National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.
University of Nevada, Reno, Reno, Nevada, USA.
Environ Health Perspect. 2023 Dec;131(12):127015. doi: 10.1289/EHP12831. Epub 2023 Dec 20.
Phthalate exposures are ubiquitous during pregnancy and may contribute to racial and ethnic disparities in preterm birth.
We investigated race and ethnicity in the relationship between biomarkers of phthalate exposure and preterm birth by examining: ) how hypothetical reductions in racial and ethnic disparities in phthalate metabolites might reduce the probability of preterm birth; and ) exposure-response models stratified by race and ethnicity.
We pooled individual-level data on 6,045 pregnancies from 16 U.S. cohorts. We investigated covariate-adjusted differences in nine urinary phthalate metabolite concentrations by race and ethnicity [non-Hispanic White (White, 43%), non-Hispanic Black (Black, 13%), Hispanic/Latina (38%), and Asian/Pacific Islander (3%)]. Using g-computation, we estimated changes in the probability of preterm birth under hypothetical interventions to eliminate disparities in levels of urinary phthalate metabolites by proportionally lowering average concentrations in Black and Hispanic/Latina participants to be approximately equal to the averages in White participants. We also used race and ethnicity-stratified logistic regression to characterize associations between phthalate metabolites and preterm birth.
In comparison with concentrations among White participants, adjusted mean phthalate metabolite concentrations were consistently higher among Black and Hispanic/Latina participants by 23%-148% and 4%-94%, respectively. Asian/Pacific Islander participants had metabolite levels that were similar to those of White participants. Hypothetical interventions to reduce disparities in metabolite mixtures were associated with lower probabilities of preterm birth for Black [13% relative reduction; 95% confidence interval (CI): , 8.6%] and Hispanic/Latina (9% relative reduction; 95% CI: , 0.8%) participants. Odds ratios for preterm birth in association with phthalate metabolites demonstrated heterogeneity by race and ethnicity for two individual metabolites (mono--butyl and monoisobutyl phthalate), with positive associations that were larger in magnitude observed among Black or Hispanic/Latina participants.
Phthalate metabolite concentrations differed substantially by race and ethnicity. Our results show hypothetical interventions to reduce population-level racial and ethnic disparities in biomarkers of phthalate exposure could potentially reduce the probability of preterm birth. https://doi.org/10.1289/EHP12831.
孕期邻苯二甲酸酯暴露普遍存在，可能导致早产的种族和民族差异。
通过检查以下两个方面，我们研究了邻苯二甲酸酯暴露生物标志物与早产之间的种族和民族关系：）假设减少邻苯二甲酸酯代谢物的种族和民族差异可能会降低早产的概率；以及）按种族和民族分层的暴露-反应模型。
我们汇总了来自 16 个美国队列的 6045 例妊娠的个体水平数据。我们按种族和民族[非西班牙裔白种人（白种人，43%）、非西班牙裔黑种人（黑种人，13%）、西班牙裔/拉丁裔（38%）和亚洲/太平洋岛民（3%）]研究了 9 种尿邻苯二甲酸酯代谢物浓度的校正后差异。使用 g 计算，我们估计了在假设干预下，通过按比例降低黑人和西班牙裔/拉丁裔参与者尿液中邻苯二甲酸代谢物浓度以使其平均值接近白种人参与者的平均值，从而消除这些参与者尿液中邻苯二甲酸代谢物水平的差异，这可能会改变早产的概率。我们还使用按种族和民族分层的逻辑回归来描述邻苯二甲酸代谢物与早产之间的关系。
与白种人参与者相比，黑种人和西班牙裔/拉丁裔参与者的调整后邻苯二甲酸代谢物浓度分别高出 23%至 148%和 4%至 94%。亚洲/太平洋岛民参与者的代谢物水平与白种人参与者相似。假设干预措施减少了混合代谢物的差异，与黑种人（相对减少 13%；95%置信区间[CI]：，8.6%）和西班牙裔/拉丁裔（相对减少 9%；95% CI：，0.8%）参与者的早产可能性降低有关。与邻苯二甲酸代谢物相关的早产比值比在种族和民族方面表现出异质性，对于两种单独的代谢物（单丁基和单异丁基邻苯二甲酸酯），观察到黑种人或西班牙裔/拉丁裔参与者的关联幅度更大。
邻苯二甲酸酯代谢物浓度在种族和民族之间存在显著差异。我们的结果表明，假设干预措施减少了邻苯二甲酸酯暴露生物标志物的人群水平的种族和民族差异，可能降低早产的概率。
