Abstract
BackgroundExposure to phthalates, a class of endocrine disrupting chemicals, is ubiquitous. We examined the association of urinary phthalate metabolite concentrations during pregnancy with maternal blood pressure and risk of pregnancy-induced hypertensive diseases.MethodsWe used data from the Health Outcomes and Measures of the Environment Study, a prospective birth cohort of low-risk pregnant women recruited between March 2003 and January 2006. We analyzed maternal urine samples collected at 16 and 26 weeks gestation for 9 phthalate monoester metabolites reflecting exposure to 6 phthalate diesters. Outcomes included maternal blood pressure at <20 and ≥20 weeks gestation and pregnancy induced hypertensive diseases (gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome).ResultsData were available for 369 women who gave birth to singleton, live-born infants without congenital anomalies. Of the phthalate metabolites evaluated, only mono-benzyl phthalate (MBzP) concentrations were significantly associated with maternal diastolic blood pressure at <20 weeks gestation. Women in the third MBzP tercile at 16 weeks gestation had diastolic blood pressure 2.2 (95 % CI: 0.5–3.9) mm Hg higher at <20 weeks gestation and 2.8 (95 % CI: 0.9–4.7) mm Hg higher at ≥20 weeks gestation compared to women in the first tercile. Compared to women in the first tercile, women in the top MBzP tercile at 16 weeks had an increased risk of developing pregnancy-induced hypertensive diseases (RR = 2.92, 95 % CI 1.15–7.41, p-value for trend = 0.01). MBzP concentrations at 26 weeks gestation were not as strongly associated with blood pressure at ≥20 weeks gestation or risk of pregnancy-induced hypertensive diseases.ConclusionThis study suggests that maternal urinary MBzP concentrations may be associated with increased diastolic blood pressure and risk of pregnancy-induced hypertensive diseases.
Highlights
Exposure to phthalates, a class of endocrine disrupting chemicals, is ubiquitous
All women had detectable levels of at least one phthalate metabolite in their urine; the frequency of detection at 16 or 26 weeks ranged from 75 % (MEHP, level of detection (LOD) 1.2 ng/mL) to 100 % (MEP, LOD 0.5 ng/mL)
Most urine phthalate metabolite concentrations at 16 weeks gestation were similar among women who remained enrolled in the study and those who dropped out prior to delivery; ΣDBP (31 vs. 27 μg/g Cr), ΣDEHP (99 vs. 89 μg/g Cr), mono-3carboxylpropyl phthalate (MCPP) (2.5 vs. 2.7 μg/g Cr), and monobenzyl phthalate (MBzP) (9.2 vs. 11.2 μg/g Cr)
Summary
A class of endocrine disrupting chemicals, is ubiquitous. We examined the association of urinary phthalate metabolite concentrations during pregnancy with maternal blood pressure and risk of pregnancy-induced hypertensive diseases. Recent studies have suggested that exposure to phthalic acid diesters (i.e., phthalates) may be associated with elevated blood pressure and increased risk of cardiovascular disease. A cross-sectional analysis of the National Health and Nutrition Examination Survey suggested that increased urinary phthalate concentrations are associated with higher blood pressure in children [1]. Women of reproductive age in the United States have almost ubiquitous exposure to phthalates [3, 4]. Phthalate diesters can be found in polyvinyl chloride plastics, personal care products (e.g., shampoo, soap, perfume), flooring, adhesives, and food processing equipment. Phthalates are metabolized into their respective monoester metabolites after
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