Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000, Odense, Denmark.
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Environ Health. 2020 Mar 13;19(1):32. doi: 10.1186/s12940-020-00586-x.
Prenatal phthalate exposure has been suggested to alter immune responses and increase the risk of asthma, eczema and rhinitis. However, few studies have examined the effects in prospective cohorts and only one examined rhinitis. We therefore studied associations between maternal urinary concentrations of phthalate metabolites and asthma, eczema and rhinitis in offspring aged 5 years.
From 552 pregnant women in the Odense Child Cohort, we quantified urinary concentrations of 12 phthalate metabolites in third trimester. We assessed asthma, rhinitis and eczema in their offspring at age 5 years with a questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC), and conducted logistic regression adjusting for relevant confounders.
7.4% of the children had asthma, 11.7% eczema and 9.2% rhinitis. Phthalate exposure was low compared to previous cohorts. No significant associations between prenatal phthalate exposure and asthma were found. Odds ratios (ORs) of child rhinitis with a doubling in ΣDiNP and di-2-ethylhexyl phthalate metabolite (ΣDEHP) concentrations were, respectively, 1.15 (95% confidence interval (CI) 0.97,1.36) and 1.21 (CI 0.93,1.58). The OR of eczema when doubling ΣDiNP was 1.24 (CI 1.00,1.55), whereas the OR of using medicine against eczema when doubling a di-ethyl phthalate (DEP) metabolite was 0.81 (CI 0.68,0.96).
The lack of association between maternal phthalate exposure and asthma in the offspring may be due to low exposure and difficulties in determining asthma in 5-year-olds. The higher odds of rhinitis may raise public concern but further research in larger cohorts of older children is warranted.
已有研究提示产前邻苯二甲酸酯暴露可改变免疫应答并增加哮喘、特应性皮炎和鼻炎的发病风险。然而，仅有少数研究在前瞻性队列中探讨了该关联，且仅有一项研究针对鼻炎。因此，我们研究了孕妇孕晚期尿液中邻苯二甲酸酯代谢产物浓度与 5 岁子代哮喘、特应性皮炎和鼻炎之间的关系。
在奥登塞儿童队列中，我们从 552 名孕妇中定量检测了其孕晚期尿液中 12 种邻苯二甲酸酯代谢产物的浓度。在子代 5 岁时，我们使用基于国际儿童哮喘和过敏研究（ISAAC）的调查问卷评估了哮喘、鼻炎和特应性皮炎的患病情况，并采用 logistic 回归模型，校正了相关混杂因素。
7.4%的儿童患有哮喘，11.7%的儿童患有特应性皮炎，9.2%的儿童患有鼻炎。与以往队列相比，本次研究中的孕妇邻苯二甲酸酯暴露水平较低。未发现产前邻苯二甲酸酯暴露与哮喘之间存在显著关联。与二（2-乙基己基）邻苯二甲酸酯代谢物（ΣDEHP）浓度加倍相比，双（2-正丁氧基乙基）邻苯二甲酸酯（ΣDiNP）浓度加倍时儿童鼻炎的比值比（OR）分别为 1.15（95%置信区间（CI）为 0.97，1.36）和 1.21（CI 为 0.93，1.58）。与 ΣDiNP 浓度加倍时相比，DEHP 代谢物浓度加倍时儿童患特应性皮炎且使用药物治疗的 OR 为 0.81（95%CI 为 0.68，0.96）。
子代中母亲邻苯二甲酸酯暴露与哮喘之间缺乏关联可能是由于暴露水平较低以及 5 岁儿童哮喘诊断困难所致。鼻炎发生风险增加可能会引起公众关注，但仍需要在更大的儿童队列中开展进一步的研究。
