Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Durham, NC, 27709, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
Environ Health. 2021 Jun 10;20(1):68. doi: 10.1186/s12940-021-00724-z.
While fetal growth is a tightly regulated process, it is sensitive to environmental exposures that occur during pregnancy. Many commonly used consumer products contain chemicals that can disturb processes underlying fetal growth. However, mixtures of these chemicals have been minimally examined. We investigated associations between prenatal exposure to 33 consumer product chemicals (nine organophosphate ester flame retardant [OPE] metabolites, 12 phthalate metabolites, and 12 phenols) and the odds of small- or large-for-gestational age (SGA and LGA) births.
This case-control study was comprised of SGA (N = 31), LGA (N = 28), and appropriate for gestational age control (N = 31) births selected from the larger LIFECODES cohort. Biomarkers of exposure to consumer product chemicals were quantified in maternal urine collected from up to three study visits during pregnancy. In a single-pollutant approach, odds ratios (OR) and 95% confidence intervals (CI) of SGA and LGA associated with an interquartile range (IQR)-increase in exposure biomarkers were estimated using multinomial logistic regression. In a multi-pollutant approach, quantile g-computation was used to jointly estimate the OR (95% CI) of SGA and LGA per simultaneous one quartile-change in all biomarkers belonging to each chemical class.
Among the 33 biomarkers analyzed, 20 were detected in at least 50% of the participants. After adjusting for potential confounders, we observed reduced odds of LGA in association with higher urinary concentrations of several exposure biomarkers. For example, an IQR-increase in the OPE metabolite, diphenyl phosphate, was associated with lower odds of LGA (OR: 0.40 [95% CI: 0.18, 0.87]). Using quantile g-computation, we estimated lower odds of an LGA birth for higher OPE metabolite concentrations (OR: 0.49 [95% CI: 0.27, 0.89]) and phthalate metabolite concentrations (OR: 0.23 [95% CI: 0.07, 0.73]). Associations between consumer product chemicals and SGA were largely null.
Joint exposure to OPEs and phthalates was associated with lower odds of delivering LGA. Associations with LGA could indicate a specific impact of these exposures on the high end of the birth weight spectrum. Future work to understand this nuance in the associations between consumer product chemical mixtures and fetal growth is warranted.
尽管胎儿的生长过程受到严格调控，但它对外界环境变化非常敏感，而这些变化往往发生在孕期。许多常用的消费品都含有能扰乱胎儿生长相关进程的化学物质。然而，目前对于这些化学物质的混合物研究还很少。本研究旨在探讨产前暴露于 33 种消费品化学物质（9 种有机磷酸酯阻燃剂[OPE]代谢物、12 种邻苯二甲酸酯代谢物和 12 种酚类）与胎儿生长受限（SGA）或胎儿生长过度（LGA）的关联性。
这项病例对照研究由 LIFECODES 队列中选择的 SGA（n=31）、LGA（n=28）和适于胎龄的对照组（n=31）出生的婴儿组成。在妊娠期间进行最多三次研究就诊时，收集了母亲尿液，并用其定量检测暴露于消费品化学物质的生物标志物。在单污染物分析中，使用多分类逻辑回归估计了每个 IQR 增加暴露生物标志物与 SGA 和 LGA 之间的比值比（OR）及其 95%置信区间（CI）。在多污染物分析中，使用分位数计算法同时分析了每个化学类别的所有生物标志物的每一个四分位数变化的 SGA 和 LGA 的联合 OR（95%CI）。
在所分析的 33 种生物标志物中，有 20 种至少在 50%的参与者中被检测到。在调整了潜在混杂因素后，我们观察到几种暴露生物标志物浓度较高与 LGA 风险降低有关。例如，OPE 代谢物二苯膦酸的 IQR 增加与 LGA 风险降低有关（OR：0.40 [95%CI：0.18，0.87]）。使用分位数计算法，我们估计较高的 OPE 代谢物浓度（OR：0.49 [95%CI：0.27，0.89]）和邻苯二甲酸酯代谢物浓度（OR：0.23 [95%CI：0.07，0.73]）与较低的 LGA 出生风险相关。消费品化学物质与 SGA 之间的关联大多为阴性。
OPE 和邻苯二甲酸酯的联合暴露与 LGA 风险降低有关。LGA 相关关联可能表明这些暴露对出生体重谱的高端有特定影响。未来需要进一步研究以了解消费品化学混合物与胎儿生长之间关联的细微差别。
