The association between maternal urinary phthalate concentrations and blood pressure in pregnancy: The HOME Study.
The association between maternal urinary phthalate concentrations and blood pressure in pregnancy: The HOME Study.
复制标题
母亲尿邻苯二甲酸盐浓度与妊娠期血压之间的关联：HOME 研究。
DOI：
10.1186/s12940-015-0062-3
复制
发表时间：
2015-09-17
期刊：
影响因子：
--
通讯作者：
Lanphear BP
中科院分区：
文献类型：
--
作者：
Werner EF;Braun JM;Yolton K;Khoury JC;Lanphear BP
邻苯二甲酸盐是一类干扰内分泌的化学物质，它的暴露无处不在。我们研究了妊娠期间尿邻苯二甲酸酯代谢物浓度与母体血压和妊娠高血压疾病风险的关系。我们使用的数据来自健康结果和环境研究的措施，这是一个在2003年3月至2006年1月招募的低风险孕妇的前瞻性出生队列。我们分析了在妊娠16周和26周采集的母体尿液样本中的9种邻苯二甲酸单酯代谢物，反映了6种邻苯二甲酸二酯的暴露。结局包括妊娠<20周和≥20周时的母体血压和妊娠高血压疾病（妊娠高血压、先兆子痫、子痫和HELLP综合征）。有369名妇女生育了无先天性异常的单胎活产婴儿。在评价的邻苯二甲酸酯代谢物中，只有邻苯二甲酸单苄酯（MBzP）浓度与妊娠<20周的母体舒张压显著相关。与第一个三分位数的妇女相比，妊娠16周时第三个三分位数的妇女在妊娠<20周时舒张压高2.2（95% CI：0.5-3.9）mm Hg，在妊娠≥20周时舒张压高2.8（95% CI：0.9-4.7）mm Hg。与第一个三分位数的女性相比，第16周时MBzP最高三分位数的女性发生妊娠高血压疾病的风险增加（RR = 2.92，95%CI 1.15-7.41，趋势p值= 0.01）。妊娠26周时的MBzP浓度与妊娠≥20周时的血压或妊娠高血压疾病的风险没有强烈的相关性。这项研究表明，母亲尿MBzP浓度可能与舒张压升高和妊娠高血压疾病的风险。
Exposure to phthalates, a class of endocrine disrupting chemicals, is ubiquitous. We examined the association of urinary phthalate metabolite concentrations during pregnancy with maternal blood pressure and risk of pregnancy-induced hypertensive diseases. We used data from the Health Outcomes and Measures of the Environment Study, a prospective birth cohort of low-risk pregnant women recruited between March 2003 and January 2006. We analyzed maternal urine samples collected at 16 and 26 weeks gestation for 9 phthalate monoester metabolites reflecting exposure to 6 phthalate diesters. Outcomes included maternal blood pressure at <20 and ≥20 weeks gestation and pregnancy induced hypertensive diseases (gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome). Data were available for 369 women who gave birth to singleton, live-born infants without congenital anomalies. Of the phthalate metabolites evaluated, only mono-benzyl phthalate (MBzP) concentrations were significantly associated with maternal diastolic blood pressure at <20 weeks gestation. Women in the third MBzP tercile at 16 weeks gestation had diastolic blood pressure 2.2 (95 % CI: 0.5–3.9) mm Hg higher at <20 weeks gestation and 2.8 (95 % CI: 0.9–4.7) mm Hg higher at ≥20 weeks gestation compared to women in the first tercile. Compared to women in the first tercile, women in the top MBzP tercile at 16 weeks had an increased risk of developing pregnancy-induced hypertensive diseases (RR = 2.92, 95 % CI 1.15–7.41, p-value for trend = 0.01). MBzP concentrations at 26 weeks gestation were not as strongly associated with blood pressure at ≥20 weeks gestation or risk of pregnancy-induced hypertensive diseases. This study suggests that maternal urinary MBzP concentrations may be associated with increased diastolic blood pressure and risk of pregnancy-induced hypertensive diseases.