Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, USA.
Department of Perinatal Health, Center for Population Health Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico.
Sci Total Environ. 2024 Dec 1;954:176311. doi: 10.1016/j.scitotenv.2024.176311. Epub 2024 Sep 16.
Prenatal phthalate exposure may influence lung development and lead to wheezing and asthma in childhood, and these associations may vary by sex. Despite ubiquity of exposure, there is limited epidemiologic data on these associations in Latin America.
We assessed 593 mother-child dyads enrolled in the Programming Research in Obesity, Growth, Environment, and Social Stressors birth cohort in Mexico City. We quantified 15 phthalate metabolites in 2nd and 3rd trimester maternal urine. Report of ever wheeze, wheeze in the past 12 months (current wheeze) and ever asthma were obtained using a validated survey when children were 4 and 6 years of age. We examined individual associations with modified Poisson models. Mixture effects were assessed using Bayesian Weighted Quantile Sum (BWQS) regression. All models were adjusted for child's sex, maternal age and education at enrollment, and parity.
In Poisson models, a doubling of mono (carboxy-isononyl) phthalate (MCNP) during the 2nd trimester was associated with higher risk of wheeze (RR: 1.14, 95 % CI: 1.01, 1.29), and asthma (RR: 1.44, 95 % CI: 1.05, 1.97) at 4 years of age. Higher concentrations of the sum of di-isononyl phthalate metabolites (∑DiNP) during the 2nd trimester were also associated with asthma at 4 years of age (RR: 1.30, 95 % CI: 1.04, 1.61). Mixture associations of phthalate metabolite concentrations during the 2nd trimester and asthma at 4 years of age were stronger in males (BWQS, OR: 1.94, 95 % CI: 0.90, 4.60; 90 % CrI: 1.04, 3.73) compared to females (BWQS, OR: 1.23, 95 % CI: 0.56, 2.88; 90 % CrI: 0.61, 2.55). Additionally, we observed stronger inverse associations between prenatal phthalate mixtures during the 3rd trimester and current wheeze at 4 and 6 years of age in females (BWQS, OR: 0.54, 90 % CrI: 0.35, 0.82; OR: 0.45, 90 % CrI: 0.22, 0.84) compared to males (BWQS, OR: 0.95, 90 % Cri: 0.68, 1.35; OR: 0.97, 90 % CrI: 0.59, 1.54).
Prenatal phthalate metabolite concentrations were associated with respiratory outcomes in childhood, with some evidence of sex specific effects. Future work investigating phthalate exposure and wheeze trajectories/lung function will be important for understanding how these may predict later disease.
产前邻苯二甲酸酯暴露可能会影响肺部发育，导致儿童时期喘息和哮喘，这些关联可能因性别而异。尽管接触普遍存在，但在拉丁美洲，关于这些关联的流行病学数据有限。
我们评估了 593 对在墨西哥城编程研究肥胖、生长、环境和社会压力源出生队列中登记的母婴对子。我们在第 2 个和第 3 个孕期的母亲尿液中量化了 15 种邻苯二甲酸酯代谢物。当孩子 4 岁和 6 岁时，使用经过验证的调查评估了过去 12 个月（当前喘息）和过去喘息的报告。我们使用修正泊松模型检查了与个体相关的情况。使用贝叶斯加权分位数总和 (BWQS) 回归评估混合物效应。所有模型均根据儿童的性别、母亲在登记时的年龄和教育程度以及产次进行了调整。
在泊松模型中，第 2 个孕期的单（羧基异壬基）邻苯二甲酸酯（MCNP）浓度增加一倍与 4 岁时喘息（RR：1.14，95%CI：1.01，1.29）和哮喘（RR：1.44，95%CI：1.05，1.97）的风险增加有关。第 2 个孕期二异壬基邻苯二甲酸酯代谢物总和（∑DiNP）浓度升高也与 4 岁时哮喘有关（RR：1.30，95%CI：1.04，1.61）。第 2 个孕期邻苯二甲酸酯代谢物浓度的混合物关联与 4 岁时的哮喘在男性中更强（BWQS，OR：1.94，95%CI：0.90，4.60；90%CrI：1.04，3.73），而在女性中较弱（BWQS，OR：1.23，95%CI：0.56，2.88；90%CrI：0.61，2.55）。此外，我们还观察到，在女性中，第 3 个孕期产前邻苯二甲酸酯混合物与 4 岁和 6 岁时当前喘息之间存在更强的负相关（BWQS，OR：0.54，90%CrI：0.35，0.82；OR：0.45，90%CrI：0.22，0.84），而在男性中较弱（BWQS，OR：0.95，90%CrI：0.68，1.35；OR：0.97，90%CrI：0.59，1.54）。
产前邻苯二甲酸酯代谢物浓度与儿童期的呼吸道结局有关，有一些证据表明存在性别特异性影响。未来研究邻苯二甲酸酯暴露与喘息轨迹/肺功能的工作将有助于了解这些因素如何预测日后的疾病。
