Ryva Brad A, Wylie Blair J, Aung Max T, Schantz Susan L, Strakovsky Rita S
Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan, USA.
College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA.
Environ Health Perspect. 2025 May;133(5):57008. doi: 10.1289/EHP15547. Epub 2025 May 14.
Pregnant women are exposed to numerous endocrine-disrupting chemicals (EDCs). Pregnancy-related nausea likely has hormonal etiology and may persist beyond the first trimester.
Therefore, we aimed to determine the relationship between EDC biomarkers and pregnancy nausea characteristics.
Illinois Kids Development Study (I-KIDS) pregnant women () reported nausea symptoms monthly from conception to delivery. We categorized women as never having nausea (9%) or as having typical (ends by 17 wk gestation; 42%), persistent (ends after 17 wk gestation; 25%), or irregular (24%) nausea. Women provided five urine samples across pregnancy, which we pooled and analyzed for phthalate/replacement, phenol, and triclocarban biomarkers. Using covariate-adjusted logistic regression, we evaluated relationships of EDCs with nausea and used quantile-based g-computation (QGComp) and Bayesian kernel machine regression (BKMR) to evaluate joint associations of EDCs with nausea symptoms. We also considered differences in associations by fetal sex.
Only the sum of urinary biomarkers of di(isononyl) cyclohexane-1,2-dicarboxylate () was associated with higher risk of persistent nausea compared to typical nausea [odds ratio (OR) ; 95% CI: 1.01, 1.37] in all women. However, using QGComp, a 10% higher concentration of the EDC mixture was associated with 14% higher risk of persistent nausea [relative risk (RR) ; 95% CI: 1.01, 1.30], due to , ethylparaben, and the sum of di-2-ethylhexyl phthalate () metabolites. Similarly, using BMKR, the EDC mixture was associated with greater odds of persistent nausea in all women. In women carrying male offspring, ethylparaben was associated with persistent nausea, and a 10% higher concentration of the QGComp mixture was associated with 26% higher risk of persistent nausea (; 95% CI:1.13, 1.41), driven by ethylparaben and . Consistently, using BKMR, EDCs were positively associated with persistent nausea in women carrying males. We did not identify associations between EDC biomarkers and persistent nausea in women carrying females or between EDC biomarkers and other nausea patterns.
Nonpersistent EDCs, modeled as a mixture, are associated with persistent nausea in pregnancy, primarily in women carrying males. Future work should explore possible mechanisms, clinical implications, and interventions to reduce exposures and symptoms. https://doi.org/10.1289/EHP15547.
孕妇会接触到多种内分泌干扰化学物质（EDCs）。与妊娠相关的恶心可能具有激素病因，并且可能持续至孕早期之后。
因此，我们旨在确定EDC生物标志物与妊娠恶心特征之间的关系。
伊利诺伊儿童发育研究（I-KIDS）中的孕妇从受孕到分娩每月报告恶心症状。我们将女性分为从未有过恶心（9%）或有典型恶心（在妊娠17周结束；42%）、持续性恶心（在妊娠17周后结束；25%）或不规则恶心（24%）。女性在整个孕期提供了五份尿液样本，我们将其合并并分析邻苯二甲酸盐/替代物、苯酚和三氯生生物标志物。使用协变量调整逻辑回归，我们评估了EDC与恶心的关系，并使用基于分位数的g计算（QGComp）和贝叶斯核机器回归（BKMR）来评估EDC与恶心症状的联合关联。我们还考虑了胎儿性别的关联差异。
与典型恶心相比，在所有女性中，只有二（异壬基）环己烷-1,2-二羧酸酯（DINCH）的尿液生物标志物总和与持续性恶心的较高风险相关[比值比（OR）；95%置信区间：1.01，1.37]。然而，使用QGComp，EDC混合物浓度高出10%与持续性恶心风险高出14%相关[相对风险（RR）；95%置信区间：1.01，1.30]，这是由于对羟基苯甲酸乙酯、邻苯二甲酸二（2-乙基己基）酯（DEHP）代谢物总和所致。同样，使用BKMR，EDC混合物与所有女性持续性恶心的较高几率相关。在怀有男性后代的女性中，对羟基苯甲酸乙酯与持续性恶心相关，QGComp混合物浓度高出10%与持续性恶心风险高出26%相关（；95%置信区间：1.13，1.41），由对羟基苯甲酸乙酯和DEHP驱动。一致地，使用BKMR，EDC与怀有男性胎儿的女性持续性恶心呈正相关。我们未发现EDC生物标志物与怀有女性胎儿的女性持续性恶心之间或EDC生物标志物与其他恶心模式之间的关联。
以混合物形式建模的非持久性EDC与孕期持续性恶心相关，主要是怀有男性胎儿的女性。未来的工作应探索可能的机制、临床意义以及减少暴露和症状的干预措施。https://doi.org/10.1289/EHP15547 。
