Abstract
Introduction: Preterm infants admitted to the neonatal intensive care unit (NICU) are exposed to the chemical-laden hospital environment during a developmentally sensitive time period. Epidemiologic studies show an association between in utero exposure to common organic chemicals and suboptimal intrauterine growth. Animal studies show an association between exposure to organic chemicals and poor growth in infancy. Hypothesis: Environmental chemical exposure in the NICU is associated with poor growth velocity during the NICU hospitalization. Method: We conducted a pilot prospective observational study of 20 preterm infants admitted to a tertiary care NICU. Data on 61 more subjects are pending analyses. We collected serial urine specimens and compared biomarkers of 25 organic chemicals to growth parameters from birth to discharge (22-131days, median 49). We fitted a multivariable-adjusted functional mixed model with penalized splines for each chemical to identify the effect on growth during the NICU hospitalization. Result: Biomarkers of methyl-paraben and monoethyl phthalate were inversely associated with weight gain. This effect was seen even at low urinary biomarker levels (median (ng/mL) = 14.98; 11.52). As with nutritional growth restriction, height and head circumference were not impacted. Conclusion: Our findings indicate an inverse association between phthalate and paraben exposure and growth in hospitalized preterm neonates. As weight gain during infancy is an important predictor of neurodevelopmental outcome, these findings have potential implications to NICU care.
Published Version
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