Nudrat Noor1, Kelly K Ferguson2, John D Meeker3, Ellen W Seely4, Russ Hauser1, Tamarra James-Todd5, Thomas F McElrath6. 1. Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. 2. Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, 27709, USA. 3. Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA. 4. Division of Endocrine, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA. 5. Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA. Electronic address: tjtodd@hsph.harvard.edu. 6. Division of Maternal Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA. Electronic address: tmcelrath@bwh.harvard.edu.
Abstract
BACKGROUND: Higher birth weight is an important adverse outcome associated with hyperglycemia in pregnancy. Recent studies suggest that phthalate exposure is associated with elevated glucose levels in pregnant women, with implications for higher birth weight in the offspring. No study to date has investigated the association between prenatal phthalate exposure on infant high birth weight accounting for the range of pregnancy glucose levels. METHODS: A total of 350 women participating in an ongoing pregnancy cohort had data available on urinary phthalate metabolite concentrations at up to four time points across pregnancy. Urinary phthalate metabolites were averaged across pregnancy and log-transformed, specific gravity-adjusted and analyzed in quartiles. Birth weight was examined continuously (in grams), as well as dichotomized as large for gestational age (>90th percentile). Glucose levels were assessed based on Results from 50-g glucose challenge tests as a part of screening for gestational diabetes conducted at 24-28 weeks gestation, and grouped into 3 categories <120 mg/dL, 120-<140 mg/dL and ≥140 mg/dL. Multivariable linear regression was performed, adjusting for potential confounders in the overall population and stratified by pregnancy glucose levels. RESULTS: Approximately 20% of infants born to women with glucose levels ≥140 mg/dL were large for gestational age. Average mono-ethyl phthalate (MEP) concentrations were higher among women who had glucose levels ≥140 mg/dL (geometric mean 140.9 μg/L; 95% CI: 91.6-216.8); however, higher MEP concentrations were not associated with higher birth weight. When stratified by maternal glucose levels, there was a suggestive association between higher concentrations of mono-(3-carboxypropyl) phthalate (MCPP) and higher birth weight among women with glucose levels ≥140 mg/dL (adj. birth weight: 569.2 g; 95% CI: 14.1, 1178.2). CONCLUSIONS: Higher urinary phthalate metabolite concentrations were not significantly associated with higher birth weight. Counter to our hypothesis, women with higher glucose levels and higher urinary phthalate metabolites did not deliver babies with higher birth weight.
BACKGROUND: Higher birth weight is an important adverse outcome associated with hyperglycemia in pregnancy. Recent studies suggest that phthalate exposure is associated with elevated glucose levels in pregnant women, with implications for higher birth weight in the offspring. No study to date has investigated the association between prenatal phthalate exposure on infant high birth weight accounting for the range of pregnancy glucose levels. METHODS: A total of 350 women participating in an ongoing pregnancy cohort had data available on urinary phthalate metabolite concentrations at up to four time points across pregnancy. Urinary phthalate metabolites were averaged across pregnancy and log-transformed, specific gravity-adjusted and analyzed in quartiles. Birth weight was examined continuously (in grams), as well as dichotomized as large for gestational age (>90th percentile). Glucose levels were assessed based on Results from 50-g glucose challenge tests as a part of screening for gestational diabetes conducted at 24-28 weeks gestation, and grouped into 3 categories <120 mg/dL, 120-<140 mg/dL and ≥140 mg/dL. Multivariable linear regression was performed, adjusting for potential confounders in the overall population and stratified by pregnancy glucose levels. RESULTS: Approximately 20% of infants born to women with glucose levels ≥140 mg/dL were large for gestational age. Average mono-ethyl phthalate (MEP) concentrations were higher among women who had glucose levels ≥140 mg/dL (geometric mean 140.9 μg/L; 95% CI: 91.6-216.8); however, higher MEP concentrations were not associated with higher birth weight. When stratified by maternal glucose levels, there was a suggestive association between higher concentrations of mono-(3-carboxypropyl) phthalate (MCPP) and higher birth weight among women with glucose levels ≥140 mg/dL (adj. birth weight: 569.2 g; 95% CI: 14.1, 1178.2). CONCLUSIONS: Higher urinary phthalate metabolite concentrations were not significantly associated with higher birth weight. Counter to our hypothesis, women with higher glucose levels and higher urinary phthalate metabolites did not deliver babies with higher birth weight.
Authors: Haotian Wu; Allan C Just; Elena Colicino; Antonia M Calafat; Emily Oken; Joseph M Braun; Nia McRae; Alejandra Cantoral; Ivan Pantic; María Luisa Pizano-Zárate; Mary Cruz Tolentino; Robert O Wright; Martha M Téllez-Rojo; Andrea A Baccarelli; Andrea L Deierlein Journal: Environ Int Date: 2021-05-06 Impact factor: 13.352
Authors: Abee L Boyles; Brandiese E Beverly; Suzanne E Fenton; Chandra L Jackson; Anne Marie Z Jukic; Vicki L Sutherland; Donna D Baird; Gwen W Collman; Darlene Dixon; Kelly K Ferguson; Janet E Hall; Elizabeth M Martin; Thaddeus T Schug; Alexandra J White; Kelly J Chandler Journal: J Womens Health (Larchmt) Date: 2020-11-18 Impact factor: 2.681