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Berezovsky E, Kohn E, Britzi M, Efreim S, Berlin M, Oppenheimer S, Avitsur R, Agajany N, Berkovitch M, Sheinberg R. Possible associations between prenatal exposure to environmental pollutants and neurodevelopmental outcome in children. Reprod Toxicol 2024; 128:108658. [PMID: 38972363 DOI: 10.1016/j.reprotox.2024.108658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/01/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024]
Abstract
This study aimed to evaluate associations between prenatal and childhood exposure to phthalates and prenatal exposure to polychlorinated biphenyls (PCBs) and the development of 4-year-old children. Urinary metabolites of five phthalates were measured in women upon delivery, as well as serum concentrations of four PCB congeners. Postnatal phthalate metabolites were measured from children's urine obtained at the time of developmental assessment. The primary outcome was cognitive function as evaluated by the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) administered at 4 years. Secondary outcomes were motor function and response to sensory stimuli as evaluated by the Developmental Coordination Disorder Questionnaire (DCDQ) and Short Sensory Profile (SSP) that the mothers filled out, respectively. The study included 57 mother-child pairs. Higher maternal phthalate metabolite concentrations were inversely associated with WPPSI-III scores among boys and not among girls. After using linear regression models and controlling for confounding variables, we found that higher levels of monobenzyl phthalate (MBzP) were the ones associated with lower WPPSI-III scores (p=0.004, 95 %CI [-14.18; -3.16]), lower DCDQ scores (p=0.007, 95 %CI [-6.08; -1.17] and lower SSP scores (p=0.004, 95 %CI [-7.47; -1.79]). No association was found between child urinary phthalate metabolite concentrations or maternal PCB blood concentrations and developmental function. These findings indicate that higher prenatal phthalate metabolite levels may be associated with deficits in neurologic development of young boys.
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Affiliation(s)
- Elena Berezovsky
- Pediatrics Division, Shamir (Assaf Harofeh) Medical Center, Zerifin, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Elkana Kohn
- Clinical Pharmacology and Toxicology Unit, Shamir (Assaf Harofeh) Medical Center, Zerifin, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Malka Britzi
- Kimron Veterinary Institute, National Residue Control Laboratory, Beit Dagan, Israel
| | - Solomon Efreim
- Kimron Veterinary Institute, National Residue Control Laboratory, Beit Dagan, Israel
| | - Maya Berlin
- Clinical Pharmacology and Toxicology Unit, Shamir (Assaf Harofeh) Medical Center, Zerifin, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sabrina Oppenheimer
- School of Behavioural Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Ronit Avitsur
- School of Behavioural Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Netanel Agajany
- Pediatrics Division, Shamir (Assaf Harofeh) Medical Center, Zerifin, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Matitiahu Berkovitch
- Pediatrics Division, Shamir (Assaf Harofeh) Medical Center, Zerifin, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Clinical Pharmacology and Toxicology Unit, Shamir (Assaf Harofeh) Medical Center, Zerifin, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Revital Sheinberg
- Pediatrics Division, Shamir (Assaf Harofeh) Medical Center, Zerifin, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Clinical Pharmacology and Toxicology Unit, Shamir (Assaf Harofeh) Medical Center, Zerifin, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Lu M, Gan H, Zhou Q, Han F, Wang X, Zhang F, Tong J, Huang K, Gao H, Yan S, Jin Z, Wang Q, Tao F. Trimester-specific effect of maternal co-exposure to organophosphate esters and phthalates on preschooler cognitive development: The moderating role of gestational vitamin D status. ENVIRONMENTAL RESEARCH 2024; 251:118536. [PMID: 38442813 DOI: 10.1016/j.envres.2024.118536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/12/2024] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
Organophosphate esters (OPEs) and phthalate acid esters (PAEs) are prevalent endocrine-disrupting chemicals (EDCs). Humans are often exposed to OPEs and PAEs simultaneously through multiple routes. Given that fetal stage is a critical period for neurodevelopment, it is necessary to know whether gestational co-exposure to OPEs and PAEs affects fetal neurodevelopment. However, accessible epidemiological studies are limited. The present study included 2, 120 pregnant women from the Ma'anshan Birth Cohort (MABC) study. The concentrations of tris (2-chloroethyl) phosphate (TCEP), 6 OPE metabolites and 7 PAE metabolites were measured in the first, second and third trimester using ultra-performance liquid chromatography-tandem mass spectrometry (LC-MS). Cognitive development of preschooler was assessed based on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV) of the Chinese version. Generalized estimating equations (GEEs), restricted cubic spline (RCS) and generalized additive models (GAMs) were employed to explore the associations between individual OPE exposure and preschooler cognitive development. The quantile-based g-computation (QGC) method was used to estimate the joint effect of PAEs and OPEs exposure on cognitive development. GEEs revealed significant adverse associations between diphenyl phosphate (DPHP) (β: -0.58, 95% CI: -1.14, -0.01), bis (2-butoxyethyl) phosphate(BBOEP) (β: -0.44, 95% CI: -0.85, -0.02), bis(1-chloro-2-propyl) phosphate (BCIPP) (β: -0.81, 95%CI: -1.43, -0.20) and full-scale intelligence quotient (FSIQ) in the first trimester; additionally, TCEP and bis(2-ethylhexyl) phosphate (BEHP) in the second trimester, as well as DPHP in the third trimester, were negatively associated with cognitive development. Through the QGC analyses, mixture exposure in the first trimester was negatively associated with FSIQ scores (β: -1.70, 95% CI: -3.06, -0.34), mono-butyl phthalate (MBP), BCIPP, and DPHP might be the dominant contributors after controlling for other OPEs and PAEs congeners. Additionally, the effect of OPEs and PAEs mixture on cognitive development might be driven by vitamin D deficiency.
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Affiliation(s)
- Mengjuan Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hong Gan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qiong Zhou
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Feifei Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiaorui Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fu Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Juan Tong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hui Gao
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Healthcare (MCH) Center, Ma'anshan, 243011, China
| | - Zhongxiu Jin
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qunan Wang
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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Qiao JC, Li ZH, Ma YB, Ma HY, Zhang MY, Zhang XJ, Hu CY. Associations of per- and polyfluoroalkyl substances (PFAS) and their mixture with risk of rheumatoid arthritis in the U.S. adult population. Environ Health 2024; 23:38. [PMID: 38609943 PMCID: PMC11015572 DOI: 10.1186/s12940-024-01073-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are known environmental contaminants with immunosuppressive properties. Their connection to rheumatoid arthritis (RA), a condition influenced by the immune system, is not well studied. This research explores the association between PFAS exposure and RA prevalence. METHODS This research utilized data from the NHANES, encompassing a sample of 10,496 adults from the 2003-2018 cycles, focusing on serum levels of several PFAS. The presence of RA was determined based on self-reports. This study used multivariable logistic regression to assess the relationship between individual PFAS and RA risk, adjusting for covariates to calculate odds ratios (ORs). The combined effects of PFAS mixtures were evaluated using BKMR, WQS regression, and quantile g-computation. Additionally, sex-specific associations were explored through stratified analysis. RESULTS Higher serum PFOA (OR = 0.88, 95% CI: 0.79, 0.98), PFHxS (OR = 0.91, 95% CI: 0.83, 1.00), PFNA (OR = 0.87, 95% CI: 0.77, 0.98), and PFDA (OR = 0.89, 95% CI: 0.81, 0.99) concentration was related to lower odds of RA. Sex-specific analysis in single chemical models indicated the significant inverse associations were only evident in females. BKMR did not show an obvious pattern of RA estimates across PFAS mixture. The outcomes of sex-stratified quantile g-computation demonstrated that an increase in PFAS mixture was associated with a decreased odds of RA in females (OR: 0.76, 95% CI: 0.62, 0.92). We identified a significant interaction term of the WQS*sex in the 100 repeated hold out WQS analysis. Notably, a higher concentration of the PFAS mixture was significantly associated with reduced odds of RA in females (mean OR = 0.93, 95% CI: 0.88, 0.98). CONCLUSIONS This study indicates potential sex-specific associations of exposure to various individual PFAS and their mixtures with RA. Notably, the observed inverse relationships were statistically significant in females but not in males. These findings contribute to the growing body of evidence indicating that PFAS may have immunosuppressive effects.
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Affiliation(s)
- Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhen-Hua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yu-Bo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Hui-Ya Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Management & Checkup Center, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230022, China
| | - Meng-Yue Zhang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei, 230032, China.
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei, 230032, China.
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
- Department of Humanistic Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Wu Y, Yang H, Jin W, Wu Y, Yu Y, Chen Q, He B, Yan F, Li Y, Chen F. Association between polycyclic aromatic hydrocarbons and periodontitis: Results from a large population-based study. J Clin Periodontol 2024; 51:441-451. [PMID: 38158854 DOI: 10.1111/jcpe.13919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
AIM To explore the association between polycyclic aromatic hydrocarbons (PAHs) (measured using urinary metabolites) and periodontitis using data from the National Health and Nutrition Examination Survey 2009-2014. MATERIALS AND METHODS Weighted binary logistic regression, Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) regression were used to evaluate independent and joint associations between the six urinary monohydroxylated metabolites of PAHs (OH-PAHs) and periodontitis. RESULTS In all, 3413 participants were included in this study. All six urinary OH-PAHs were present at higher levels in the periodontitis group compared with the non-periodontitis group (p < .001). Fully adjusted multivariable logistic regressions showed positive associations between the six urinary OH-PAHs and periodontitis (p < .05). Higher concentrations of OH-PAHs were also positively associated with attachment loss, periodontal pocket depth (PPD) and the number of tooth loss. BKMR and WQS regression yielded similar positive associations between OH-PAH mixtures and periodontitis. CONCLUSIONS PAHs and their mixture are positively associated with periodontitis, which may provide novel insights into periodontitis prevention from an environmental exposure perspective.
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Affiliation(s)
- Yuxuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Han Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Weiqiu Jin
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yuying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yiming Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Qiansi Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Baochang He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Fuhua Yan
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yanfen Li
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Fa Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Clinical Research Unit, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
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Jiang Q, Wan Y, Zhu K, Wang H, Feng Y, Xiang Z, Liu R, Zhao S, Zhu Y, Song R. Association of exposure to phthalates and phthalate alternatives with dyslexia in Chinese primary school children. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:28392-28403. [PMID: 38538993 DOI: 10.1007/s11356-024-32871-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/05/2024] [Indexed: 04/30/2024]
Abstract
Previous studies have shown associations between children's exposure to phthalates and neurodevelopmental disorders. Whereas the impact of exposure to phthalate alternatives is understudied. This study aimed to evaluate the association of exposure to phthalates/their alternatives with the risk of dyslexia. We recruited 745 children (355 dyslexia and 390 non-dyslexia) via the Tongji Reading Environment and Dyslexia Research Project, and their urine samples were collected. A total of 26 metabolites of phthalates/their alternatives were measured. Multivariate logistic regression and quantile-based g-computation were used to estimate the associations of exposure to the phthalates/their alternatives with dyslexia. More than 80% of the children had 17 related metabolites detected in their urine samples. After adjustment, the association between mono-2-(propyl-6-hydroxy-heptyl) phthalate (OH-MPHP) with the risk of dyslexia was observed. Compared with the lowest quartile of OH-MPHP levels, the odds of dyslexia for the third quartile was 1.93 (95% CI 1.06, 3.57). Regarding mixture analyses, it was found that OH-MPHP contributed the most to the association. Further analyses stratified by sex revealed that this association was only observed in boys. Our results suggested a significantly adverse association of di-2-propylheptyl phthalate exposure with children's language abilities. It highlights the necessity to prioritize the protection of children's neurodevelopment by minimizing their exposure to endocrine-disrupting chemicals like di-2-propylheptyl phthalate.
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Affiliation(s)
- Qi Jiang
- Department of Maternal and Child Health and MOE (Ministry of Education) the Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yanjian Wan
- Center for Public Health Laboratory Service, Institute of Environmental Health, Wuhan Centers for Disease Control & Prevention, Wuhan, 430024, Hubei, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and MOE (Ministry of Education) the Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Haoxue Wang
- Department of Maternal and Child Health and MOE (Ministry of Education) the Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yanan Feng
- Department of Maternal and Child Health and MOE (Ministry of Education) the Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhen Xiang
- Department of Maternal and Child Health and MOE (Ministry of Education) the Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Rundong Liu
- Department of Maternal and Child Health and MOE (Ministry of Education) the Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shuai Zhao
- Department of Maternal and Child Health and MOE (Ministry of Education) the Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ying Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Ranran Song
- Department of Maternal and Child Health and MOE (Ministry of Education) the Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Day DB, LeWinn KZ, Karr CJ, Loftus CT, Carroll KN, Bush NR, Zhao Q, Barrett ES, Swan SH, Nguyen RHN, Trasande L, Moore PE, Adams Ako A, Ji N, Liu C, Szpiro AA, Sathyanarayana S. Subpopulations of children with multiple chronic health outcomes in relation to chemical exposures in the ECHO-PATHWAYS consortium. ENVIRONMENT INTERNATIONAL 2024; 185:108486. [PMID: 38367551 PMCID: PMC10961192 DOI: 10.1016/j.envint.2024.108486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
A multimorbidity-focused approach may reflect common etiologic mechanisms and lead to better targeting of etiologic agents for broadly impactful public health interventions. Our aim was to identify clusters of chronic obesity-related, neurodevelopmental, and respiratory outcomes in children, and to examine associations between cluster membership and widely prevalent chemical exposures to demonstrate our epidemiologic approach. Early to middle childhood outcome data collected 2011-2022 for 1092 children were harmonized across the ECHO-PATHWAYS consortium of 3 prospective pregnancy cohorts in six U.S. cities. 15 outcomes included age 4-9 BMI, cognitive and behavioral assessment scores, speech problems, and learning disabilities, asthma, wheeze, and rhinitis. To form generalizable clusters across study sites, we performed k-means clustering on scaled residuals of each variable regressed on study site. Outcomes and demographic variables were summarized between resulting clusters. Logistic weighted quantile sum regressions with permutation test p-values associated odds of cluster membership with a mixture of 15 prenatal urinary phthalate metabolites in full-sample and sex-stratified models. Three clusters emerged, including a healthier Cluster 1 (n = 734) with low morbidity across outcomes; Cluster 2 (n = 192) with low IQ and higher levels of all outcomes, especially 0.4-1.8-standard deviation higher mean neurobehavioral outcomes; and Cluster 3 (n = 179) with the highest asthma (92 %), wheeze (53 %), and rhinitis (57 %) frequencies. We observed a significant positive, male-specific stratified association (odds ratio = 1.6; p = 0.01) between a phthalate mixture with high weights for MEP and MHPP and odds of membership in Cluster 3 versus Cluster 1. These results identified subpopulations of children with co-occurring elevated levels of BMI, neurodevelopmental, and respiratory outcomes that may reflect shared etiologic pathways. The observed association between phthalates and respiratory outcome cluster membership could inform policy efforts towards children with respiratory disease. Similar cluster-based epidemiology may identify environmental factors that impact multi-outcome prevalence and efficiently direct public policy efforts.
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Affiliation(s)
- Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, Washington 98101, USA.
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco, CA 94143, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Epidemiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Kecia N Carroll
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Qi Zhao
- Department of Preventive Medicine, Division of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Road, Piscataway, NJ 08854, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, Minnesota 55455, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232, USA
| | - Ako Adams Ako
- Department of Pediatrics, Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY 10467, USA
| | - Nan Ji
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Chang Liu
- Department of Psychology, Washington State University, Johnson Tower, Pullman, WA 99164, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, 3980 15th Avenue NE, Seattle, WA 98195, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, Washington 98101, USA; Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Epidemiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
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7
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Brennan Kearns P, van den Dries MA, Julvez J, Kampouri M, López-Vicente M, Maitre L, Philippat C, Småstuen Haug L, Vafeiadi M, Thomsen C, Yang TC, Vrijheid M, Tiemeier H, Guxens M. Association of exposure to mixture of chemicals during pregnancy with cognitive abilities and fine motor function of children. ENVIRONMENT INTERNATIONAL 2024; 185:108490. [PMID: 38364572 DOI: 10.1016/j.envint.2024.108490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
Chemical exposures often occur in mixtures and exposures during pregnancy may lead to adverse effects on the fetal brain, potentially reducing lower cognitive abilities and fine motor function of the child. We investigated the association of motheŕs exposure to a mixture of chemicals during pregnancy (i.e., organochlorine compounds, per- and polyfluoroalkyl substances, phenols, phthalates, organophosphate pesticides) with cognitive abilties and fine motor function in their children. We studied 1097 mother-child pairs from five European cohorts participating in the Human Early Life Exposome study (HELIX). Measurement of 26 biomarkers of exposure to chemicals was performed on urine or blood samples of pregnant women (mean age 31 years). Cognitive abilities and fine motor function were assessed in their children (mean age 8 years) with a battery of computerized tests administered in person (Raveńs Coloured Progressive Matrices, Attention Network Test, N-back Test, Trail Making Test, Finger Tapping Test). We estimated the joint effect of prenatal exposure to chemicals on cognitive abilities and fine motor function using the quantile-based g-computation method, adjusting for sociodemographic characteristics. A quartile increase in all the chemicals in the overall mixture was associated with worse fine motor function, specifically lower scores in the Finger Tapping Test [-8.5 points, 95 % confidence interval (CI) -13.6 to -3.4; -14.5 points, 95 % CI -22.4 to -6.6, and -18.0 points, 95 % CI -28.6 to -7.4) for the second, third and fourth quartile of the overal mixture, respectively, when compared to the first quartile]. Organochlorine compounds, phthalates, and per- and polyfluoroalkyl substances contributed most to this association. We did not find a relationship with cognitive abilities. We conclude that exposure to chemical mixtures during pregnancy may influence neurodevelopment, impacting fine motor function of the offspring.
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Affiliation(s)
- Pavla Brennan Kearns
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia
| | - Michiel A van den Dries
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Jordi Julvez
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Clinical and Epidemiological Neuroscience (NeuroÈpia), Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
| | - Mariza Kampouri
- University of Crete, Heraklion, Greece; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mónica López-Vicente
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Lea Maitre
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Claire Philippat
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Line Småstuen Haug
- Norwegian Institute of Public Health, Department of Food Safety, Oslo, Norway
| | | | - Cathrine Thomsen
- Norwegian Institute of Public Health, Department of Food Safety, Oslo, Norway
| | - Tiffany C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Mònica Guxens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain.
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8
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Yang P, Xie J, Huang S, Li X, Deng L, Zhang J, Chen L, Wu N, Huang G, Zhou C, Xiao L, Shen X. "Cocktail" of environmental chemicals and early reproductive outcomes of IVF: The insight from paternal and maternal exposure. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 348:119462. [PMID: 37925986 DOI: 10.1016/j.jenvman.2023.119462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/09/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Humans are exposed to various chemicals, including organophosphate esters (OPEs), phthalates (PAEs), and phenols. The effects on early reproductive outcomes of in vitro fertilization (IVF) remain unclear. METHODS We recruited 192 women and 157 men who underwent IVF treatment. A total of forty-nine urinary chemicals were detected, including six OPEs, fifteen PAEs, six parabens, two chlorophenols, nine bisphenols, five benzophenones, and six synthetic phenolic antioxidants. We examined the individual and joint effects of parental chemical exposure on early reproductive outcomes. RESULTS We found that certain chemicals were associated with early reproductive outcomes in Poisson regression models. For example, urinary diphenyl phosphate was negatively associated with high-quality embryos in both female (β: -0.12, 95%CI: -0.17, -0.07) and male partners (β: -0.09, 95%CI: -0.15, -0.03). A negative association was found between mixed chemicals and high-quality embryos in Bayesian kernel machine regression, weighted quantile sum regression (β: -0.34, 95%CI: -0.60, -0.07), and quantile-based g-computation model (β: -0.69, 95%CI: -1.34, -0.05) among female partners. Paternal mixture exposure was not associated with early reproductive outcomes. CONCLUSIONS Our results indicated that increased exposure to environmental chemicals was associated with adverse early reproductive outcomes of IVF, especially female partners.
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Affiliation(s)
- Pan Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, 510632, China; Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 510632, China
| | - Jinying Xie
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Songyi Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Xiaojie Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Langjing Deng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Jinglei Zhang
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Lin Chen
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Nanxin Wu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Guangtong Huang
- School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Canquan Zhou
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
| | - Li Xiao
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
| | - Xiaoting Shen
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
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9
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Casey JA, Daouda M, Babadi RS, Do V, Flores NM, Berzansky I, González DJ, Van Horne YO, James-Todd T. Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021. Curr Environ Health Rep 2023; 10:312-336. [PMID: 37581863 PMCID: PMC10504232 DOI: 10.1007/s40572-023-00406-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE OF REVIEW The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods. RECENT FINDINGS We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.
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Affiliation(s)
- Joan A. Casey
- University of Washington School of Public Health, Seattle, WA USA
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Misbath Daouda
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Ryan S. Babadi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Vivian Do
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Nina M. Flores
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Isa Berzansky
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - David J.X. González
- Department of Environmental Science, Policy & Management and School of Public Health, University of California, Berkeley, Berkeley, CA 94720 USA
| | | | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
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10
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Dewey D, Martin JW, MacDonald AM, Kinniburgh DW, Letourneau N, Giesbrecht GF, Field CJ, Bell RC, England-Mason G. Sex-specific associations between maternal phthalate exposure and neurodevelopmental outcomes in children at 2 years of age in the APrON cohort. Neurotoxicology 2023; 98:48-60. [PMID: 37517784 DOI: 10.1016/j.neuro.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/05/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND There is inconsistent evidence regarding the sex-specific associations between prenatal phthalate exposure and children's neurodevelopment. This could be due to differences in the phthalate exposures investigated and the neurodevelopmental domains assessed. OBJECTIVE To evaluate the associations between prenatal phthalate exposure and sex-specific outcomes on measures of cognition, language, motor, executive function, and behaviour in children 2 years of age in the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort. METHODS We evaluated the associations between prenatal phthalate exposure and sex-specific neurodevelopmental outcomes in children at 2 years of age using data from 448 mothers and their children (222 girls, 226 boys). Nine phthalate metabolites were measured in maternal urine collected in the second trimester of pregnancy. Children's cognitive, language, and motor outcomes were assessed using the Bayley Scales of Infant Development - Third Edition (Bayley-III). Parents completed questionnaires on children's executive function and behavior, the Behavior Rating Inventory of Executive Function- Preschool Version (BRIEF-P) and Child Behavior Checklist (CBCL), respectively. Sex-stratified robust multivariate regressions were performed. RESULTS Higher maternal concentrations of ΣDEHP and its metabolites were associated with lower scores on the Bayley-III Cognitive (β's from -11.8 to -0.07 95% CI's from -21.3 to -0.01), Language (β's from -11.7 to -0. 09, 95% CI's from -22.3 to -0.02) and Motor (β's from -10.9 to -0.07, 95% CI from -20.4 to -0.01) composites in boys. The patterns of association in girls were in the opposite direction on the Cognitive and Language composites; on the Motor composite they were in the same direction as boys, but of reduced strength. Higher concentrations of ΣDEHP and its metabolites were associated with higher scores (i.e., more difficulties) on all measures of executive function in girls: inhibitory self-control (B's from 0.05 to 0.11, 95% CI s from -0.01 to 0.15), flexibility (B's from 0.04 to 0.11, 95% CI s from 0.01 to 0.21) and emergent metacognition (B's from -0.01 to 0.06, 95% CIs from -0.01 to 0.20). Similar patterns of attenuated associations were seen in boys. Higher concentrations of ΣDEHP and its metabolites were associated with more Externalizing Problems in girls and boys (B's from 0.03 to 6.82, 95% CIs from -0.08 to 12.0). Two phthalates, MMP and MBP, had sex-specific adverse associations on measures of executive function and behaviour, respectively, while MEP was positively associated with boys' cognitive, language, and motor performance. Limited associations were observed between mixtures of maternal phthalates and sex-specific neurodevelopmental outcomes. CONCLUSIONS Maternal prenatal concentrations of DEHP phthalates were associated with sex specific difference on measures of cognition and language at 2 years of age, specifically, poorer outcomes in boys. Higher exposure to DEHP was associated with poorer motor, executive function, and behavioural outcomes in girls and boys but the strength of these associations differed by sex. Limited associations were noted between phthalate mixtures and child neurodevelopment.
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Affiliation(s)
- Deborah Dewey
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
| | - Jonathan W Martin
- Department of Environmental Science, Science for Life Laboratory, Stockholm University, Stockholm, Sweden
| | - Amy M MacDonald
- Alberta Centre for Toxicology, University of Calgary, Calgary, Alberta, Canada
| | - David W Kinniburgh
- Alberta Centre for Toxicology, University of Calgary, Calgary, Alberta, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Nicole Letourneau
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Faculty of Nursing, Univerity of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gerald F Giesbrecht
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada
| | - Catherine J Field
- Department of Agricultural, Food and Nutrition Science, University of Alberta, Edmonton, Alberta, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutrition Science, University of Alberta, Edmonton, Alberta, Canada
| | - Gillian England-Mason
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
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11
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Ramos AM, Herring AH, Villanger GD, Thomsen C, Sakhi AK, Cequier E, Aase H, Engel SM. The association of prenatal phthalates, organophosphorous pesticides, and organophosphate esters with early child language ability in Norway. ENVIRONMENTAL RESEARCH 2023; 225:115508. [PMID: 36813071 PMCID: PMC10071760 DOI: 10.1016/j.envres.2023.115508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/02/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Prenatal exposure to phthalates, organophosphate esters, and organophosphorous pesticides have been associated with neurodevelopmental deficits including language ability, however, few studies consider the effect of exposure mixtures and the potential longitudinal detriments over time. OBJECTIVE This study examines the influence of prenatal exposure to phthalates, organophosphate esters, and organophosphorous pesticides, on children's language ability from toddlerhood to the preschool period. METHODS This study includes 299 mother-child dyads from Norway in the Norwegian Mother, Father and Child Cohort Study (MoBa). Prenatal exposure to chemicals were assessed at 17 weeks' gestation, and child language skills were assessed at 18 months using the Ages and Stages Questionnaire communication subscale and at preschool age using the Child Development Inventory. We ran two structural equation models to examine the simultaneous influences of chemical exposures on parent-reported and teacher-reported child language ability. RESULTS Prenatal organophosphorous pesticides were negatively associated with preschool language ability through language ability at 18 months. Additionally, there was a negative association between low molecular weight phthalates and teacher-reported preschool language ability. There was no effect of prenatal organophosphate esters on child language ability at either 18 months or preschool age. CONCLUSIONS This study adds to the literature on prenatal exposure to chemicals and neurodevelopment and highlights the importance of developmental pathways in early childhood.
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Affiliation(s)
- Amanda M Ramos
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Amy H Herring
- Department of Statistical Science, Global Health, Biostatistics & Bioinformatics, Duke University, Durham, NC, USA
| | - Gro D Villanger
- Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Cathrine Thomsen
- Department of Environmental Health, Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Amrit K Sakhi
- Department of Environmental Health, Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Enrique Cequier
- Department of Environmental Health, Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Stephanie M Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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12
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Vilmand M, Beck IH, Bilenberg N, Andersson AM, Juul A, Schoeters G, Boye H, Frederiksen H, Jensen TK. Prenatal and current phthalate exposure and cognitive development in 7-year-old children from the Odense child cohort. Neurotoxicol Teratol 2023; 96:107161. [PMID: 36690047 DOI: 10.1016/j.ntt.2023.107161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 11/28/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Phthalates are endocrine disrupters used in a variety of consumer products. Human studies suggest an association between phthalate exposure and cognitive development but adverse effects of the recently introduced phthalate substitutes have only been sparsely studied. OBJECTIVES To investigate associations between prenatal and concurrent exposure to phthalates and IQ in 7-year-old children from the Odense Child Cohort. METHODS Pregnant women from the Odense Child Cohort had phthalate metabolites measured in urine samples during 3rd trimester in 2010 to 2012. In addition, phthalates were also measured in urine samples from their offspring at age 7 years. IQ was assessed at age 7 years using four subtests from Wechsler Intelligence Scale for Children. The total study population consisted of 585 mother-child pairs with available prenatal urinary phthalate metabolites concentrations and IQ data at age 7 years. A subset of those (N = 274) had urinary phthalate metabolites measured in child urine at age 7 years. Phthalate concentrations were grouped into tertiles and associations with IQ were investigated using multiple linear regression adjusting for sex, maternal education and maternal/child BMI. RESULTS Urinary phthalate metabolite concentrations both in pregnant women and children were generally lower compared to previous cohorts. Children with high prenatal urinary concentrations of MEP and metabolites of DEHP (∑DEHPm)(3rd tertile) had -3.1 (95% CI: -5.5, -0.6) (MEP) and - 3.0 (-5.5, -0.6) (∑DEHPm) IQ points at age 7 years compared to children with low concentrations (1st tertile). High concurrent urinary phthalate concentrations of MCPP, ∑DnHxPm, ∑DiDPm and ∑DiNPm in the 3rd tertile was associated with -3.7 (-7.2, -0.2), -4.4 (-7.9, -0.9), -3.7 (-7.2, -0.2) and - 5.6 (-9.1, -2.2) IQ points, respectively, compared to those with the lowest concentrations (1st tertile). CONCLUSION We found significant inverse associations between some prenatal and concurrent urinary phthalate concentrations and IQ at age 7 years in this low exposed population. This suggests that exposure to phthalates both prenatally and during early childhood could be hazardous to child neurodevelopment, however, large-scale prospective studies assessing phthalate exposure through multiple urine samples, and possibly investigating cocktail effects of the chemicals as well as long term follow-up are warranted.
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Affiliation(s)
- Mikkel Vilmand
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Iben Have Beck
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Psychiatry, Odense, Mental Health Services in Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Greet Schoeters
- Environmental Risk and Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, 2000 Antwerp, Belgium
| | - Henriette Boye
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Odense Patient data Explorative Network (OPEN), Odense, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Odense Patient data Explorative Network (OPEN), Odense, Denmark.
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13
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Park S, Zimmerman E, Huerta-Montañez G, Rosario-Pabón Z, Vélez-Vega CM, Cordero JF, Alshwabekah A, Meeker JD, Watkins DJ. Gestational Exposure to Phthalates and Phthalate Replacements in Relation to Neurodevelopmental Delays in Early Childhood. TOXICS 2023; 11:65. [PMID: 36668792 PMCID: PMC9863718 DOI: 10.3390/toxics11010065] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/01/2023] [Accepted: 01/02/2023] [Indexed: 06/10/2023]
Abstract
Phthalates have been linked to changes in child neurodevelopment. However, sex-specificity has been reported inconsistently, and little is known about the impact of recent phthalate replacement chemicals. Our analysis included mother−child pairs (N = 274) from the PROTECT birth cohort in Puerto Rico. Phthalate metabolites were measured in multiple maternal urine collected during pregnancy. Neurodevelopment was measured at 6, 12, and 24 months of age using the Battelle Developmental Inventory-2nd edition (BDI), which provides scores for adaptive, personal-social, communication, motor, and cognitive domains. Multivariable linear regression was used to examine associations between phthalate metabolite concentrations and BDI scores, adjusting for maternal age, maternal education, child age, and specific gravity. Sex-specificity was assessed with sex X exposure interaction terms and stratified models. Results show that all five domains were significantly associated with mono-3-carboxypropyl phthalate (MCPP) at age 24 months, suggesting a holistic developmental delay related to this metabolite. Sex-specificity existed for all timepoints (p-interaction < 0.2), in general, showing stronger associations among boys. For example, metabolites of a recent phthalate replacement, di-2-ethylhexyl terephthalate (DEHTP), were differentially associated with the adaptive domain (boys −7.53%/IQR, 95% CI: −14.58, −0.48 vs. girls −0.85%/IQR, 95% CI: −5.08, 3.37), and the cognitive domain (boys −6.05%/IQR, 95% CI: −10.88, −1.22 vs. girls −1.93%/IQR, 95%CI: −4.14, 0.28) at 6 months. To conclude, gestational exposure to phthalates and phthalate replacements was associated with neurodevelopmental delay across multiple domains, with differences by sex and child age.
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Affiliation(s)
- Seonyoung Park
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA 02115, USA
| | - Gredia Huerta-Montañez
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115, USA
| | - Zaira Rosario-Pabón
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115, USA
| | - Carmen M. Vélez-Vega
- Department of Social Sciences, UPR Medical Sciences Campus, University of Puerto Rico Graduate School of Public Health, San Juan, PR 00936, USA
| | - José F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA 30602, USA
| | - Akram Alshwabekah
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA 02115, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Deborah J. Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
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Wallace ER, Buth E, Szpiro AA, Ni Y, Loftus CT, Masterson E, Day DB, Sun BZ, Sullivan A, Barrett E, Nguyen RH, Robinson M, Kannan K, Mason A, Sathyanarayana S, LeWinn KZ, Bush NR, Karr CJ. Prenatal exposure to polycyclic aromatic hydrocarbons is not associated with behavior problems in preschool and early school-aged children: A prospective multi-cohort study. ENVIRONMENTAL RESEARCH 2023; 216:114759. [PMID: 36370819 PMCID: PMC9817935 DOI: 10.1016/j.envres.2022.114759] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Epidemiological study findings are inconsistent regarding associations between prenatal polycyclic aromatic hydrocarbon (PAH) exposures and childhood behavior. This study examined associations of prenatal PAH exposure with behavior at age 4-6 years in a large, diverse, multi-region prospective cohort. Secondary aims included examination of PAH mixtures and effect modification by child sex, breastfeeding, and child neighborhood opportunity. METHODS The ECHO PATHWAYS Consortium pooled 1118 mother-child dyads from three prospective pregnancy cohorts in six U.S. cities. Seven PAH metabolites were measured in prenatal urine. Child behavior was assessed at age 4-6 using the Total Problems score from the Child Behavior Checklist (CBCL). Neighborhood opportunity was assessed using the socioeconomic and educational scales of the Child Opportunity Index. Multivariable linear regression was used to estimate associations per 2-fold increase in each PAH metabolite, adjusted for demographic, prenatal, and maternal factors and using interaction terms for effect modifiers. Associations with PAH mixtures were estimated using Weighted Quantile Sum Regression (WQSR). RESULTS The sample was racially and sociodemographically diverse (38% Black, 49% White, 7% Other; household-adjusted income range $2651-$221,102). In fully adjusted models, each 2-fold increase in 2-hydroxynaphthalene was associated with a lower Total Problems score, contrary to hypotheses (b = -0.80, 95% CI = -1.51, -0.08). Associations were notable in boys (b = -1.10, 95% CI = -2.11, -0.08) and among children breastfed 6+ months (b = -1.31, 95% CI = -2.25, -0.37), although there was no statistically significant evidence for interaction by child sex, breastfeeding, or neighborhood child opportunity. Associations were null for other PAH metabolites; there was no evidence of associations with PAH mixtures from WQSR. CONCLUSION In this large, well-characterized, prospective study of mother-child pairs, prenatal PAH exposure was not associated with child behavior problems. Future studies characterizing the magnitude of prenatal PAH exposure and studies in older childhood are needed.
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Affiliation(s)
- Erin R Wallace
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Erin Buth
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Erin Masterson
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Bob Z Sun
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Alexis Sullivan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Ruby Hn Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, 10016, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, 10016, USA
| | - Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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15
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Loftus CT, Szpiro AA, Workman T, Wallace ER, Hazlehurst MF, Day DB, Ni Y, Carroll KN, Adgent MA, Moore PE, Barrett ES, Nguyen RHN, Kannan K, Robinson M, Masterson EE, Tylavsky FA, Bush NR, LeWinn KZ, Sathyanarayana S, Karr CJ. Maternal exposure to urinary polycyclic aromatic hydrocarbons (PAH) in pregnancy and childhood asthma in a pooled multi-cohort study. ENVIRONMENT INTERNATIONAL 2022; 170:107494. [PMID: 36279735 PMCID: PMC9810359 DOI: 10.1016/j.envint.2022.107494] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/06/2022] [Accepted: 08/29/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Prenatal exposure to polycyclic aromatic hydrocarbons (PAH) may increase risk of pediatric asthma, but existing human studies are limited. OBJECTIVES We estimated associations between gestational PAHs and pediatric asthma in a diverse US sample and evaluated effect modification by child sex, maternal asthma, and prenatal vitamin D status. METHODS We pooled two prospective pregnancy cohorts in the ECHO PATHWAYS Consortium, CANDLE and TIDES, for an analytic sample of N = 1296 mother-child dyads. Mono-hydroxylated PAH metabolites (OH-PAHs) were measured in mid-pregnancy urine. Mothers completed the International Study on Allergies and Asthma in Childhood survey at child age 4-6 years. Poisson regression with robust standard errors was used to estimate relative risk of current wheeze, current asthma, ever asthma, and strict asthma associated with each metabolite, adjusted for potential confounders. We used interaction models to assess effect modification. We explored associations between OH-PAH mixtures and outcomes using logistic weighted quantile sum regression augmented by a permutation test to control Type 1 errors. RESULTS The sociodemographically diverse sample spanned five cities. Mean (SD) child age at assessment was 4.4 (0.4) years. While there was little evidence that either individual OH-PAHs or mixtures were associated with outcomes, we observed effect modification by child sex for most pairs of OH-PAHs and outcomes, with adverse associations specific to females. For example, a 2-fold increase in 2-hydroxy-phenanthrene was associated with current asthma in females but not males (RRfemale = 1.29 [95 % CI: 1.09, 1.52], RRmale = 0.95 [95 % CI: 0.79, 1.13]; pinteraction = 0.004). There was no consistent evidence of modification by vitamin D status or maternal asthma. DISCUSSION This analysis, the largest cohort study of gestational PAH exposure and childhood asthma to date, suggests adverse associations for females only. These preliminary findings are consistent with hypothesized endocrine disruption properties of PAHs, which may lead to sexually dimorphic effects.
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Affiliation(s)
- Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Adam A Szpiro
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Tomomi Workman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Erin R Wallace
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Marnie F Hazlehurst
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Department of Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Kecia N Carroll
- Department of Pediatrics, Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret A Adgent
- Department of Pediatrics, College of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily S Barrett
- Department of Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, Department of Environmental Medicine, New York University School of Medicine, New York City, NY, USA
| | - Morgan Robinson
- Department of Pediatrics, Department of Environmental Medicine, New York University School of Medicine, New York City, NY, USA
| | - Erin E Masterson
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nicole R Bush
- Department of Psychiatry and Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- Department of Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, School of Medicine, Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Catherine J Karr
- Department of Pediatrics, School of Medicine, Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
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16
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Mathew L, Snyder NW, Lyall K, Lee BK, McClure LA, Elliott AJ, Newschaffer CJ. The associations between prenatal phthalate exposure measured in child meconium and cognitive functioning of 12-month-old children in two cohorts at elevated risk for adverse neurodevelopment. ENVIRONMENTAL RESEARCH 2022; 214:113928. [PMID: 35870502 PMCID: PMC9890962 DOI: 10.1016/j.envres.2022.113928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/17/2022] [Accepted: 07/15/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Phthalate metabolites in gestational-maternal urine represents short-term maternal exposure, but meconium, the newborn's first stool may better capture cumulative fetal exposure. We quantified phthalate metabolites in meconium from two cohorts of children at higher risk of adverse neurodevelopment and evaluated associations with their cognitive function at 12 months. METHODS Meconium phthalate metabolites were quantified in the Safe Passage Study (SPS), N = 720, a pregnancy cohort with high community-levels of prenatal alcohol use, and the Early Autism Risk Longitudinal Investigation (EARLI), N = 236, a high familial autism risk pregnancy cohort. EARLI also had second and third trimester (T2/T3) maternal urine for exposure assessment. Molar sum of di (2-ethylhexyl) (∑DEHP) metabolites and an anti-androgenic score (AAS) using mono-isobutyl, mono-n-butyl, monobenzyl (MBZP), and DEHP metabolites were computed. Cognitive function was assessed at 12 months using the Mullen Scales of Early Learning-Composite (ELC). Multivariable linear regression assessed associations between loge-transformed metabolites and ELC. Quadratic terms explored nonlinearity and interaction terms of metabolite by child's sex examined effect modification. RESULTS In SPS, MBzP (βLinear = -6.73; 95% CI: 12.04, -1.42; βquadratic = 1.95; 0.27, 3.62) and mono (2-ethyl-5-carboxypentyl), (βLinear = -3.81; -7.53, -0.27; βquadratic = 0.93; 0.09, 1.77) had U-shaped associations with ELC. In EARLI, T2 urine mono-carboxyisononyl was associated with linear decrease in ELC, indicating lower cognitive function. Interaction with sex was suggested (P < 0.2) for several urine metabolites, mostly indicating negative association between phthalates and ELC among girls but reversed among boys. Only mono-isononyl phthalate and ∑DEHP had consistent main effect associations across matrixes and cohorts, but similar interaction with sex was observed for meconium-measured ∑DEHP, AAS, MBzP, and mono (2-ethylhexyl) in both cohorts. CONCLUSIONS Few phthalate metabolites were consistently associated with children's cognitive function, but a similar set of meconium metabolites from both cohorts displayed sex-specific associations. Gestational phthalate exposure may have sexually-dimorphic associations with early cognitive function in children at higher risk for adverse neurodevelopment.
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Affiliation(s)
- Leny Mathew
- AJ Drexel Autism Institute, Drexel University, 3020 Market St, Suite 560, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market Street, Philadelphia, PA, 19104, USA.
| | - Nathaniel W Snyder
- AJ Drexel Autism Institute, Drexel University, 3020 Market St, Suite 560, Philadelphia, PA, 19104, USA
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, 3020 Market St, Suite 560, Philadelphia, PA, 19104, USA
| | - Brian K Lee
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market Street, Philadelphia, PA, 19104, USA
| | | | - Craig J Newschaffer
- AJ Drexel Autism Institute, Drexel University, 3020 Market St, Suite 560, Philadelphia, PA, 19104, USA; College of Health and Human Development, Pennsylvania State University, 325 HHD Building, University Park, PA, 16802, USA
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17
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LeWinn KZ, Karr CJ, Hazlehurst M, Carroll K, Loftus C, Nguyen R, Barrett E, Swan SH, Szpiro AA, Paquette A, Moore P, Spalt E, Younglove L, Sullivan A, Colburn T, Byington N, Sims Taylor L, Moe S, Wang S, Cordeiro A, Mattias A, Powell J, Johnson T, Norona-Zhou A, Mason A, Bush NR, Sathyanarayana S. Cohort profile: the ECHO prenatal and early childhood pathways to health consortium (ECHO-PATHWAYS). BMJ Open 2022; 12:e064288. [PMID: 36270755 PMCID: PMC9594508 DOI: 10.1136/bmjopen-2022-064288] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Exposures early in life, beginning in utero, have long-term impacts on mental and physical health. The ECHO prenatal and early childhood pathways to health consortium (ECHO-PATHWAYS) was established to examine the independent and combined impact of pregnancy and childhood chemical exposures and psychosocial stressors on child neurodevelopment and airway health, as well as the placental mechanisms underlying these associations. PARTICIPANTS The ECHO-PATHWAYS consortium harmonises extant data from 2684 mother-child dyads in three pregnancy cohort studies (CANDLE [Conditions Affecting Neurocognitive Development and Learning in Early Childhood], TIDES [The Infant Development and Environment Study] and GAPPS [Global Alliance to Prevent Prematurity and Stillbirth]) and collects prospective data under a unified protocol. Study participants are socioeconomically diverse and include a large proportion of Black families (38% Black and 51% White), often under-represented in research. Children are currently 5-15 years old. New data collection includes multimodal assessments of primary outcomes (airway health and neurodevelopment) and exposures (air pollution, phthalates and psychosocial stress) as well as rich covariate characterisation. ECHO-PATHWAYS is compiling extant and new biospecimens in a central biorepository and generating the largest placental transcriptomics data set to date (N=1083). FINDINGS TO DATE Early analyses demonstrate adverse associations of prenatal exposure to air pollution, phthalates and maternal stress with early childhood airway outcomes and neurodevelopment. Placental transcriptomics work suggests that phthalate exposure alters placental gene expression, pointing to mechanistic pathways for the developmental toxicity of phthalates. We also observe associations between prenatal maternal stress and placental corticotropin releasing hormone, a marker of hormonal activation during pregnancy relevant for child health. Other publications describe novel methods for examining exposure mixtures and the development of a national spatiotemporal model of ambient outdoor air pollution. FUTURE PLANS The first wave of data from the unified protocol (child age 8-9) is nearly complete. Future work will leverage these data to examine the combined impact of early life social and chemical exposures on middle childhood health outcomes and underlying placental mechanisms.
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Affiliation(s)
- Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences and Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Marnie Hazlehurst
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Kecia Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christine Loftus
- Department of Environmental Health and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Ruby Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota System, Minneapolis, Minnesota, USA
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Alison Paquette
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Paul Moore
- Division of Allergy, Immunology, and Pulmonology and the Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth Spalt
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Lisa Younglove
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Alexis Sullivan
- Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Trina Colburn
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Nora Byington
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Lauren Sims Taylor
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Stacey Moe
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota System, Minneapolis, Minnesota, USA
| | - Sarah Wang
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Alana Cordeiro
- Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Aria Mattias
- Department of Envrionmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jennifer Powell
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Tye Johnson
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA
| | - Amanda Norona-Zhou
- Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Alex Mason
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences and the Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health; Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington, USA
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18
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Gaylord A, Kannan K, Lakuleswaran M, Zhu H, Ghassabian A, Jacobson MH, Long S, Liu H, Afanasyeva Y, Kahn LG, Gu B, Liu M, Mehta-Lee SS, Brubaker SG, Trasande L. Variability and correlations of synthetic chemicals in urine from a New York City-based cohort of pregnant women. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 309:119774. [PMID: 35841991 PMCID: PMC9600950 DOI: 10.1016/j.envpol.2022.119774] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/05/2022] [Accepted: 07/10/2022] [Indexed: 05/19/2023]
Abstract
Fetal exposure to environmental chemicals has been associated with adverse health outcomes in children and later into adulthood. While several studies have examined correlations and variability of non-persistent chemical exposures throughout pregnancy, many do not capture more recent exposures, particularly in New York City. Our goal was to characterize exposure to phthalates, bisphenols, polycyclic aromatic hydrocarbons, and organophosphate pesticides among pregnant women residing in New York City who enrolled in the New York University Children's Health and Environment Study (NYU CHES) between 2016 and 2018. We measured urinary chemical metabolite concentrations in 671 women at early, mid, and late pregnancy (median 10.8, 20.8, and 29.3 weeks, respectively). We calculated Spearman correlation coefficients among chemical concentrations at each measurement time point. We compared changes in population-level urinary metabolites at each stage using paired Wilcoxon signed-rank tests and calculated intraclass correlation coefficients (ICCs) to quantify intra-individual variability of metabolites across pregnancy. Geometric means and ICCs were compared to nine other pregnancy cohorts that recruited women in 2011 or later as well as nationally reported levels from women of child-bearing age. Compared with existing cohorts, women in NYU CHES had higher geometric means of organophosphate pesticides (Σdiethylphosphates = 28.7 nmol/g cr, Σdimethylphosphates = 57.3 nmol/g cr, Σdialkyl phosphates = 95.9 nmol/g cr), bisphenol S (0.56 μg/g cr), and 2-naphthalene (8.98 μg/g cr). Five PAH metabolites and two phthalate metabolites increased between early to mid and early to late pregnancy at the population level. Spearman correlation coefficients for chemical metabolites were generally below 0.50. Intra-individual exposures varied over time, as indicated by low ICCs (0.22-0.88, median = 0.38). However, these ICCs were often higher than those observed in other pregnancy cohorts. These results provide a general overview of the chemical metabolites measured in NYU CHES in comparison to other contemporary pregnancy cohorts and highlight directions for future studies.
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Affiliation(s)
- Abigail Gaylord
- Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Mathusa Lakuleswaran
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Hongkai Zhu
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Akhgar Ghassabian
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Melanie H Jacobson
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Sara Long
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Hongxiu Liu
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Hubei, PR China
| | - Yelena Afanasyeva
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Linda G Kahn
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Bo Gu
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - Leonardo Trasande
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; New York University Wagner School of Public Service, New York, NY, USA; New York University College of Global Public Health, New York, NY, USA
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19
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Day DB, Sathyanarayana S, LeWinn KZ, Karr CJ, Mason WA, Szpiro AA. A Permutation Test-Based Approach to Strengthening Inference on the Effects of Environmental Mixtures: Comparison between Single-Index Analytic Methods. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:87010. [PMID: 36040702 PMCID: PMC9426671 DOI: 10.1289/ehp10570] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 07/12/2022] [Accepted: 08/02/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Optimization of mixture analyses is critical to assess potential impacts of human exposures to multiple pollutants. Single-index regression methods quantify total mixture association and chemical component contributions. Single-index methods include several variants of quantile g-computation (QGC) and weighted quantile sum regression (WQSr), though each has limitations. OBJECTIVES We developed a novel permutation test for WQSr and compared its performance to extant versions of WQSr and QGC in simulation studies and an analysis of prenatal phthalates and childhood cognition. METHODS WQSr uses ensemble nonlinear optimization to identify weights for mixture exposures in an index associated with the outcome in a prespecified direction, with ensembles based on bootstrap resampling (WQSBS) or random subsetting of exposures (WQSRS). Statistical significance can be assessed without splitting the data (Nosplit), by splitting the data into training and test sets (Split), by repeatedly holding out test sets (RH), or by using a novel permutation test (PT) to obtain a more accurate p -value. QGC instead provides a sum mixture coefficient and component coefficients with no constraints on direction. In simulations, we compared false positive rates (FPR) and power to detect true associations and accuracy in estimating mixture weights. We also estimated associations between prenatal phthalate mixtures and childhood IQ in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood cohort using each method. RESULTS FPR was well controlled at ≤ 7 % in all but the Nosplit WQSr variants. Among these methods, the WQSBS and WQSRS PT variants had the highest power (89%-98%), with lower power for QGC (85%-93%) and RH (60%-97%) or Split WQSr variants (40%-78%). WQSr methods estimated mixture weights 2-4 times more accurately than the QGC method. Coefficients for mixture associations with full scale IQ varied 3- to 4-fold across analytic methods. DISCUSSION WQSr paired with our novel permutation test best balanced power and false positive rate when assessing a mixture effect. As new methods develop, each should be examined for performance and applicability. https://doi.org/10.1289/EHP10570.
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Affiliation(s)
- Drew B. Day
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Catherine J. Karr
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - W. Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
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20
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Freije SL, Enquobahrie DA, Day DB, Loftus C, Szpiro AA, Karr CJ, Trasande L, Kahn LG, Barrett E, Kannan K, Bush NR, LeWinn KZ, Swan S, Alex Mason W, Robinson M, Sathyanarayana S. Prenatal exposure to polycyclic aromatic hydrocarbons and gestational age at birth. ENVIRONMENT INTERNATIONAL 2022; 164:107246. [PMID: 35453081 PMCID: PMC9269995 DOI: 10.1016/j.envint.2022.107246] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous chemicals with mechanisms of toxicity that include endocrine disruption. We examined associations of prenatal urinary PAH with spontaneous preterm birth (PTB) and gestational age (GA) at birth. We also assessed whether infant sex modifies the association of PAH exposure with spontaneous PTB and GA at birth. METHODS Participants included 1,677 non-smoking women from three cohorts (CANDLE, TIDES, and GAPPS) in the ECHO PATHWAYS Consortium. Twelve monohydroxylated-PAHs were measured in second trimester maternal urine. Seven metabolites with >60% overall detection were included in analyses: 1-hydroxynaphthalene [1-OH-NAP], 2-hydroxynaphthalene [2-OH-NAP], 2-hydroxyphenanthrene [2-OH-PHEN], 3-hydroxyphenanthrene [3-OH-PHEN], 1/9-hydroxyphenanthrene [1/9-OH-PHEN], 2/3/9-hydroxyfluorene [2/3/9-OH-FLUO], and 1-hydroxypyrene [1-OH-PYR]. Logistic and linear regression models were fit for spontaneous PTB and GA among births ≥34 weeks, respectively, with log10-transformed OH-PAH concentrations as the exposure, adjusted for specific gravity and suspected confounders. Effect modification by infant sex was assessed using interaction terms and marginal estimates. RESULTS Percent detection was highest for 2-OH-NAP (99.8%) and lowest for 1-OH-PYR (65.2%). Prevalence of spontaneous PTB was 5.5% (N = 92). Ten-fold higher 2-OH-NAP exposure was associated with 1.60-day (95% CI: -2.92, -0.28) earlier GA at birth. Remaining associations in the pooled population were null. Among females, we observed significant inverse associations between 1-OH-PYR and PTB (OR: 2.65 [95% CI: 1.39, 5.05]); and 2-OH-NAP with GA: -2.46 days [95% CI: -4.15, -0.77]). Among males, we observed an inverse association between 2/3/9-OH-FLUO and PTB (OR = 0.40 [95% CI: 0.17,0.98]). ORs for PTB were higher among females than males for 2-OH-PHEN (p = 0.02) and 1-OH-PYR (p = 0.02). DISCUSSION We observed inverse associations of 2-OH-NAP exposure with GA and null associations of remaining OH-PAHs with GA and PTB. Females may be more susceptible to spontaneous PTB or shorter GA following prenatal exposure to some OH-PAHs. This study is the first to assess sex-specific OH-PAH toxicity in relation to spontaneous PTB and GA.
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Affiliation(s)
- Sophia L Freije
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Daniel A Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, USA
| | - Christine Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Catherine J Karr
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Leonardo Trasande
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine and New York University School of Global Public Health, New York University, New York, NY, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, New Brunswick, NJ, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, USA
| | - Shanna Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - W Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
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21
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Wallace ER, Ni Y, Loftus CT, Sullivan A, Masterson E, Szpiro AA, Day DB, Robinson M, Kannan K, Tylavsky FA, Sathyanarayana S, Bush NR, LeWinn KZ, Karr CJ. Prenatal urinary metabolites of polycyclic aromatic hydrocarbons and toddler cognition, language, and behavior. ENVIRONMENT INTERNATIONAL 2022; 159:107039. [PMID: 34902794 PMCID: PMC8748410 DOI: 10.1016/j.envint.2021.107039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Animal and epidemiological studies suggest that prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) may negatively impact toddler neurodevelopment. METHODS We investigated this association in 835 mother-child pairs from CANDLE, a diverse pregnancy cohort in the mid-South region of the U.S. PAH metabolite concentrations were measured in mid-pregnancy maternal urine. Cognitive and Language composite scores at ages 2 and 3 years were derived from the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-3). Behavior Problem and Competence scores at age 2 were derived from the Brief Infant and Toddler Social Emotional Assessment (BITSEA). We used multivariate linear or Poisson regression to estimate associations with continuous scores and relative risks (RR) of neurodevelopment delay or behavior problems per 2-fold increase in PAH, adjusted for maternal health, nutrition, and socioeconomic status. Secondary analyses investigated associations with PAH mixture using Weighted Quantile Sum Regression (WQS) with a permutation test extension. RESULTS 1- hydroxypyrene was associated with elevated relative risk for Neurodevelopmental Delay at age 2 (RR = 1.20, 95% CI: 1.03,1.39). Contrary to hypotheses, 1-hydroxynaphthalene was associated with lower risk for Behavior Problems at age 2 (RR = 0.90, 95% CI: 0.83,0.98), and combined 1- and 9-hydroxyphenanthrene was associated with 0.52-point higher (95% CI: 0.11,0.93) Cognitive score at age 3. For PAH mixtures, a quintile increase in hydroxy-PAH mixture was associated with lower Language score at age 2 (βwqs = -1.59; 95% CI: -2.84, -0.34; ppermutation = 0.07) and higher Cognitive score at age 3 (βwqs = 0.96; 95% CI: 0.11, 1.82; ppermutation = 0.05). All other estimates were consistent with null associations. CONCLUSION In this large southern U.S. population we observed some support for adverse associations between PAHs and neurodevelopment.
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Affiliation(s)
- Erin R Wallace
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Alexis Sullivan
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Erin Masterson
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Fran A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Nicole R Bush
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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22
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Sprowles JL, Dzwilewski KL, Merced-Nieves FM, Musaad SM, Schantz SL, Geiger SD. Associations of prenatal phthalate exposure with neurobehavioral outcomes in 4.5- and 7.5-month-old infants. Neurotoxicol Teratol 2022; 92:107102. [PMID: 35588931 PMCID: PMC9271634 DOI: 10.1016/j.ntt.2022.107102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Abstract
Phthalates are ubiquitous endocrine-disrupting chemicals, and research indicates that prenatal exposure to some phthalates may affect neurodevelopment. In a prospective birth cohort study, five first-morning urine samples collected across pregnancy were pooled and the following phthalate biomarkers assessed: sum of di-(2-ethylhexyl) phthalate metabolites (ΣDEHP), sum of diisononyl phthalate metabolites (ΣDINP), sum of dibutyl phthalate metabolites (ΣDBP), sum of anti-androgenic metabolites (ΣAA), monoethyl phthalate (MEP), and sum of all phthalate metabolites (ΣAll). The Ages & Stages Questionnaires® (ASQ), a standardized parent-reported, age-adapted screening tool, measured communication, personal-social, problem solving, and motor domains in infants at 4.5 and 7.5 months (n = 123). Adjusting for maternal age, annual household income, gestational age at birth, infant age at assessment, and sex, repeated-measures generalized linear regression models were used to examine associations between prenatal phthalate urine biomarker concentrations and domain scores (assuming a Poisson distribution). Beta estimates were exponentiated back to the domain scale for ease of interpretation. Mothers were mostly white and college-educated, and most reported an annual household income of ≥$60,000. Associations of phthalate concentrations with ASQ outcomes are presented as follows: (1) anti-androgenic phthalate metabolites (ΣDEHP, ΣDINP, ΣDBP, and ΣAA), (2) MEP, which is not anti-androgenic, and (3) ΣAll. Overall, anti-androgenic phthalates were associated with higher (i.e., better) scores. However, there were exceptions, including the finding that a one-unit increase in ΣDBP was associated with a 12% increase in problem solving scores in 4.5-month-old females (β = 1.12; 95% CI: 0.99, 1.28; p = 0.067) but a 85% decrease for 7.5-month-old females (β = 0.54; 95% CI: 0.3, 0.99; p = 0.047). In contrast, MEP was associated with poorer scores on several outcomes. Sex- and timepoint-specific estimates demonstrated a one-unit increase in MEP was associated with: a 52% decrease in personal-social scores in 7.5-month-old males (β = 0.66; 95% CI: 0.46, 0.95; p = 0.02), a 39% decrease in fine motor scores in 7.5-month-old males (β = 0.72; 95% CI: 0.52, 0.98; p = 0.035), and a 6% decrease in fine motor scores in 4.5-month-old females (β = 0.94; 95% CI: 0.88, 0.99; p = 0.03). A one-unit increase in ΣAll was associated with a 4% increase in personal-social scores in 4.5-month-old males (β = 1.04; 95% CI: 0.99, 1.1; p = 0.08) but a 17% decrease in 7.5-month-old males (β = 0.85; 95% CI: 0.73, 0.99; p = 0.03). These data suggest age- and sex-specific associations of prenatal phthalates with infant neurobehavior. The current findings should be confirmed by longitudinal studies with larger sample sizes.
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Affiliation(s)
- Jenna L.N. Sprowles
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA.,Corresponding author at: Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA. (J. L. N. Sprowles)
| | - Kelsey L.C. Dzwilewski
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA
| | - Francheska M. Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Salma M.A. Musaad
- United States Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Ave., Houston, TX 77030, USA
| | - Susan L. Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA
| | - Sarah D. Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA.,Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Khan Annex Room 2013, 1206 S. Fourth St., Champaign, IL 61820, USA
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23
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van den Dries MA, Ferguson KK, Keil AP, Pronk A, Spaan S, Ghassabian A, Santos S, Jaddoe VWV, Trasande L, Tiemeier H, Guxens M. Prenatal Exposure to Nonpersistent Chemical Mixtures and Offspring IQ and Emotional and Behavioral Problems. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:16502-16514. [PMID: 34878787 PMCID: PMC11148873 DOI: 10.1021/acs.est.1c04455] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Prenatal exposure to nonpersistent chemicals such as phthalates, bisphenols, and organophosphate (OP) pesticides is ubiquitous and occurs in mixtures. So far, epidemiological studies investigating neurodevelopmental consequences of these exposures have mainly been restricted to single-pollutant models. Thus, we studied the association between prenatal exposure to nonpersistent chemical mixtures and child IQ and emotional and behavioral problems. Data came from 782 mother-child pairs. Eleven phthalate, one bisphenol, and five OP pesticide urinary exposure biomarkers were measured three times during pregnancy and averaged. Nonverbal IQ, internalizing and attention problems, aggressive behavior, and autistic traits were assessed at child age 6 years. We used quantile g-computation to estimate the change in each outcome per quartile increase in all chemicals within the mixture. Higher exposure to the mixture was associated with lower nonverbal IQ (-4.0 points (95%CI = -7.0, -1.0), -5.5 points (95%CI = -10.2, -0.9), and -4.6 points (95%CI = -10.8, 1.5) for the second, third, and fourth quartile, respectively, compared to the first quartile). These results were mainly driven by the phthalate mixture. No association was observed with emotional and behavioral problems. Prenatal exposure to nonpersistent chemical mixtures was associated with lower nonverbal IQ in children. Exposure to chemical mixtures during gestation is universal and may impact neurodevelopment.
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Affiliation(s)
- Michiel A van den Dries
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, 3015 CN The Netherlands
- The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, 3015 CN The Netherlands
- ISGlobal, Barcelona, 08003, Spain
- Pompeu Fabra University, Barcelona, 08002, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
| | - Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, North Carolina 27709, United States
| | - Alexander P Keil
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, North Carolina 27709, United States
- Department of Epidemiology, University of North Carolina, Chapel Hill North Carolina 27516, United States
| | - Anjoeka Pronk
- Department of Risk Analysis for Products in Development, TNO, Utrecht, 3584 CB, The Netherlands
| | - Suzanne Spaan
- Department of Risk Analysis for Products in Development, TNO, Utrecht, 3584 CB, The Netherlands
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University School of Medicine, New York City, New York 10016, United States
- Department of Environmental Medicine, New York University School of Medicine, New York City, New York 10016, United States
- Department of Population Health, New York University School of Medicine, New York City, New York 10016, United States
| | - Susana Santos
- The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, 3015 CN The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3015 CN The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, 3015 CN The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3015 CN The Netherlands
| | - Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, New York City, New York 10016, United States
- Department of Environmental Medicine, New York University School of Medicine, New York City, New York 10016, United States
- Department of Population Health, New York University School of Medicine, New York City, New York 10016, United States
- New York University Wagner School of Public Service, New York City, New York 10012, United States
- New York University College of Global Public Health, New York City, New York 10003, United States
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, 3015 CN The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Mònica Guxens
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, 3015 CN The Netherlands
- ISGlobal, Barcelona, 08003, Spain
- Pompeu Fabra University, Barcelona, 08002, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
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24
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Donat-Vargas C, Perez-Carrascosa F, Gomez-Peña C, Mustieles V, Salcedo-Bellido I, Frederiksen H, Åkesson A, Arrebola JP. Associations of serum phthalate metabolites with thyroid hormones in GraMo cohort, Southern Spain. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 287:117606. [PMID: 34426375 DOI: 10.1016/j.envpol.2021.117606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/26/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
The general population is continuously exposed to phthalates via various consumer products. Epidemiological research relating phthalate exposure to thyroid function during non-developmental periods is limited. This study aimed to investigate the associations between specific serum phthalate metabolites and indicators of thyroid function in adults. We measured 10 serum phthalate metabolites and thyroid hormones - total triiodothyronine (TT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) - in a subsample of 207 adults from the GraMo cohort. This subsample was made up of men and women (in equal proportions) of middle age (49 ± 17 years) and from Southern Spain (province of Granada). Data on age, sex, body mass index, residence area, tobacco use, alcohol consumption and attained education were obtained from a questionnaire. Phthalate metabolites were log-transformed and categorized into tertiles. Cross-sectional associations of each metabolite with thyroid hormones were analyzed using multivariable-adjusted linear regression models. The mixture effect of metabolite phthalates was assessed using weighted quantile sum regression. After multivariable-adjustment, the following phthalate metabolites were significantly associated with TT3 in a dose-response manner: MMP (β = 0.90: 95% confidence interval 0.68,1.12), MEP (β = 0.67: 0.44, 0.90), MiBP (β = 0.49: 0.21, 0.77), MiDP (β = 0.27: 0.03, 0.52), MBzP (β = 0.51: 0.28, 0.73), MEHP (β = -0.59: -0.82, -0.35) and MiNP (β = -0.43: -0.71, -0.14), when comparing highest vs. lowest exposed. The sum of all metabolites was also linked to FT4 levels. No significant associations were observed for TSH except for MiNP. Although phthalate metabolites with different molecular weight showed opposite associations, overall metabolite concentrations seem to associate with increased TT3 and FT4 serum levels. The cross-sectional nature of this analysis limits causal inference.
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Affiliation(s)
- Carolina Donat-Vargas
- IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Francisco Perez-Carrascosa
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Biosanitary Research Institute, ibs.GRANADA, Granada, Spain; Radiation Oncology Department, University Hospital Virgen de las Nieves, Granada, Spain
| | | | - Vicente Mustieles
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Biosanitary Research Institute, ibs.GRANADA, Granada, Spain
| | - Inmaculada Salcedo-Bellido
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Biosanitary Research Institute, ibs.GRANADA, Granada, Spain
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Juan Pedro Arrebola
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; University of Granada, Center for Biomedical Research (CIBM), Granada, Spain.
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25
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Martínez-Martínez MI, Alegre-Martínez A, Cauli O. Prenatal exposure to phthalates and its effects upon cognitive and motor functions: A systematic review. Toxicology 2021; 463:152980. [PMID: 34624397 DOI: 10.1016/j.tox.2021.152980] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 01/15/2023]
Abstract
Phthalates are chemicals widely used in packaging and consumer products, which have been shown to interfere with normal hormonal function and development in some human and animal studies. In recent decades, pregnant women's exposure to phthalates has been shown to alter the cognitive outcomes of their babies, and some studies have found delays in motor development. METHODS electronic databases including PubMed/MEDLINE and Scopus were searched from their inception to March 2021, using the keywords "phthalate", "cognitive" and "motor". RESULTS most studies find statistically significant inverse relationships between maternal urinary phthalate concentration during pregnancy and subsequent outcomes in children's cognitive and motor scales, especially in boys rather than girls. However, many associations are not significant, and there were even positive associations, especially in the third trimester. CONCLUSION the relationship between exposure to phthalates during pregnancy and low results on neurocognitive scales is sufficiently clear to adopt policies to reduce exposure. Further studies are needed to analyze sex differences, coordination and motor scales, and phthalate levels during breastfeeding.
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Affiliation(s)
- María Isabel Martínez-Martínez
- Department of Nursing, University of Valencia, Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, Valencia, Spain
| | - Antoni Alegre-Martínez
- Department of Biomedical Sciences, CEU Cardinal Herrera University. Avenida Seminario, s/n, 46113 Montcada, Valencia, Spain
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, Valencia, Spain.
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26
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Huang PC, Kuo PL, Chang WH, Shih SF, Chang WT, Lee CC. Prenatal Phthalates Exposure and Cord Thyroid Hormones: A Birth Cohort Study in Southern Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084323. [PMID: 33921744 PMCID: PMC8074059 DOI: 10.3390/ijerph18084323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The regulation of thyroid hormones in the early stages of gestation plays a crucial role in the outcome of a pregnancy. Furthermore, thyroid hormones are fundamental for the fetal development of all organs, including endocrine hormone changes in uterus. Endocrine disrupting chemicals have been shown to have an effect on thyroid hormone homeostasis in newborns, which affects their later development. Few studies have proposed how phthalates could alter thyroid function through several mechanisms and the possible effects on thyroid hormone homeostasis of phthalates on pregnant women. However, the effects of cord blood phthalates and prenatal phthalate exposure on thyroid hormones in newborns remain unclear. OBJECTIVES We aim to follow up on our previous established subjects and determine the correlation between phthalate exposure and thyroid hormones in pregnant women and newborns. MATERIALS AND METHODS We recruited 61 pregnant women from the Obstetrics and Gynecology Department of a medical hospital in southern Taiwan and followed up. High performance liquid chromatography electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) was used to analyze urine samples for five phthalate metabolites. Serum levels of thyroid hormones were analyzed using electrochemoluminescence immunoassay (ECLIA) method. We used Spearman and Pearson correlation coefficients to evaluate the correlation between each phthalate metabolites in serum and the thyroid hormone levels in fetus and parturient. Finally, multiple logistic regression was used to explore the relationship between hormones and their corresponding phthalate metabolites in cord blood. RESULTS High MBP in cord blood was correlated with negative cord serum TSH in newborns (r = -0.25, p < 0.06). By using multiple linear regression after adjusting for potential confounders (gestational and maternal age), cord serum MBP levels showed a negative association with cord serum TSH (β = 0.217, p < 0.05), cord serum T4 (β = 1.71, p < 0.05) and cord serum T4 × TSH (β = 42.8, p < 0.05), respectively. CONCLUSION We found that levels of cord serum TSH and T4 in newborns was significantly negatively associated with cord serum MBP levels after adjusting for significant covariate. The fall in TSH in newborns may potentially be delaying their development.
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Affiliation(s)
- Po-Chin Huang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 350, Taiwan; (P.-C.H.); (W.-T.C.)
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 406040, Taiwan
| | - Pao-Lin Kuo
- Department of Obstetrics and Gynecology, Medical College, National Cheng Kung University, Tainan 701, Taiwan;
| | - Wei-Hsiang Chang
- Department of Food Safety/Hygiene and Risk Management, National Cheng Kung University, Tainan 701, Taiwan;
- Research Center of Environmental Trace Toxic Substances, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Shu-Fang Shih
- Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | - Wan-Ting Chang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 350, Taiwan; (P.-C.H.); (W.-T.C.)
| | - Ching-Chang Lee
- Research Center of Environmental Trace Toxic Substances, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Environmental and Occupational Health, Medical College, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: ; Tel.: +886-6-274-4412
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Day DB, Collett BR, Barrett ES, Bush NR, Swan SH, Nguyen RHN, Szpiro AA, Sathyanarayana S. Phthalate mixtures in pregnancy, autistic traits, and adverse childhood behavioral outcomes. ENVIRONMENT INTERNATIONAL 2021; 147:106330. [PMID: 33418196 PMCID: PMC9291724 DOI: 10.1016/j.envint.2020.106330] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/28/2020] [Accepted: 12/07/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Prenatal exposure to multiple phthalates is ubiquitous, and yet few studies have evaluated these exposures as a mixture in relation to child autistic traits and behavioral problems. OBJECTIVES To assess cumulative associations between prenatal phthalate mixtures and child behaviors, including effect modification by exposure timing and child sex. METHODS Analyses included 501 mother/child pairs from the multicenter pregnancy cohort The Infant Development and Environment Study (TIDES). Nine maternal urinary phthalate metabolites were measured in early and late pregnancy, and behavior was assessed at ages 4-5 years using composite T scores for the Behavioral Assessment System for Children (BASC-2), which measures several dimensions of child behavior, and the Social Responsiveness Scale (SRS-2), which measures social impairment consistent with autistic traits. We utilized weighted quantile sum (WQS) regressions to examine pregnancy period-specific associations between phthalate mixtures and behavioral outcomes. Full-sample 95% WQS confidence intervals are known to be anti-conservative, so we calculated a confirmatory p-value using a permutation test. Effect modification by sex was examined with stratified analyses. RESULTS A one-quintile increase in the early pregnancy phthalate mixture was associated with increased SRS-2 total score (coefficient = 1.0, confirmatory p = 0.01) and worse adaptive skills (coefficient = -1.0, confirmatory p = 0.06) in both sexes. In sex-stratified analyses, the early pregnancy phthalate mixture was associated with increased SRS-2 total score in boys (coefficient = 1.2, confirmatory p = 0.04) and girls (coefficient = 1.0, confirmatory p = 0.10) and worse BASC-2 adaptive skills score in girls (coefficient = -1.5, confirmatory p = 0.06), while the late pregnancy phthalate mixture was associated with increased BASC-2 externalizing score in boys (coefficient = 1.3, confirmatory p = 0.03). CONCLUSION Our results suggest cumulative adverse associations between prenatal phthalate mixtures and multiple facets of childhood behavior.
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Affiliation(s)
- Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA.
| | - Brent R Collett
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA.
| | - Emily S Barrett
- Department of Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, 170 Frelinghuysen Road, Piscataway, NJ 08854, USA.
| | - Nicole R Bush
- Center for Health and Community, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, Department of Pediatrics, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 E. 102nd Street, CAM Building, 3 West, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, MN 55455, USA.
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, 1705 Northeast Pacific Street, Seattle, WA 98195, USA.
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA; Department of Pediatrics, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA.
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