Home Medizin Vorgeburtliche Exposition gegenüber Phthalaten ist mit einem höheren Risiko für Frühgeburten und niedrigem Geburtsgewicht verbunden

Vorgeburtliche Exposition gegenüber Phthalaten ist mit einem höheren Risiko für Frühgeburten und niedrigem Geburtsgewicht verbunden

von NFI Redaktion

A study published in the journal The Lancet Planetary Health reveals that prenatal exposure to phthalate metabolites may increase the risk of preterm birth and low birth weight.


Studie: Pränatale Phthalatexposition und ungünstige Geburtsergebnisse in den USA: eine prospektive Analyse von Geburten und Schätzungen der zurechenbaren Belastung und Kosten. Bildquelle: Sibirische Sonne / Shutterstock










Studie: Pränatale Phthalatexposition und ungünstige Geburtsergebnisse in den USA: eine prospektive Analyse von Geburten und Schätzungen der zurechenbaren Belastung und Kosten. Bildquelle: Sibirische Sonne / Shutterstock

Hintergrund

Preterm births and low birth weight are associated with many adverse outcomes, including infant and child mortality, psychological, behavioral, and educational problems in young adulthood, as well as cardiovascular diseases in adulthood. In the United States, approximately 8% and 10% of infants experienced low birth weight and preterm birth, respectively, in the year 2020.

Many risk factors are linked to adverse birth outcomes, including maternal age, low socioeconomic status, preeclampsia, and inadequate prenatal care. Various synthetic chemicals such as phthalates are also known to increase the risk of birth complications.

Phthalate and its metabolites are used in personal care products and food packaging. These chemicals have pro-inflammatory, oxidative, and endocrine-disrupting effects. The interplay between these signaling pathways may disrupt hormonal regulation during pregnancy and lead to placental insufficiency, preeclampsia, and premature membrane rupture.

In this study, researchers investigated the effects of prenatal phthalate exposure on birth weight and gestational age at birth. They also estimated the adverse birth outcomes attributable to phthalate exposure and the associated costs.

Study Design

The researchers collected data from the National Institutes of Health’s Environmental influences on Child Health Outcomes (ECHO) program, which encompasses 69 unique pediatric cohorts from across the United States to identify environmental and preventable factors associated with low birth weight, preterm birth, and other birth complications.

The concentrations of 20 phthalate metabolites were measured in maternal urine samples. The study analyzed the associations of these metabolites with gestational age at birth, birth weight, birth length, and birth weight for gestational age Z-scores (an age-independent assessment of fetal growth).

Key Findings

The study was conducted on 5006 mother-child dyads identified from 13 cohorts in the ECHO program. The concentrations of phthalate metabolites in these mothers were similar to those found in national surveys of women of childbearing age. A similar distribution of phthalates was observed across trimesters. The metabolites of di-2-ethylhexylphthalate (DEHP) showed strong correlations with each other. Monoethylphthalate and phthalic acid exhibited the highest concentrations in maternal urine samples.

Higher concentrations of several phthalate metabolites were observed in non-Hispanic Black mothers. Conversely, Hispanic mothers showed higher concentrations of low molecular weight metabolites and lower concentrations of high molecular weight metabolites, DEHP, and phthalic acid.

An inverse association was observed between maternal age and the concentrations of all metabolites. Additionally, a positive correlation was observed between maternal age, birth weight, and length.

Influence of Phthalates on Birth Outcomes

The study’s analysis revealed strong associations of phthalic acid, diisodecylphthalate (DiDP), di-n-octylphthalate (DnOP), and diisononylphthalate (DiNP) with gestational age, birth length, and birth weight. These associations were stronger than those observed for low and high molecular weight metabolites and DEHP.

Overall, phthalate metabolites showed an association with low birth weight, with the strongest associations observed between the concentrations of phthalic acid, DiNP, DiDP, and DnOP and preterm birth and low birth weight. The magnitude of these associations was stronger in the third trimester than in the first and second trimesters.

Sensitive analysis results showed that the association between DnOP and preterm birth in female infants was stronger than in male infants. Additionally, the associations of phthalic acid, DiNP, and DnOP with many birth outcomes were stronger in non-Hispanic White mothers and mothers with a college degree.

Regarding phthalate-related adverse birth outcomes and associated costs, the study estimated 56,595 cases of preterm birth with associated costs of 3.84 billion US dollars in 2018. A sensitive analysis, taking into account DiDP exposure, found 57,017 to 79,947 attributable cases with associated costs of 3.86 to 5.42 billion US dollars. Similarly, the analysis for DiNP exposure found 76,838 to 120,116 attributable cases with associated costs of 5.21 to 8.14 billion US dollars.

Study Significance

The study concludes that prenatal exposure to phthalate metabolites may increase the risk of preterm birth and low birth weight. The observed pattern of associations in the study suggests that phthalate metabolites, replacing DHEP in food packaging, are responsible for the increase in preterm births. This highlights the need to regulate chemicals with similar properties as a class.

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