Racial disparity in maternal phthalates exposure; Association with racial disparity in fetal growth and birth outcomes
Racial disparity in maternal phthalates exposure; Association with racial disparity in fetal growth and birth outcomes
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DOI：
10.1016/j.envint.2019.04.005
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发表时间：
2019-06-01
影响因子：
11.8
通讯作者：
Newman, Roger B.
中科院分区：
文献类型：
--
作者：
Bloom, Michael S.;Wenzel, Abby G.;Newman, Roger B.
实验和观察数据表明，邻苯二甲酸盐是发育毒物。然而，几乎没有数据可以评估孕妇按种族和婴儿性别接触妊娠的风险。为了解决这一数据差距，我们描述了来自美国东南部人口的非裔美国人和白人母亲的母体尿邻苯二甲酸酯代谢物与分娩结局之间的关联。我们招募了怀孕的非洲裔美国人(n=152)和白人(n=158)，她们的单胎活产在怀孕18到22周之间。我们测量了两个孕妇尿样中的邻苯二甲酸单丁酯(MBP)、邻苯二甲酸单异丁酯(MBP)、邻苯二甲酸单丁酯(MBZP)、邻苯二甲酸单(2-乙基己基)酯(MEHP)、邻苯二甲酸单乙酯(MEOHP)、邻苯二甲酸单乙酯(MEHHP)、邻苯二甲酸单乙酯(MEP)、邻苯二甲酸单甲酯(MMPs)以及DEHP(Sigma DEHP)和DBP(Sigma DBP)代谢物的总和，并评估了每自然对数单位较大浓度的邻苯二甲酸单乙酯(MEOHP)、邻苯二甲酸单乙酯(MEHHP)、邻苯二甲酸单乙酯(MEP)和DBP(Sigma DBP)代谢物的总和小于胎龄儿(SGA；早产(孕37周)和低出生体重(LBW；<；2500克)。我们还测试了母体种族和婴儿性别之间的相互作用。我们发现较低的z分数与较大的MBP(beta=-0.28；95%CI：-0.54，-0.02)和MMP值(beta=-0.30；95%CI：-0.52，-0.09)相关，而MEP与种族之间存在交互作用(p=0.04)，表明白人(beta=-0.14；95%CI：-0.28，0.001)之间存在关联，但在非裔美国人中没有关联(beta=0.05；95%CI=-0.09，0.19)。较大的MBP(OR=2.82；95%CI：1.21、6.56)和MEOHP(OR=2.80；在白人(OR=3.26，95%CI：0.64，16.56)中，MEHP越大，SGA风险越高(P=0.10)，而在非裔美国人中(OR=0.71，95%CI：0.07，7.17)，MBP(P=0.02)和Sigma DBP(P=0.02)的关联因婴儿性别而异。我们发现了肺结核的相互作用，其中非裔美国人比白人有更高的MBP(p=0.08)和MEP(p=0.02)的风险，而MEHP更高的风险(p=0.09)。男性的风险高于女性，且男性的MBP(p=0.002)、MBP(p=0.02)、MBZP(p=0.01)、MEP(p=0.002)、MMP0.09(p=0.09)和Sigma DBP(p=0.01)浓度高于女性。总体而言，我们的结果表明，孕期邻苯二甲酸盐暴露与不良的产妇分娩结局有关，而且这种影响因产妇种族和婴儿性别而异。
Experimental and observational data implicate phthalates as developmental toxicants. However, few data are available to assess the maternal risks of gestational exposure by race and infant sex. To begin to address this data gap, we characterized associations between maternal urinary phthalate metabolites and birth outcomes among African American and white mothers from a southeastern U.S. population. We enrolled pregnant African American (n = 152) and white (n = 158) women with singleton live births between 18 and 22 weeks gestation. We measured phthalate metabolites (mono-n-butyl phthalate (MBP), monoisobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), monoethyl phthalate (MEP), monomethyl phthalate (MMP), and the sums of DEHP (Sigma DEHP) and DBP (Sigma DBP) metabolites) in up to two gestational urine specimens from mothers, and evaluated confounder-adjusted associations per natural log unit greater concentration with birth weight for gestational age z-score, small for gestational age (SGA; < 10th %tile), preterm birth (PTB; < 37 weeks gestation), and low birth weight (LBW; < 2500 g). We also tested for interactions by maternal race and infant sex. We found that lower z-scores were associated with greater MiBP (beta = -0.28; 95% CI: -0.54, -0.02) and MMP (beta = -0.30; 95% CI: -0.52, -0.09) concentrations, while MEP interacted with race (p = 0.04), indicating an association among whites (beta = -0.14; 95% CI: -0.28, 0.001) but not among African Americans (beta = 0.05; 95% CI = -0.09, 0.19). Greater MiBP (OR = 2.82; 95% CI: 1.21, 6.56) and MEOHP (OR = 2.80; 95% CI: 1.05, 7.42) were associated with an overall higher SGA risk, greater MEHP was associated with higher SGA risk (p = 0.10) in whites (OR = 3.26 95% CI: 0.64, 16.56) but not in African Americans (OR = 0.71 95% CI: 0.07, 7.17), and the associations for MiBP (p = 0.02) and Sigma DBP (p = 0.02) varied by infant sex. We detected interactions for PTB in which African Americans were at higher risk than whites for greater MiBP (p = 0.08) and MEP (p = 0.02) although lower risk for greater MEHP (p = 0.09). Greater MEP was associated with an overall higher LBW risk (OR = 1.33; 95% CI: 0.95, 1.86), and males were at higher risk than females with greater MBP (p = 0.002), MiBP (p = 0.02), MBzP (p = 0.01), MEP (p = 0.002), MMP (p = 0.09), and Sigma DBP (p = 0.01) concentrations. Overall, our results suggest that gestational phthalate exposure is associated with adverse maternal birth outcomes, and that the effects vary by maternal race and infant sex.