Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
Sci Total Environ. 2019 Dec 10;695:133855. doi: 10.1016/j.scitotenv.2019.133855. Epub 2019 Aug 9.
Personal care products (PCPs), known sources of endocrine disrupting chemicals (EDCs) such as phthalates and parabens, are widely used among women of reproductive age. EDCs have been linked to pregnancy complications such as gestational diabetes (GDM), and PCP use could represent a modifiable source of exposure in this sensitive time window. Yet, to our knowledge, no study has directly evaluated the association between pregnancy use of PCP and late pregnancy glucose levels, established risk factors for complications such as GDM.
A total of 233 women from the Environment and Reproductive Health (EARTH) Study had data available on 1st and/or 2nd trimester PCP use, assessed through self-reported use over the previous 24 h, and blood glucose levels after the glucose loading test (GLT), taken at late 2nd trimester. Associations between each individual PCP and total PCP with glucose levels were evaluated in multivariable adjusted linear regression models.
Both positive and negative differences in glucose levels were observed when comparing users vs. non-users of several PCPs including 2nd trimester use of deodorant (adjusted mean difference: 12.2 mg/dL, 95% CI: -0.6, 24.9); bar soap (6.9 mg/dL, 95% CI: -0.9, 14.7 mg/dL); and liquid soap (-13.3, 95% CI: -26.8, 0.1 mg/dL), and 1st trimester use of sunscreen (-14.6 mg/dL, 95% CI: -27.8, -1.5 mg/dL). Total number of PCPs used in the 2nd trimester was also associated with higher glucose levels, with the largest difference of 20 mg/dL when comparing individuals who used eight vs none PCPs (95% CI: 3-37).
In a pregnancy cohort of women seeking care at a fertility clinic, we found the use of several PCPs to be positively or negatively associated with glucose levels in the late second trimester, which may reflect increased risk of GDM and subsequent perinatal outcomes. These results strengthen the role of product use as a potentially modifiable source of EDCs that may impact glucose levels.
个人护理产品(PCP)是内分泌干扰化学物质(EDC)的已知来源,如邻苯二甲酸酯和对羟基苯甲酸酯,在育龄妇女中广泛使用。EDC 与妊娠并发症有关,如妊娠期糖尿病(GDM),而 PCP 的使用可能代表了这个敏感窗口期内可改变的暴露源。然而,据我们所知,没有研究直接评估妊娠期间使用 PCP 与晚期妊娠血糖水平之间的关系,而血糖水平是 GDM 等并发症的既定危险因素。
共有 233 名来自环境与生殖健康(EARTH)研究的女性,她们的数据可用于评估 1 期和/或 2 期 PCP 使用情况,通过自我报告的过去 24 小时内的使用情况进行评估,以及在妊娠中期进行葡萄糖负荷试验(GLT)后测量的血糖水平。在多变量调整的线性回归模型中,评估了每种 PCP 与总 PCP 与血糖水平之间的关系。
当比较几种 PCP 的使用者与非使用者时,观察到血糖水平出现正差异和负差异,包括妊娠中期使用除臭剂(调整后的平均差异:12.2mg/dL,95%CI:-0.6,24.9);肥皂(6.9mg/dL,95%CI:-0.9,14.7mg/dL);和液体肥皂(-13.3,95%CI:-26.8,0.1mg/dL),以及妊娠 1 期使用防晒霜(-14.6mg/dL,95%CI:-27.8,-1.5mg/dL)。在妊娠中期使用的 PCP 总数也与血糖水平升高有关,当比较使用 8 种与不使用任何 PCP 的个体时,差异最大为 20mg/dL(95%CI:3-37)。
在一个寻求生育诊所护理的孕妇队列中,我们发现使用几种 PCP 与妊娠中期晚期的血糖水平呈正相关或负相关,这可能反映了 GDM 和随后的围产期结局的风险增加。这些结果加强了产品使用作为潜在可改变的 EDC 来源的作用,这些 EDC 可能会影响血糖水平。