School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, China; Department of Obstetrics and Gynecology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, China; Department of Reproductive Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, China.
School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, China.
Ecotoxicol Environ Saf. 2024 Oct 1;284:116868. doi: 10.1016/j.ecoenv.2024.116868. Epub 2024 Aug 14.
Many studies have indicated that individual exposure to phthalates (PAEs) or polycyclic aromatic hydrocarbons (PAHs) affects pregnancy outcomes. However, combined exposure to PAEs and PAHs presents a more realistic situation, and research on the combined effects of PAEs and PAHs on gestational age and newborn size is still limited. This study aimed to assess the effects of combined exposure to PAEs and PAHs on neonatal gestational age and birth size. Levels of 9 PAE and 10 PAH metabolites were measured from the urine samples of 1030 women during early pregnancy from the Zunyi Birth Cohort in China. Various statistical models, including linear regression, restricted cubic spline, Bayesian kernel machine regression, and quantile g-computation, were used to study the individual effects, dose-response relationships, and combined effects, respectively. The results of this prospective study revealed that each ten-fold increase in the concentration of monoethyl phthalate (MEP), 2-hydroxynaphthalene (2-OHNap), 2-hydroxyphenanthrene (2-OHPhe), and 1-hydroxypyrene (1-OHPyr) decreased gestational age by 1.033 days (95 % CI: -1.748, -0.319), 0.647 days (95 % CI: -1.076, -0.219), 0.845 days (95 % CI: -1.430, -0.260), and 0.888 days (95 % CI: -1.398, -0.378), respectively. Moreover, when the concentrations of MEP, 2-OHNap, 2-OHPhe, and 1-OHPyr exceeded 0.528, 0.039, 0.012, and 0.002 µg/g Cr, respectively, gestational age decreased in a dose-response manner. Upon analyzing the selected PAE and PAH metabolites as a mixture, we found that they were significantly negatively associated with gestational age, birth weight, and the ponderal index, with 1-OHPyr being the most important contributor. These findings highlight the adverse effects of single and combined exposure to PAEs and PAHs on gestational age. Therefore, future longitudinal cohort studies with larger sample sizes should be conducted across different geographic regions and ethnic groups to confirm the impact of combined exposure to PAEs and PAHs on birth outcomes.
许多研究表明，个体暴露于邻苯二甲酸酯（PAEs）或多环芳烃（PAHs）会影响妊娠结局。然而，PAEs 和 PAHs 的联合暴露呈现出更为现实的情况，而关于 PAEs 和 PAHs 联合暴露对胎龄和新生儿大小的影响的研究仍然有限。本研究旨在评估 PAEs 和 PAHs 联合暴露对新生儿胎龄和出生体重的影响。在中国遵义出生队列中，对 1030 名孕妇在妊娠早期的尿液样本中检测了 9 种 PAE 和 10 种 PAH 代谢物的水平。分别采用线性回归、限制立方样条、贝叶斯核机回归和分位数 g 计算等多种统计模型来分别研究个体效应、剂量-反应关系和联合效应。这项前瞻性研究的结果表明，单乙基邻苯二甲酸酯（MEP）、2-羟基萘（2-OHNap）、2-羟基菲（2-OHPhe）和 1-羟基芘（1-OHPyr）浓度每增加 10 倍，胎龄分别减少 1.033 天（95%置信区间：-1.748，-0.319）、0.647 天（95%置信区间：-1.076，-0.219）、0.845 天（95%置信区间：-1.430，-0.260）和 0.888 天（95%置信区间：-1.398，-0.378）。此外，当 MEP、2-OHNap、2-OHPhe 和 1-OHPyr 的浓度分别超过 0.528、0.039、0.012 和 0.002 µg/g Cr 时，胎龄呈剂量反应式减少。当分析作为混合物的选定的 PAE 和 PAH 代谢物时，我们发现它们与胎龄、出生体重和体重指数呈显著负相关，其中 1-OHPyr 是最重要的贡献者。这些发现强调了 PAEs 和 PAHs 单独和联合暴露对胎龄的不良影响。因此，未来应在不同地理区域和种族群体中开展具有更大样本量的纵向队列研究，以证实 PAEs 和 PAHs 联合暴露对出生结局的影响。
