Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
Sci Total Environ. 2022 Dec 10;851(Pt 2):158236. doi: 10.1016/j.scitotenv.2022.158236. Epub 2022 Aug 27.
Growing evidence indicated that maternal exposure to some endocrine disrupting chemicals (EDCs) may increase the risk of preterm birth (PTB). However, few studies have evaluated the joint effect of EDCs on PTB.
This study aimed to evaluate the associations of maternal EDCs mixture in the 1st, 2nd, and 3rd trimesters during pregnancy with PTB, and identify the vital components that mainly contribute to PTB.
This study included 847 pregnant women that provided urine samples for all three trimesters. Urinary concentrations of thirteen EDC metabolites (four phthalates, two parabens, three phenols, and four benzotriazoles and benzothiazoles) were examined. Logistic regression model, quantile g-computation and Bayesian kernel machine regression (BKMR) models were applied to study the association.
Logistic regression model suggested that only bisphenol A (BPA) in the 1st trimester significantly increased the OR of PTB after adjusting for BPA exposure in the 2nd and 3rd trimesters. Quantile g-computation model identified that urinary EDCs mixture in the 1st trimester were positively associated with PTB [OR (95 % CI): 1.98 (1.10, 3.58)], and the most heavily weighted component for PTB was BPA (26 %), followed by mono-2ethylhexyl phthalate (MEHP) (22 %). BKMR model determined a significant association between EDCs mixture in the 1st trimester and PTB when all EDC concentrations were at or above their 55th percentile compared with the median. The BKMR model found that BPA and MEHP were associated with an increase in the estimated probability of PTB, when the other EDCs were held to their 50th and 75th percentiles, respectively, in the 1st trimester.
The results of mixture analysis models indicated that exposure to higher EDCs mixture in the 1st trimester may increase the risk of PTB. BPA was considered as the most contributing factor for PTB among the detected EDCs.
越来越多的证据表明，母体接触某些内分泌干扰化学物质（EDCs）可能会增加早产（PTB）的风险。然而，很少有研究评估 EDC 对 PTB 的联合作用。
本研究旨在评估妊娠 1、2 和 3 个月期间母体 EDC 混合物与 PTB 的关系，并确定对 PTB 有主要贡献的重要成分。
本研究纳入了 847 名孕妇，她们在所有三个孕期都提供了尿液样本。检测了 13 种 EDC 代谢物（四种邻苯二甲酸酯、两种对羟基苯甲酸酯、三种酚类和四种苯并三唑和苯并噻唑）的尿浓度。应用 logistic 回归模型、分位数 g 计算和贝叶斯核机器回归（BKMR）模型来研究关联。
logistic 回归模型表明，仅在调整了 2 期和 3 期 BPA 暴露后，1 期的双酚 A（BPA）才显著增加了 PTB 的 OR。分位数 g 计算模型发现，1 期尿 EDC 混合物与 PTB 呈正相关[OR（95%CI）：1.98（1.10，3.58）]，对 PTB 贡献最大的成分是 BPA（26%），其次是单-2-乙基己基邻苯二甲酸酯（MEHP）（22%）。当所有 EDC 浓度均处于或高于中位数的第 55 百分位数时，BKMR 模型确定 1 期 EDC 混合物与 PTB 之间存在显著关联。BKMR 模型发现，当其他 EDC 分别保持在第 50 百分位和第 75 百分位时，BPA 和 MEHP 与估计的 PTB 发生概率增加有关，1 期。
混合分析模型的结果表明，在 1 期接触更高的 EDC 混合物可能会增加 PTB 的风险。在检测到的 EDC 中，BPA 被认为是导致 PTB 的最重要因素。
