and OCP accumulation Reg. Stud. Mar. Sci. 2025 89 104368

[20] Chawla M.. Chapter 7 - Environmental contamination and toxicology of benzene-hexachloride (BHC). In Hazardous chemicals; Academic Press, 2025; pp. 85-103

[21] Yin S.,Zhang J.,Guo F..et al. Supporting dataset and methods for transplacental transfer of organochlorine pesticides: concentration ratio and chiral properties Data Brief 2019 25 104278 PMC6675946

[22] Kumar A.,Dayal P.,Shukla G.,Singh G.,Joseph P. E.. DDT and HCH residue load in mother's breast milk: a survey of lactating mother’s from remote villages in Agra region Environ. Int. 2006 32 248 51

[23] European Medicines Agency, 2011. EMA guideline on bioanalytical method validation. https://www.tga.gov.au/sites/default/files/2023-08/ewp1922172009bioanalytical_method_validationcurrent.pdf (accessed 2026-03-31).

[24] Xu C.,Yin S.,Tang M.,Liu K.,Yang F.,Liu W.. Environmental exposure to DDT and its metabolites in cord serum: distribution, enantiomeric patterns, and effects on infant birth outcomes Sci. Total Environ. 2017 580 491 8

[25] WHO. Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (accessed 2026-03-30).

[26] China, NHC, Growth standard for children under 7 years of age; WS/T 423-2022; National Health Commission of the People’s Republic of China: Beijing, 2022. https://www.nhc.gov.cn/fzs/c100048/202211/5001d7cf57774770a1d49c1df46a291f/files/1733125082501_81468.pdf (accessed 2026-03-30).

[27] Zhu Y.,Liu H.,Xi Z.,Cheng H.,Xu X.. Organochlorine pesticides (DDTs and HCHs) in soils from the outskirts of Beijing, China Chemosphere 2005 60 770 8

[28] Zhang, Y., Qi, S., Xing, X., et al. Chapter 15 - Legacies of organochlorine pesticides (OCPs) in soil of China - a review, and cases in Southwest and Southeast China. In Environmental geochemistry, 2th ed.; Elsevier, 2018; pp 543-65

[29] Chen L.,Qian Y.,Jia Q..et al. A large geographic-scale characterization of organochlorine pesticides (OCPs) in surface sediments and multiple aquatic foods of inland freshwater aquaculture ponds in China: Co-occurrence, source and risk assessment Environ. Pollut. 2022 308 119716

[30] Chen C.,Yang F.,Wu Q..et al. Ocean as source or sink for legacy persistent organic pollutants J. Hazard. Mater. 2025 486 136987

[31] Hammel S. C.,Andersen H. V.,Knudsen L. E.,Frederiksen M.. Inhalation and dermal absorption as dominant pathways of PCB exposure for residents of contaminated apartment buildings Int. J. Hyg. Environ. Health 2023 247 114056

[32] Hou R.,Lin L.,Li H..et al. Occurrence, bioaccumulation, fate, and risk assessment of novel brominated flame retardants (NBFRs) in aquatic environments - a critical review Water Res. 2021 198 117168

[33] Rawn D. F.,Sadler A. R.,Casey V. A..et al. Legacy halogenated flame retardants in Canadian human milk from the maternal-infant research on environmental chemicals study J. Environ. Expo. Assess. 2024 3 16

[34] Hammel S. C.,Vorkamp K.,Nielsen J. B.,Sørensen L. S.,Knudsen L. E.,Frederiksen M.. Novel and legacy brominated flame retardants in human breast milk and house dust from Denmark J. Environ. Expo. Assess. 2024 3 8

[35] Shahmoradi B.,Maleki A.,Kohzadi S.,Khoubi J.,Zandi S.. Levels of organochlorine pesticides in human breast milk in marivan, west of iran J. Adv. Environ. Health Res. 2019 7 32 7

[36] Sanguos C. L.,Suárez O. L.,Martínez-Carballo E.,Couce M. L.. Postnatal exposure to organic pollutants in maternal milk in north-western Spain Environ. Pollut. 2023 318 120903

[37] Dimitriadou L.,Malarvannan G.,Covaci A..et al. Levels and profiles of brominated and chlorinated contaminants in human breast milk from Thessaloniki, Greece Sci. Total Environ. 2016 539 350 8

[38] Müller M. H. B.,Polder A.,Brynildsrud O. B..et al. Prenatal exposure to persistent organic pollutants in Northern Tanzania and their distribution between breast milk, maternal blood, placenta and cord blood Environ. Res. 2019 170 433 42

[39] Antignac J. P.,Main K. M.,Virtanen H. E..et al. Country-specific chemical signatures of persistent organic pollutants (POPs) in breast milk of French, Danish and Finnish women Environ. Pollut. 2016 218 728 38

[40] Herceg Romanić S.,Milićević T.,Jovanović G..et al. Persistent organic pollutants in Croatian breast milk: an overview of pollutant levels and infant health risk assessment from 1976 to the present Food Chem. Toxicol. 2023 179 113990

[41] Torres-Moreno A. C.,Mejia-Grau K.,Puente-DelaCruz L..et al. Polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) in human breast milk from Colombia: a probabilistic risk assessment approach Chemosphere 2023 339 139597

[42] Fromme H.,Fuchs V.,Albrecht M..et al. Polychlorinated dioxins and dibenzofurans (PCDD/F), polybrominated dioxins and dibenzofurans (PBDD/F), polychlorinated biphenyls (PCB), polybrominated diphenyl ethers (PBDE), and per- and polyfluoroalkyl substances (PFAS) in German breast milk samples (LUPE 8) Sci. Total Environ. 2022 825 154066

[43] Darnerud P. O.,Lignell S.,Aune M..et al. Time trends of polybrominated diphenylether (PBDE) congeners in serum of Swedish mothers and comparisons to breast milk data Environ. Res. 2015 138 352 60

[44] Bramwell L.,Fernandes A.,Rose M.,Harrad S.,Pless-Mulloli T.. PBDEs and PBBs in human serum and breast milk from cohabiting UK couples Chemosphere 2014 116 67 74

[45] Amininejad A. H.,Movassaghghazani M.. Risk assessment and daily intake of aldrin, dieldrin, and dichloro-diphenyl-trichloroethane through milk in Tehran, Iran J. Food Compos. Anal. 2025 143 107583

[46] Vijgen J.,de Borst B.,Weber R.,Stobiecki T.,Forter M.. HCH and lindane contaminated sites: European and global need for a permanent solution for a long-time neglected issue Environ. Pollut. 2019 248 696 705

[47] Chen L.,Qian Y.,Jia Q..et al. A national-scale distribution of organochlorine pesticides (OCPs) in cropland soils and major types of food crops in China: Co-occurrence and associated risks Sci. Total Environ. 2023 861 160637

[48] Avila B. S.,Mendoza D. P.,Ramírez A.,Peñuela G. A.. Occurrence and distribution of persistent organic pollutants (POPs) in the atmosphere of the Andean city of Medellin, Colombia Chemosphere 2022 307 135648

[49] Gopalan N. K.,Chenicherry S.. Fate and distribution of organochlorine insecticides (OCIs) in Palakkad soil, India Sustain. Environ. Res. 2018 28 179 85

[50] Fábelová L.,Wimmerová S.,Šovčíková E..et al. Prenatal and postnatal exposure to PCBs and neurodevelopment of preschoolers living in the PCB-contaminated region Environ. Res. 2025 282 122044

[51] Idowu I. G.,Megson D.,Tiktak G.,Dereviankin M.,Sandau C. D.. Polychlorinated biphenyl (PCB) half-lives in humans: a systematic review Chemosphere 2023 345 140359

[52] Landrigan P. J.,Sonawane B.,Mattison D.,McCally M.,Garg A.. Chemical contaminants in breast milk and their impacts on children’s health: an overview Environ. Health Perspect. 2002 110 A313 5

[53] Turner A.. PBDEs in the marine environment: sources, pathways and the role of microplastics Environ. Pollut. 2022 301 118943

[54] Ohoro C. R.,Adeniji A. O.,Okoh A. I.,Okoh O. O.. Polybrominated diphenyl ethers in the environmental systems: a review J. Environ. Health Sci. Eng. 2021 19 1229 47 PMC8172818

[55] Jones K. C.. Persistent organic pollutants (POPs) and related chemicals in the global environment: some personal reflections Environ. Sci. Technol. 2021 55 9400 12

[56] Chen F.,Yin S.,Kelly B. C.,Liu W.. Chlorinated polyfluoroalkyl ether sulfonic acids in matched maternal, cord, and placenta samples: a study of transplacental transfer Environ. Sci. Technol. 2017 51 6387 94

[57] Malik S.,Chakraborty D.,Agnihotri P.,Sharma A.,Biswas S.. Mitochondrial functioning in Rheumatoid arthritis modulated by estrogen: evidence-based insight into the sex-based influence on mitochondria and disease Mitochondrion 2024 76 101854

[58] Kuang L.,Hou Y.,Huang F..et al. Pesticide residues in breast milk and the associated risk assessment: a review focused on China Sci. Total Environ. 2020 727 138412

[59] Zheng G.,Schreder E.,Dempsey J. C..et al. Per- and polyfluoroalkyl substances (PFAS) in breast milk: concerning trends for current-use PFAS Environ. Sci. Technol. 2021 55 7510 20

[60] Anadón, A., Martínez-larrañaga, M. R., Ares, I., Martínez, M. A. Drugs and chemical contaminants in human breast milk. In Reproductive and developmental toxicology, 3th ed.; Elsevier, 2022; pp 1019-52

[61] Gascon M.,Verner M. A.,Guxens M..et al. Evaluating the neurotoxic effects of lactational exposure to persistent organic pollutants (POPs) in Spanish children Neurotoxicology 2013 34 9 15

[62] Terzaghi E.,Zanardini E.,Morosini C..et al. Rhizoremediation half-lives of PCBs: role of congener composition, organic carbon forms, bioavailability, microbial activity, plant species and soil conditions, on the prediction of fate and persistence in soil Sci. Total Environ. 2018 612 544 60

[63] Zhang X.,Zhang W.,Liu T..et al. Levels, distribution, sources and children's health risk of PBDEs in household dust from 2010 to 2022 in China Indoor Environ. 2025 2 100114

[64] Pelletier M.,Glorennec P.,Mandin C..et al. Chemical-by-chemical and cumulative risk assessment of residential indoor exposure to semivolatile organic compounds in France Environ. Int. 2018 117 22 32

[65] Kodavanti P. R.. S., Loganathan, B. G. Polychlorinated biphenyls, polybrominated biphenyls, and brominated flame retardants. In Biomarkers in toxicology; Elsevier, 2019; pp 501-18

[66] Sehgal N.,Morello-Frosch R.,Padula A. M..et al. Mixture effects of prenatal exposure to polybrominated diphenyl ethers on urinary oxidative stress biomarkers in the chemicals in our bodies cohort Am. J. Epidemiol. 2025 194 1507 14 PMC12492299

[67] Liu M.,Cheng S.,Ou D..et al. Organochlorine pesticides in surface sediments and suspended particulate matters from the Yangtze estuary, China Environ. Pollut. 2008 156 168 73

[68] Ebsa G.,Gizaw B.,Admassie M.,Degu T.,Alemu T.. The role and mechanisms of microbes in dichlorodiphenyltrichloroethane (DDT) and its residues bioremediation Biotechnol. Rep. 2024 42 e00835 PMC10972831

[69] Yu H.,Lin T.,Hu L..et al. Sources of polychlorinated biphenyls (PCBs) in sediments of the East China marginal seas: role of unintentionally-produced PCBs Environ. Pollut. 2023 338 122707

[70] Jahnke J. C.,Martinez A.,Hornbuckle K. C.. Distinguishing aroclor and non-aroclor sources to Chicago air Sci. Total Environ. 2022 823 153263 PMC9116205

[71] Zhai L.,Zhao J.,Zhu Y..et al. Downregulation of leptin receptor and kisspeptin/GPR54 in the murine hypothalamus contributes to male hypogonadism caused by high-fat diet-induced obesity Endocrine 2018 62 195 206

[72] Da C.,Wang R.,Huang Q..et al. Sediment records of polybrominated diphenyl ethers (PBDEs) from the Anhui province section of Yangtze River, China Bull. Environ. Contam. Toxicol. 2021 106 334 41

[73] Tokarz JA, 3. R. D.; Ahn, M. Y.; Leng, J.; Filley, T. R.; Nies, L. Reductive debromination of polybrominated diphenyl ethers in anaerobic sediment and a biomimetic system Environ. Sci. Technol. 2008 42 1157 64

[74] Chen J.,Wang C.,Pan Y.,Farzana S. S.,Tam N. F.. Biochar accelerates microbial reductive debromination of 2,2’,4,4’-tetrabromodiphenyl ether (BDE-47) in anaerobic mangrove sediments J. Hazard. Mater. 2018 341 177 86

[75] Wang Y.,Feng Y.,Chen Y..et al. Annual flux estimation and source apportionment of PCBs and PBDEs in the middle reach of Yangtze River, China Sci. Total Environ. 2023 885 163772

[76] Wang G.,Liu Y.,Tao W.,Zhao X.,Li X.. Reflection of concentrations of polybrominated diphenyl ethers in health risk assessment: A case study in sediments from the metropolitan river, North China Environ. Pollut. 2019 247 80 8

[77] Shim M.,Lee J. Y.,Joung S. K..et al. Simultaneous determination of 12 novel brominated flame retardants and their potential exposure via the dietary intake of processed foods in Korea Food Chem. 2025 494 142733

[78] Yuan T. H.,Tai C. J.,Tsai C. H..et al. Exploring the influence of PCB exposure on neonatal birth outcomes and neurobehavioral development after 15 years of prohibition Environ. Pollut. 2025 368 125761

[79] Wang Y.,Wang Q.,Zhou L..et al. Metabolomics insights into the prenatal exposure effects of polybrominated diphenyl ethers on neonatal birth outcomes Sci. Total Environ. 2022 836 155601

[80] Morley L. C.,Debant M.,Walker J. J.,Beech D. J.,Simpson N. A. B.. Placental blood flow sensing and regulation in fetal growth restriction Placenta 2021 113 23 8 PMC8448138

[81] Dewan P.,Jain V.,Gupta P.,Banerjee B. D.. Organochlorine pesticide residues in maternal blood, cord blood, placenta, and breastmilk and their relation to birth size Chemosphere 2013 90 1704 10

[82] Han B.,Wang L.,Wang X..et al. Association between multipollutant exposure and thyroid hormones in elderly people: a cross-sectional study in China Environ. Res. 2024 252 118781

[83] Park C. M.,Kim K. T.,Rhyu D. Y.. Low-concentration exposure to organochlorine pesticides (OCPs) in L6 myotubes and RIN-m5F pancreatic beta cells induces disorders of glucose metabolism Toxicol. In Vitro 2020 65 104767

[84] Hong S.,Kim J. Y.,Hwang J.,Shin K. S.,Kang S. J.. Heptachlor induced mitochondria-mediated cell death via impairing electron transport chain complex III Biochem. Biophys. Res. Commun. 2013 437 632 6

[85] Sheikh I. A.,Beg M. A.. Structural studies on the endocrine-disrupting role of polybrominated diphenyl ethers (PBDEs) in thyroid diseases Environ. Sci. Pollut. Res. Int. 2020 27 37866 76

[86] Chen L.,Wang C.,Cui C..et al. Prenatal exposure to polybrominated diphenyl ethers and birth outcomes Environ. Pollut. 2015 206 32 7

[87] Ison E. K.,Kent-Dennis C. E.,Fazioli J.,Mulligan M. K.,Pham A.,Pasternak J. A.. Compensatory mechanisms in response to induced hypothyroidism in the late gestation pig fetus^† Biol. Reprod. 2023 108 731 43 PMC10183360

[88] Sharma N.,Garg D.,Deb R.,Samtani R.. Toxicological profile of organochlorines aldrin and dieldrin: an Indian perspective Rev. Environ. Health 2017 32 361 72

[89] Goasdoué K.,Miller S. M.,Colditz P. B.,Björkman S. T.. Review: the blood-brain barrier; protecting the developing fetal brain Placenta 2017 54 111 6

[90] Drakvik E.,Altenburger R.,Aoki Y..et al. Statement on advancing the assessment of chemical mixtures and their risks for human health and the environment Environ. Int. 2020 134 105267 PMC6979318

[91] Deoni S.. Dean D, 3. R. D.; Joelson, S.; O'Regan, J.; Schneider, N. Early nutrition influences developmental myelination and cognition in infants and young children Neuroimage 2018 178 649 59 PMC6540800

[92] US-EPA - United States Environmental Protection Agency, 2008. Child-specific exposure factors handbook. EPA/600/R-06/096F, 2008. U.S. Environmental Protection Agency, Washington, DC. https://ordspub.epa.gov/ords/eims/eimscomm.getfile?p_download_id=484738 (accessed 2026-03-30).