Maternal phthalate urine concentrations, fetal growth and adverse birth outcomes. A population-based prospective cohort study.
Maternal phthalate urine concentrations, fetal growth and adverse birth outcomes. A population-based prospective cohort study.
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DOI：
10.1016/j.envint.2021.106443
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发表时间：
2021-02
影响因子：
11.8
通讯作者：
S. Santos;Chalana M. Sol;Charissa van Zwol-Janssens;E. Philips;Alexandros G. Asimakopoulos;M. Martinez-Moral;K. Kannan;V. Jaddoe;L. Trasande
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文献类型：
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作者：
S. Santos;Chalana M. Sol;Charissa van Zwol-Janssens;E. Philips;Alexandros G. Asimakopoulos;M. Martinez-Moral;K. Kannan;V. Jaddoe;L. Trasande
重要性邻苯二甲酸酯暴露可能会影响胎儿生长，但以前的研究是不一致的，并没有探讨三个月的具体影响邻苯二甲酸酯对胎儿生长的重复措施。目的评估母亲邻苯二甲酸酯代谢物尿液浓度与胎儿生长措施和出生结果的关联，并确定潜在的暴露窗口。R世代研究（2002-2006）。数据分析从2019年11月至2020年6月进行。设置荷兰鹿特丹。孕妇1379名。暴露量母体邻苯二甲酸酯代谢物在早期、中期和晚期的尿液浓度。主要结局和测量胎儿头围，在第二和第三个三个月通过超声波测量的长度和体重以及出生时和早产时和出生时胎龄较小的尺寸。平均邻苯二甲酸、低分子量邻苯二甲酸酯（LMWP）、高分子量邻苯二甲酸酯（HMWP）和邻苯二甲酸二（2-乙基己基）酯（DEHP）浓度倾向于与整个妊娠期胎儿体重SDS较低相关。随着妊娠的进展，邻苯二甲酸和LMWP与胎儿体重的相关性变得更强（在40周时，邻苯二甲酸和LMWP每四分位数范围增加，SDS差异分别为-0.08（95%CI-0.14至-0.02）和-0.09（95%CI-0.16至-0.02））。较高浓度的特定LMWP、HMWP和DEHP代谢物也与出生时较小的头围和较低的SDS长度以及早产和出生时胎龄较小的风险增加相关（p值< 0.05）。我们观察到这些association.Conclusions和relevanceHigher母体邻苯二甲酸酯代谢物尿液浓度的暴露时间的差异似乎与胎儿生长受限和早产有关。邻苯二甲酸盐可能对胎儿生长和出生结果有三个月的特定影响。需要进一步的研究来探索潜在的机制和长期后果。
ImportanceExposure to phthalates may affect fetal growth, but previous studies are inconsistent and have not explored the trimester-specific effects of phthalates on repeated measures of fetal growth.ObjectiveTo assess the associations of maternal phthalate metabolites urine concentrations with fetal growth measures and birth outcomes and identify potential windows of vulnerability to exposure.DesignPopulation-based prospective cohort study, the Generation R Study (2002–2006). Data analysis was performed from November 2019 to June 2020.SettingRotterdam, the Netherlands.Participants1379 pregnant women.ExposuresMaternal phthalate metabolites urine concentrations in first, second and third trimester.Main outcomes and measuresFetal head circumference, length and weight measured in the second and third trimester by ultrasound and at birth and preterm birth and small size for gestational age at birth.ResultsHigher pregnancy-averaged phthalic acid, low molecular weight phthalate (LMWP), high molecular weight phthalate (HMWP) and di-2-ethylhexylphthalate (DEHP) concentrations tended to be associated with lower fetal weight SDS across gestation. The associations of phthalic acid and LMWP with fetal weight became stronger as pregnancy progressed (differences −0.08 (95% CI −0.14 to −0.02) SDS and −0.09 (95% CI −0.16 to −0.02) SDS at 40 weeks per interquartile range increase in phthalic acid and LMWP, respectively). Higher concentrations of specific LMWP, HMWP and DEHP metabolites were also associated with smaller head circumference and lower length SDS at birth and an increased risk of preterm birth and small size for gestational age at birth (p-values < 0.05). We observed differences by timing of exposure in these associations.Conclusions and relevanceHigher maternal phthalate metabolites urine concentrations seem to be related with fetal growth restriction and preterm birth. Phthalates may have trimester specific effects on fetal growth and birth outcomes. Further studies are needed to explore the underlying mechanisms and long-term consequences.