ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
Norwegian Institute of Public Health, Oslo, Norway.
Int J Hyg Environ Health. 2019 Apr;222(3):446-454. doi: 10.1016/j.ijheh.2018.12.011. Epub 2018 Dec 27.
Hypertensive disorders during pregnancy are one of the leading causes of maternal and offspring mortality and morbidity. Exposure to environmental chemicals is suspected to increase blood pressure (BP) but few studies have investigated the impact of non-persistent chemicals, in particular among pregnant women.
Women included in the study were 152 volunteer participants in the Human Early-Life Exposome (HELIX) project. They provided 3 urine samples daily over one week in two pregnancy trimesters (at around 18 and 32 weeks of gestation) to assess their exposure to phthalates (10 metabolites), phenols (7 compounds) and organophosphate pesticides (4 metabolites). BP was measured at the end of the two collection weeks. Associations between biomarkers of exposure and BP were investigated using generalized estimating equations (GEE) and linear regression, and adjusted for potential confounders.
A significant decrease in systolic and/or diastolic BP was observed with exposure to some phthalate metabolites, BPA, and parabens (e.g. β GEE models for systolic BP = -0.91 mmHg (95%CI: -1.65; -0.17) per doubling of BPA concentrations). These associations were more frequently observed in the second trimester of pregnancy and remained statistically significant after correction for multiple testing for BPA only. No associations were observed with organophosphate pesticides.
This study investigates the effect of exposure to non-persistent chemicals assessed using multiple biospecimens per subject on BP during pregnancy and suggests that higher exposure to some phthalates and phenols but not pesticides is associated with lower BP during pregnancy.
怀孕期间的高血压疾病是孕产妇和后代死亡和发病的主要原因之一。环境化学物质暴露被怀疑会导致血压升高,但很少有研究调查非持久性化学物质的影响,尤其是在孕妇中。
本研究纳入了 HELIX 项目的 152 名志愿者孕妇。她们在两个妊娠阶段(约 18 周和 32 周妊娠时)的一周内每天提供 3 份尿液样本,以评估其对邻苯二甲酸酯(10 种代谢物)、酚类(7 种化合物)和有机磷酸酯农药(4 种代谢物)的暴露情况。在两个收集周结束时测量血压。使用广义估计方程(GEE)和线性回归来研究暴露生物标志物与血压之间的关系,并对潜在的混杂因素进行调整。
与某些邻苯二甲酸酯代谢物、BPA 和对羟基苯甲酸酯(例如,BPA 的 β GEE 模型为收缩压每增加一倍,收缩压降低 0.91mmHg(95%CI:-1.65;-0.17))的暴露与收缩压和/或舒张压呈显著下降趋势。这些关联在妊娠中期更为常见,并且在仅对 BPA 进行多次测试校正后仍然具有统计学意义。与有机磷酸酯农药没有观察到关联。
本研究调查了使用每个受试者的多个生物样本评估非持久性化学物质暴露对怀孕期间血压的影响,并表明一些邻苯二甲酸酯和酚类物质的暴露水平较高与怀孕期间的血压较低有关,但与农药无关。