Associations of prenatal urinary phthalate exposure with preterm birth: the Maternal-Infant Research on Environmental Chemicals (MIREC) Study

Hu, Janice M.Y.; Arbuckle, Tye E.; Janssen, Patricia A.; Lanphear, Bruce P.; Braun, Joseph M.; Platt, Robert W.; Chen, Aimin; Fraser, William D.; McCandless, Lawrence C.

doi:10.17269/s41997-020-00322-5

Cited by 25 publications

(8 citation statements)

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“…As in our study, urinary metabolites of di-n-butyl phthalate, di-isobutyl phthalate, and di(2-ethylhexyl) phthalate have been associated with reduced gestational age at delivery or increased likelihood of preterm birth in several prospective US studies included here [11][12][13][14]26,31,32 as well as studies from China 16 and Mexico. 15 Although null [17][18][19][20]56 or contradictory 14,[21][22][23] associations have also been observed, associations between metabolites of these parent chemicals and preterm birth appear to be more consistent than other phthalate metabolites. Variation across studies with respect to magnitudes of association and statistical significance is expected owing to differences in (1) sample size and preterm birth prevalence, (2) metabolite distributions, (3) exposure assessment approaches, (4) gestational age at exposure assessment, and ( 5) geographic location, where some populations may have different underlying susceptibilities or patterns of exposure.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Human and animal studies suggest that prenatal phthalate exposure is associated with adverse effects on children's neurodevelopment and male reproductive tract development. 8,9 While several studies have found positive associations between prenatal biomarkers of phthalate exposure and preterm birth, [10][11][12][13][14][15][16] others have shown null [17][18][19][20] or inverse [21][22][23] associations. This may be partly due to the limited number of preterm births included, differences in exposure assessment methods, and variation in the baseline risk of preterm birth and phthalate exposure.…”

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confidence: 99%

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Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth

et al. 2022

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and the Pooled Phthalate Exposure and Preterm Birth Study Group IMPORTANCE Phthalate exposure is widespread among pregnant women and may be a risk factor for preterm birth.OBJECTIVE To investigate the prospective association between urinary biomarkers of phthalates in pregnancy and preterm birth among individuals living in the US. DESIGN, SETTING, AND PARTICIPANTSIndividual-level data were pooled from 16 preconception and pregnancy studies conducted in the US. Pregnant individuals who delivered between 1983 and 2018 and provided 1 or more urine samples during pregnancy were included.EXPOSURES Urinary phthalate metabolites were quantified as biomarkers of phthalate exposure. Concentrations of 11 phthalate metabolites were standardized for urine dilution and mean repeated measurements across pregnancy were calculated. MAIN OUTCOMES AND MEASURESLogistic regression models were used to examine the association between each phthalate metabolite with the odds of preterm birth, defined as less than 37 weeks of gestation at delivery (n = 539). Models pooled data using fixed effects and adjusted for maternal age, race and ethnicity, education, and prepregnancy body mass index. The association between the overall mixture of phthalate metabolites and preterm birth was also examined with logistic regression. G-computation, which requires certain assumptions to be considered causal, was used to estimate the association with hypothetical interventions to reduce the mixture concentrations on preterm birth. RESULTSThe final analytic sample included 6045 participants (mean [SD] age, 29.1 [6.1] years). Overall, 802 individuals (13.3%) were Black, 2323 (38.4%) were Hispanic/Latina, 2576 (42.6%) were White, and 328 (5.4%) had other race and ethnicity (including American Indian/Alaskan Native, Native Hawaiian, >1 racial identity, or reported as other). Most phthalate metabolites were detected in more than 96% of participants. Higher odds of preterm birth, ranging from 12% to 16%, were observed in association with an interquartile range increase in urinary concentrations of mono-N-butyl phthalate (odds ratio [OR], 1.12 [95% CI, 0.98-1.27]), mono-isobutyl phthalate (OR, 1.16 [95% CI, 1.00-1.34]), mono(2-ethyl-5-carboxypentyl) phthalate (OR, 1.16 [95% CI, 1.00-1.34]), and mono(3-carboxypropyl) phthalate (OR, 1.14 [95% CI, 1.01-1.29]). Among approximately 90 preterm births per 1000 live births in this study population, hypothetical interventions to reduce the mixture of phthalate metabolite levels by 10%, 30%, and 50% were estimated to prevent 1.8 (95% CI, 0.5-3.1), 5.9 (95% CI, 1.7-9.9), and 11.1 (95% CI, 3.6-18.3) preterm births, respectively. CONCLUSIONS AND RELEVANCEResults from this large US study population suggest that phthalate exposure during pregnancy may be a preventable risk factor for preterm delivery.

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Section: Discussionmentioning

confidence: 99%

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Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth

et al. 2022

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“…Les auteurs indiquent le besoin de recherches additionnelles sur ces associations, particulièrement chez les femmes, en tenant compte du biais de survie. À l'autre extrémité du spectre de l'âge, Hu et collègues (Hu et al, 2020) examinent les associations entre les concentrations prénatales des métabolites urinaires des phtalates et les naissances avant terme. Leurs analyses ont été effectuées à l'aide des données de près de 2 000 participantes de l'Étude mère-enfant sur les composés chimiques de l'environnement (MIREC), dont les concentrations de métabolites urinaires des phtalates ont été mesurées au cours du premier trimestre de grossesse.…”

Section: éDitorialunclassified

“…On the other side of the age spectrum, Hu et al (2020) examine associations between prenatal urinary phthalate metabolite concentrations and preterm birth. These analyses were done using data collected from nearly 2000 women enrolled in the MIREC study whose urinary concentrations of phthalate metabolites were measured during their first trimester.…”

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Always better together: the Canadian Journal of Public Health and the Canadian Society for Epidemiology and Biostatistics

Villeneuve

Paradis

Muhajarine

2020

Can J Public Health

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“…According to biomonitoring reports, human exposure to phthalates is ubiquitous for children and adults [3,4], including pregnant women and their fetuses due to transplacental passage of phthalates [5]. Prenatal and early-life exposure to phthalates has been related to adverse pregnancy events [6][7][8][9][10][11] and childhood developmental and cardiometabolic outcomes [12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Maternal Urinary Phthalate Metabolites are Associated with Lipidomic Signatures Among Pregnant Women in Puerto Rico

Ashrap

Aung

Watkins

et al. 2021

Preprint

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Background: Phthalates have been reported to alter circulating lipid concentrations in animals, and investigation of these associations in humans will provide greater understanding of potential mechanisms for health outcomes. Objective: to explore associations between phthalate metabolite biomarkers and lipidomic profiles among pregnant women (n = 99) in the Puerto Rico PROTECT cohort. Methods: We measured 19 urinary phthalate metabolites during 24-28 weeks of pregnancy. Lipidomic profiles were identified from plasma samples by liquid chromatography-mass spectrometry-based shotgun lipidomics. Relationships between phthalates and lipid profiles were estimated using compound-by-compound comparisons in multiple linear regression and dimension reduction techniques. We derived sums for each lipid class and sub-class (saturated, monounsaturated, polyunsaturated) which were then regressed on phthalates. Associations were adjusted for false discovery. Results: After controlling for multiple comparisons, 33 phthalate-lipid associations were identified (q-value<0.05), and diacylglycerol 40:7 and plasmenyl-phosphatidylcholine 35:1 were the most strongly associated with multiple phthalate metabolites. Metabolites of di-2-ethylhexyl phthalate, bis(2-ethylhexyl) phthalate, dibutyl phthalates, and diisobutyl phthalate were associated with increased ceramides, lysophosphatidylcholines, lysophosphatidylethanolamines, and triacylglycerols, particularly those containing saturated and monounsaturated fatty acid chains. Significance: Characterization of associations between lipidomic markers and phthalates during pregnancy will yield mechanistic insight for maternal and child health outcomes.

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Associations of prenatal urinary phthalate exposure with preterm birth: the Maternal-Infant Research on Environmental Chemicals (MIREC) Study

Cited by 25 publications

References 34 publications

Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth

Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth

Always better together: the Canadian Journal of Public Health and the Canadian Society for Epidemiology and Biostatistics

Maternal Urinary Phthalate Metabolites are Associated with Lipidomic Signatures Among Pregnant Women in Puerto Rico

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