Janice M Y Hu1, Tye E Arbuckle2, Patricia Janssen3, Bruce P Lanphear1, Joseph M Braun4, Robert W Platt5, Aimin Chen6, William D Fraser7, Lawrence C McCandless8. 1. Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. 2. Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Canada. 3. School of Population and Public Health, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada. 4. Department of Epidemiology, Brown University, Providence, RI, USA. 5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. 6. Department of Environmental Health, University of Cincinnati, Cincinnati, OH, 45221, USA. 7. Department d'obstétrique et gynécologie, Université de Sherbrooke, Quebec, Canada. 8. Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. lmccandl@sfu.ca.
Abstract
OBJECTIVES: To examine the relation between prenatal urinary phthalate metabolite concentrations and preterm birth (PTB). METHODS: The data were drawn from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a pan-Canadian cohort of 1857 pregnant women enrolled between 2008 and 2011. We quantified urinary concentrations of 7 phthalate metabolites that were detected in > 70% of urine samples collected during the first trimester. Gestational age was obtained from either the last menstrual period or early ultrasound. We used Cox proportional hazard models to examine the associations of urinary phthalate metabolite concentrations, plus the molar sum of di-2-ethylhexyl phthalate metabolites (∑DEHP), with time to delivery before 37 weeks of gestation. We also examined PTB by clinical presentation. PTBs presented with either spontaneous labour or premature rupture of the membrane were considered spontaneous PTB (sPTB). Additionally, we used multiple linear regression to model changes in mean gestational age in relation to phthalate exposure. RESULTS: We found no evidence of an association between first trimester phthalate metabolite concentrations and PTB among the MIREC study participants. For example, each 2-fold increase in any of the 7 phthalate concentrations or ∑DEHP was associated with hazard ratios (HRs) for PTB ranging from 0.95 to 1.07 with 95% confidence intervals including the null. An assessment of non-linear trends showed some evidence of non-monotonic dose-response relationships between phthalates and PTB. Furthermore, male infants exposed to MCPP showed higher sPTB risk compared with female infants. CONCLUSION: Phthalate exposure during early pregnancy is not clearly associated with the risk of PTB among this Canadian population.
OBJECTIVES: To examine the relation between prenatal urinary phthalate metabolite concentrations and preterm birth (PTB). METHODS: The data were drawn from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a pan-Canadian cohort of 1857 pregnant women enrolled between 2008 and 2011. We quantified urinary concentrations of 7 phthalate metabolites that were detected in > 70% of urine samples collected during the first trimester. Gestational age was obtained from either the last menstrual period or early ultrasound. We used Cox proportional hazard models to examine the associations of urinary phthalate metabolite concentrations, plus the molar sum of di-2-ethylhexyl phthalate metabolites (∑DEHP), with time to delivery before 37 weeks of gestation. We also examined PTB by clinical presentation. PTBs presented with either spontaneous labour or premature rupture of the membrane were considered spontaneous PTB (sPTB). Additionally, we used multiple linear regression to model changes in mean gestational age in relation to phthalate exposure. RESULTS: We found no evidence of an association between first trimester phthalate metabolite concentrations and PTB among the MIREC study participants. For example, each 2-fold increase in any of the 7 phthalate concentrations or ∑DEHP was associated with hazard ratios (HRs) for PTB ranging from 0.95 to 1.07 with 95% confidence intervals including the null. An assessment of non-linear trends showed some evidence of non-monotonic dose-response relationships between phthalates and PTB. Furthermore, male infants exposed to MCPP showed higher sPTB risk compared with female infants. CONCLUSION:Phthalate exposure during early pregnancy is not clearly associated with the risk of PTB among this Canadian population.
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