Prenatal phthalate exposure in relation to gestational age and preterm birth in a prospective cohort study

Highlight：PAEs暴露与胎龄呈非线性关联趋势，增加早产儿和过期产儿的发生风险，提示产前PAEs暴露干扰宫内胎儿生长发育。

Abstract

This study enrolled 3266 pregnant women, to explore the relationship of prenatal phthalate exposure with the risk of preterm birth and gestational age. All participants filled questionnaires and provided with up to three urine samples during three trimesters. Seven phthalate metabolites in urines were measured. The incidences of very preterm, late preterm, early-term, late-term and postterm births were 0.58%, 3.52%, 24.22%, 10.53%, and 0.34%, respectively. Non-linear relationships were shown between phthalate metabolites and gestational age. Except for monomethyl phthalate(OR＝1.65, 95%CI＝1.17–2.34), the average concentrations of phthalate metabolites were associated with a slightly and insignificantly increased risk of overall preterm birth(＜ 37+0 gestational weeks). Through a restricted cubic spline regression, phthalate metabolites were found to be related to the risk of overall preterm birth in a linear manner(P＞0.05)or a non-linear manner(P＜0.05). All curves indicated the overall preterm birth risk rose with the increase of phthalate metabolite concentrations. Finally, compared with full-term birth(39+0to 40+6gestational weeks), phthalate metabolites were associated with the elevated risks of very preterm, late preterm and postterm births, although some relationships were not statistically significant. In conclusion, these findings suggested non-linear associations between phthalate metabolites and gestational age. Exposure to some phthalate metabolites was associated with increased risks of overall preterm birth and postterm birth.

Gao H^#, Wang Y^#, Huang K, Han Y, Zhu Y, Zhang Q, Xiang H, Qi J, Feng L, Zhu P, Hao J, Tao X, Tao F* Prenatal phthalate exposure in relation to gestational age and preterm birth in a prospective cohort study. Environ Res, 2019, 176:108530.