Racial Disparities Associated with Maternal Exposure to Environmental Endocrine Disrupting Compounds in a Southeastern U.S. Community

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PROJECT SUMMARY Aims: We propose a prospective cohort study to examine fetal developmental effects from gestational exposure to endocrine disrupting environmental phenols (EPs) and phthalates (PHTs) in African American (AA) and white mothers in a southeastern U.S. obstetrical population. The focus will be on how associations of EPs with fetal developmental outcomes vary by race. We will also explore how co-exposure to both EPs and PHTs influence these associations. Significance: The proposed study will fundamentally advance our understanding of racial disparities in exposure to EPs and how these differences may contribute to reproductive health disparities between AAs and whites. We will also explore the joint effects of gestational co-exposure to a complex mixture of EPs and PHTs on fetal development. This study directly addresses significant gaps in our understanding the impact of highly prevalent EPs and PHTs on fetal development among AAs and lays the foundation for a more definitive future study of the effect of mixed endocrine disrupting exposures on reproductive health disparities. Innovation: The proposed study will be the 1st to leverage a cohort of AA and white mothers and their newborns, to directly assess health disparities in gestational exposure to a mixture of EPs and PHTs with fetal developmental outcomes. It will be one of few studies to assess the impact of mixed gestational exposure to EPs and PHTs and the 1st to capture these data in the southeastern U.S., where disparities in rates of prematurity and low birth weight between AAs and whites is the highest in the U.S. Preliminary Study: This proposal builds upon a prospective cohort study of 8 prevalent urinary PHTs that we previously measured and fetal development among AA and white mothers in Charleston, South Carolina. The results provide strong support for the approach outlined, especially in regard to differential effects by race. Approach: AA (n=152) and white (n=158) mother-infant pairs completed our study between 2011-2014. Participants provided urine and blood specimens during gestation and at delivery, had a detailed mid-gestation fetal ultrasound, completed a study questionnaire about exposure sources and consented to medical records access. We will measure 10 prevalent EPs in archived maternal urine and correlate the concentrations to birth outcomes, newborn anogenital distances and penis dimensions by mid-gestation ultrasound and at delivery. We will explore the impact of co-exposure to EPs and PHTs and how these results vary by race. Successful completion of our project is ensured by the experience of the team, who worked together to complete the previous project, and have the necessary expertise in obstetrics, reproductive endocrinology, analytic chemistry, epidemiology and biostatistical modeling. These data will be used to develop an R01 application to support a more comprehensive and mechanistic future study to address this important biomedical research gap regarding racially disparate developmental effects of fetal exposure to endocrine disrupting compounds.