High urinary concentrations of parabens and bisphenol A in very low birth weight infants

Kenneth Strømmen,Jan Ludvig Lyche,Sissel Jennifer Moltu,Mette H.B Müller,Elin Wahl Blakstad,Astrid Nylander Almaas,Amrit Kaur Sakhi,Cathrine Thomsen,Britt Nakstad,Arild Erlend Rønnestad,Christian A Drevon,Per Ole Iversen

doi:10.1016/j.chemosphere.2021.129570

Abstract

Very low birth weight infants (VLBW; birth weight < 1500 g) are treated with pharmaceuticals and medical equipment containing parabens and bisphenol A (BPA). Parabens are used in pharmaceuticals, whereas BPA in medical equipment where concentrations are rarely reported in hospitalised VLBW infants. We measured urinary concentrations of parabens and BPA and hypothesised high and increasing concentrations in infants born at lower gestational ages (GAs), and among infants with bronchopulmonary dysplasia (BPD) and late-onset septicaemia (LOS) due to higher exposure from pharmaceuticals and medical equipment. Urinary samples were collected during the first (n = 38) and fifth (n = 36) week of life. Methylparaben, ethylparaben, propylparaben, butylparaben, and BPA concentrations were measured using ultra high-performance liquid chromatography coupled to tandem mass spectrometry. VLBW infants had very high urinary concentrations of parabens and BPA compared to term infants and older children. The Σ paraben concentration was higher than detected in previous studies on premature infants. Lower GA at birth was associated with higher concentrations of parabens and BPA. Infants born before 28 weeks GA had higher first week concentrations of propylparaben (38.6 vs. 9.05 ng/mL, p = 0.007), butylparaben (0.28 vs. 0.09 ng/mL, p = 0.05) and fifth week concentrations of BPA (15.1 vs. 6.02 ng/mL, p = 0.02) than infants born after 28 weeks GA. Infants with LOS and BPD had higher fifth week concentrations of BPA than infants without LOS and BPD (LOS: 14.2 vs. 6.77 ng/mL, p = 0.07; BPD: 18.6 vs. 7.62 ng/mL, p = 0.05).

Highlights

Hospitalised neonates are often exposed to multiple pharmaceutical products and medical equipment containing excipients to improve product quality, stability, bioavailability, and patient acceptability
Similar urinary paraben and bisphenol A (BPA) concentrations were found in the intervention and control group of the original trial respectively, the two study groups were merged and the following results are presented without emphasizing the effect of the nutritional intervention
very low birth weight infants (VLBW) infants born before 28 weeks gestational age (GA) were more often diagnosed with late-onset septicaemia (LOS) and bronchopulmonary dysplasia (BPD), promoting increased exposure to both parabens and BPA, which in turn led to higher urinary concentrations of some parabens and BPA compared to infants born after 28 weeks GA

Summary

Introduction

Hospitalised neonates are often exposed to multiple pharmaceutical products and medical equipment containing excipients to improve product quality, stability, bioavailability, and patient acceptability. A recent exploratory study reported that neonates in the NICU were exposed to BPA via three-way stopcocks, transparent film dressings, feeding tubes, umbilical catheters and infusion extension sets, whereas light therapy protection glasses, transparent film dressings, winged infusion catheters and extension sets were main sources of paraben exposure (Iribarne-Duran et al, 2019). This is equipment commonly used in NICUs worldwide

Objectives

Methods

Results

Discussion

Conclusion