Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
Departments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York.
Prenat Diagn. 2019 Feb;39(3):209-218. doi: 10.1002/pd.5398. Epub 2019 Feb 7.
Phthalates are used extensively in commercial and personal care products and maternal exposure is ubiquitous. Phthalates are anti-androgenic, but the potential effects of phthalates on male penile development have not been assessed in utero.
The study aims to investigate the association between early pregnancy phthalate exposure and fetal penile development, overall and by race.
Prospective cohort study of women with singleton pregnancies presenting for prenatal ultrasound between 18 and 22 weeks' gestation. Maternal urine samples were assayed for eight phthalate monoester metabolites. We used maternal phthalate levels at 18 to 22 weeks' gestation as predictors of fetal size using multiple linear regression models, adjusted for fetal gestational age, maternal age, race, smoking, and education. We incorporated a phthalate by race interaction into a second set of regression models.
We detected statistically significant race interactions for continuous phthalates with penile width. Race interactions were also suggested for penile length and volume using tertiles of phthalates with point estimates generally positive for whites and negative for African Americans.
Penile development is significantly influenced by race, and the impact of maternal phthalates on penile measurements also varies by race. Maternal phthalate exposure can adversely affect in utero penile growth and development, especially among African Americans.
邻苯二甲酸酯广泛应用于商业和个人护理产品中，且母体接触无处不在。邻苯二甲酸酯具有抗雄激素作用，但尚未评估其在子宫内对男性阴茎发育的潜在影响。
本研究旨在探讨孕妇妊娠早期邻苯二甲酸酯暴露与胎儿阴茎发育的关系，以及种族差异对该关系的影响。
这是一项前瞻性队列研究，纳入了 18 至 22 孕周行产前超声检查的单胎妊娠孕妇。采集孕妇尿液样本，检测 8 种邻苯二甲酸单酯代谢物。采用多元线性回归模型，根据胎儿胎龄、母亲年龄、种族、吸烟和教育等因素，对胎儿大小进行调整，将妊娠 18 至 22 周时的母体邻苯二甲酸酯水平作为胎儿大小的预测因子。我们在第二组回归模型中纳入了邻苯二甲酸酯与种族的交互作用。
我们发现，连续型邻苯二甲酸酯与阴茎宽度存在统计学显著的种族交互作用。邻苯二甲酸酯三分位数与阴茎长度和体积也存在种族交互作用，白人的点估计值通常为正，而非裔美国人的点估计值通常为负。
阴茎发育明显受种族影响，母体邻苯二甲酸酯对阴茎测量值的影响也因种族而异。母体邻苯二甲酸酯暴露可能会对子宫内的阴茎生长和发育产生不利影响，尤其是在非裔美国人中。
