Gestational exposure to organophosphate esters (OPEs) and maternal blood pressure during pregnancy: The HOME Study

Abstract

Background: After the phase-out of polybrominated diphenyl ethers, exposure to organophosphate esters (OPEs), which are potential endocrine disruptors, is ubiquitous. No study has examined the associations between gestational exposure to OPEs and blood pressure and the risk of pregnancy-induced hypertensive diseases.Methods: We used data from 333 women who had liveborn singletons without congenital abnormalities in the Health Outcomes and Measures of the Environment (HOME) Study, a prospective birth cohort. We quantified maternal urinary OPE metabolites at 16 weeks of gestation. Outcomes included the highest maternal blood pressure measurement at ≥20 weeks of gestation and pregnancy-induced hypertensive diseases (gestational hypertension, preeclampsia, and eclampsia) from medical chart review. We used linear regression and modified Poisson regression with covariate adjustment to estimate the associations of exposure with blood pressure and the risk of pregnancy-induced hypertensive diseases, respectively.Results: Diphenyl phosphate (DPHP) had the highest geometric mean urinary concentrations (1.65 µg/g creatinine), followed by bis(1,3-dichloro-2-propyl) phosphate (BDCIPP; 0.76 µg/g creatinine), bis(2-chloroethyl) phosphate (BCEP; 0.70 µg/g creatinine), and dibutyl phosphate (DBUP; 0.25 µg/g creatinine). There were 29 (8.7%) women diagnosed with pregnancy-induced hypertensive diseases. Average systolic and diastolic blood pressure, measured at an average of 31 weeks gestation (range: 20-41), were 117±13 and 72±9 mmHg, respectively. None of the urinary OPE metabolites were significantly associated with the highest maternal blood pressure at ≥20 weeks of gestation, nor were they strongly associated with an increased risk of pregnancy-induced hypertensive diseases. The relative risk (RR; 95% confidence interval) of pregnancy-induced hypertensive diseases by a 10-fold increase in exposure was 1.31 (0.66, 2.59) for DPHP, 1.36 (0.51, 3.67) for BDCIPP, 0.63 (0.16, 2.39) for BCEP and 2.13 (0.78, 5.77) for DBUP.Conclusion: This study suggests no associations between maternal urinary OPE metabolite concentrations and blood pressure or an increased risk of pregnancy-induced hypertensive diseases during pregnancy.