Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Ecotoxicol Environ Saf. 2021 Sep 1;220:112400. doi: 10.1016/j.ecoenv.2021.112400. Epub 2021 Jun 8.
The associations of bisphenol A exposure during pregnancy with risk of preterm birth (PTB) and changes in gestational age have remained controversial. To conduct the meta-analysis, the relevant studies were searched through PubMed, OVID, and Web of Science from inception through June 17, 2020. Data were independently extracted and analyzed using odds ratio (OR) or regression coefficient (β) and their 95% confidence intervals (CIs). We identified 668 references and included 7 studies for preterm birth and 9 studies for gestational age. The included studies reported that the median or geometric mean (GM) of maternal urinary BPA ranged from 0.48 to 6.44 ng/ml. The meta-analysis estimated OR to be 1.36 (95% CI: 1.03, 1.69) for preterm birth associated with maternal urinary BPA exposure during pregnancy. In the subgroup analysis based on BPA exposure level, a significant association was observed between preterm birth and higher BPA exposure among the populations had BPA median or GM concentrations higher than 2.16 ng/ml (OR: 1.92; 95% CI: 1.38, 2.47). In the subgroup analyses by maternal urinary BPA exposure assessed in different trimesters, a significant association of preterm birth was only observed with BPA assessed in the third trimester (OR: 1.62; 95% CI: 1.15, 2.09). In addition, higher maternal urinary BPA exposure during pregnancy was associated with decreased gestational age by 0.50 (-0.87, -0.13) days, and the subgroup analyses also showed that only BPA exposure in the third trimester was associated with decreased gestational age by 1.36 (-2.21, -0.52) days. This meta-analysis demonstrated that higher BPA exposure was associated with an increased risk of preterm birth and decreased length of gestational age, and suggested that BPA exposure in the third trimester of pregnancy may be a critical susceptible period of preterm birth.
孕期双酚 A 暴露与早产 (PTB) 风险和孕龄变化的关系仍存在争议。为了进行荟萃分析，通过 PubMed、OVID 和 Web of Science 从建库到 2020 年 6 月 17 日搜索了相关研究。使用优势比 (OR) 或回归系数 (β) 及其 95%置信区间 (CI) 独立提取和分析数据。我们确定了 668 篇参考文献，纳入了 7 项早产研究和 9 项孕龄研究。纳入的研究报告称，母亲尿液中 BPA 的中位数或几何平均值 (GM) 范围为 0.48 至 6.44ng/ml。荟萃分析估计，与孕期母亲尿液 BPA 暴露相关的早产 OR 为 1.36(95%CI:1.03,1.69)。在基于 BPA 暴露水平的亚组分析中，在 BPA 中位数或 GM 浓度高于 2.16ng/ml 的人群中，早产与较高的 BPA 暴露之间存在显著关联(OR:1.92;95%CI:1.38,2.47)。在按不同孕期评估母亲尿液 BPA 暴露的亚组分析中，仅在第三孕期评估时发现早产与 BPA 暴露存在显著关联(OR:1.62;95%CI:1.15,2.09)。此外，孕期较高的母亲尿液 BPA 暴露与妊娠年龄减少 0.50(-0.87,-0.13)天相关，亚组分析还表明，只有在第三孕期 BPA 暴露与妊娠年龄减少 1.36(-2.21,-0.52)天相关。这项荟萃分析表明，较高的 BPA 暴露与早产风险增加和妊娠年龄减少有关，并提示妊娠晚期的 BPA 暴露可能是早产的一个关键易感期。
