产前暴露于邻苯二甲酸盐和双酚A对不良出生结局的性别特异性影响：韩国儿童环境健康研究（Ko-CHENS）的结果
Sex-specific effects of prenatal exposure to phthalates and bisphenol A on adverse birth outcomes: Results from The Korean CHildren's ENvironmental health Study (Ko-CHENS).
作者信息
Oh Jongmin, Shah Surabhi, Lee Kyung A, Park Eunkyo, Lee Dong-Wook, Hong Yun-Chul, Song Sanghwan, Kim Sung Yeon, Park Huibyeol, Kim Hwan-Cheol, Jeong Kyoung Sook, Ha Eunhee
机构信息
Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Department of Human Systems Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
出版信息
Environ Int. 2025 May;199:109518. doi: 10.1016/j.envint.2025.109518. Epub 2025 May 6.
OBJECTIVES
Although previous epidemiological studies have reported the effects of fetal exposure to phthalates and phenols on birth outcomes, evidence is still limited. The objective of this study was to investigate whether prenatal exposure to endocrine-disrupting chemicals [EDCs; phthalates and bisphenol A (BPA)] is associated with birth outcomes and whether there are sex-specific effects.
METHODS
We used data from the Korean CHildren's ENvironmental health Study (Ko-CHENS) cohort. Exposure to phthalates and BPA was measured by urine tests, and the information on outcomes and confounders was obtained from delivery records, biomarker assessment, and a self-reported questionnaire. We performed multivariate logistic regression to estimate the association between exposure to individual phthalates and bisphenol A and birth outcomes. Additionally, to evaluate the effects of EDC mixture exposure, we performed weighted quantile sum regression analysis. Subgroup analysis stratified by maternal age and sex at birth was performed to examine potential differences in associations.
RESULTS
This study included 2,176 mother-child pairs from the Ko-CHENS. We observed a significant association between the risk of PTB and exposure to BPA during early pregnancy and mono-carboxyoctyl phthalate (MCOP) during late pregnancy, with odds ratios of 1.23 (95% CI: 1.01, 1.49) and 1.29 (95% CI: 1.03, 1.62), respectively. Additionally, there was a significant association between exposure to MCOP during early pregnancy and the risk of LBW (OR: 1.39, 95% CI: 1.03, 1.89). For male infants in particular, exposure to MCOP during early pregnancy was associated with the risk of LBW (OR: 2.44, 95% CI: 1.43, 4.15), and exposure to MCOP during late pregnancy was associated with the risk of PTB (OR 1.45, 95% CI: 1.05, 2.02).
CONCLUSIONS
This study suggests a potential association between exposure to BPA during early pregnancy and PTB, while exposure to MCOP during late pregnancy was associated with increased PTB risk in male infants.
目的
尽管先前的流行病学研究报告了胎儿暴露于邻苯二甲酸盐和酚类物质对出生结局的影响，但证据仍然有限。本研究的目的是调查产前暴露于内分泌干扰化学物质[EDCs；邻苯二甲酸盐和双酚A（BPA）]是否与出生结局相关，以及是否存在性别特异性影响。
方法
我们使用了韩国儿童环境健康研究（Ko-CHENS）队列的数据。通过尿液检测来测量邻苯二甲酸盐和双酚A的暴露情况，并从分娩记录、生物标志物评估和一份自我报告问卷中获取结局和混杂因素的信息。我们进行多变量逻辑回归以估计个体邻苯二甲酸盐和双酚A暴露与出生结局之间的关联。此外，为了评估EDC混合物暴露的影响，我们进行了加权分位数和回归分析。进行了按母亲年龄和出生时性别分层的亚组分析，以检查关联中的潜在差异。
结果
本研究纳入了来自Ko-CHENS的2176对母婴。我们观察到，孕早期暴露于双酚A以及孕晚期暴露于单羧基辛基邻苯二甲酸盐（MCOP）与早产风险之间存在显著关联，比值比分别为1.23（95%CI：1.01，1.49）和1.29（95%CI：1.03，1.62）。此外，孕早期暴露于MCOP与低出生体重风险之间存在显著关联（OR：1.39，95%CI：1.03，1.89）。特别是对于男婴，孕早期暴露于MCOP与低出生体重风险相关（OR：2.44，95%CI：1.43，(4.15)），孕晚期暴露于MCOP与早产风险相关（OR 1.45，95%CI：1.05，2.02）。
结论
本研究表明，孕早期暴露于双酚A与早产之间可能存在关联，而孕晚期暴露于MCOP与男婴早产风险增加有关。
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