Cumulative risk assessment of phthalates associated with birth outcomes in pregnant Chinese women: A prospective cohort study. Gao, H., Xu, Y. y. Y. q., Huang, K., Ge, X., Zhang, Y. w., Yao, H. y., Xu, Y. y. Y. q., Yan, S. q., Jin, Z. x., Sheng, J., Zhu, P., Hao, J. h., & Tao, F. b. Environmental pollution (Barking, Essex : 1987), 222:549–556, 2017. Publisher: Environ Pollut
Cumulative risk assessment of phthalates associated with birth outcomes in pregnant Chinese women: A prospective cohort study [link]Paper  doi  abstract   bibtex   
A prospective cohort study of a Chinese population of mother–neonate pairs (n = 3103) was conducted to investigate the relationship between the cumulative hazard index (HI) of combined diethyl phthalate (DEP), dibutyl phthalate (DBP), dibenzyl phthalate (BBzP) and di(2-ethylhexyl) phthalate (DEHP) exposure and birth outcomes. The estimated HI for phthalates was based on phthalate metabolite concentrations in urine collected between 5th and 14th gestational weeks. The median HI values according to the European Food Safety Authority tolerable daily intake (HITDI) and U.S. Environmental Protection Agency reference dose (HIRfD) were 0.358 and 0.187, respectively. A total of 16.3% and 1.9% of the women exhibited HITDIand HIRfDexceeding the value of one, respectively. In unadjusted models, the categories (low \textless P25, median P25–P50, high \textgreater P75) of HITDIwere associated with decreased birth weight (β = −26.34 g, p = 0.021) and head circumference (β = −0.09 cm, p = 0.029), whereas those for HIRfDwere negatively associated with birth weight (β = −31.74 g, p = 0.005), birth length (β = −0.11 cm, p = 0.032), head circumference (β = −0.13 cm, p = 0.003) and chest circumference (β = −0.10 cm, p = 0.021) in all neonates. Adjustment for potential confounders revealed that HIRfDwas inversely associated with head circumference (β = −0.10 cm, p = 0.020). Stratification by gender indicated that HIRfDwas associated with decreased birth length (β = −0.17 cm, p = 0.041) in infant boys and HITDIwas associated with decreased birth weight (β = −33.12 g, p = 0.036) and head circumference (β = −0.13 cm, p = 0.027) in girls. This is the first study on the cumulative risk assessment of phthalate exposures in pregnant Chinese women. We found that the HI values of multiple phthalate co-exposure were sex-specifically related to birth outcomes.
@article{gao_cumulative_2017,
	title = {Cumulative risk assessment of phthalates associated with birth outcomes in pregnant {Chinese} women: {A} prospective cohort study},
	volume = {222},
	issn = {1873-6424},
	url = {https://pubmed.ncbi.nlm.nih.gov/28024814/},
	doi = {10.1016/J.ENVPOL.2016.11.026},
	abstract = {A prospective cohort study of a Chinese population of mother–neonate pairs (n = 3103) was conducted to investigate the relationship between the cumulative hazard index (HI) of combined diethyl phthalate (DEP), dibutyl phthalate (DBP), dibenzyl phthalate (BBzP) and di(2-ethylhexyl) phthalate (DEHP) exposure and birth outcomes. The estimated HI for phthalates was based on phthalate metabolite concentrations in urine collected between 5th and 14th gestational weeks. The median HI values according to the European Food Safety Authority tolerable daily intake (HITDI) and U.S. Environmental Protection Agency reference dose (HIRfD) were 0.358 and 0.187, respectively. A total of 16.3\% and 1.9\% of the women exhibited HITDIand HIRfDexceeding the value of one, respectively. In unadjusted models, the categories (low {\textless} P25, median P25–P50, high {\textgreater} P75) of HITDIwere associated with decreased birth weight (β = −26.34 g, p = 0.021) and head circumference (β = −0.09 cm, p = 0.029), whereas those for HIRfDwere negatively associated with birth weight (β = −31.74 g, p = 0.005), birth length (β = −0.11 cm, p = 0.032), head circumference (β = −0.13 cm, p = 0.003) and chest circumference (β = −0.10 cm, p = 0.021) in all neonates. Adjustment for potential confounders revealed that HIRfDwas inversely associated with head circumference (β = −0.10 cm, p = 0.020). Stratification by gender indicated that HIRfDwas associated with decreased birth length (β = −0.17 cm, p = 0.041) in infant boys and HITDIwas associated with decreased birth weight (β = −33.12 g, p = 0.036) and head circumference (β = −0.13 cm, p = 0.027) in girls. This is the first study on the cumulative risk assessment of phthalate exposures in pregnant Chinese women. We found that the HI values of multiple phthalate co-exposure were sex-specifically related to birth outcomes.},
	urldate = {2021-12-16},
	journal = {Environmental pollution (Barking, Essex : 1987)},
	author = {Gao, Hui and Xu, Yuan yuan Ye qing and Huang, Kun and Ge, Xing and Zhang, Yun wei and Yao, Hui yuan and Xu, Yuan yuan Ye qing and Yan, Shuang qin and Jin, Zhong xiu and Sheng, Jie and Zhu, Peng and Hao, Jia hu and Tao, Fang biao},
	year = {2017},
	pmid = {28024814},
	note = {Publisher: Environ Pollut},
	keywords = {Adult, Asians, Birth Weight, Body Size, Environmental Exposure, Environmental Pollutants / metabolism, Environmental Pollutants / toxicity*, Fang-Biao Tao, Female, Gestational Age, Hui Gao, Humans, Infant, MEDLINE, Male, NCBI, NIH, NLM, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, Newborn, No-Observed-Adverse-Effect Level, Phthalic Acids / metabolism, Phthalic Acids / toxicity*, Pregnancy, Pregnancy Outcome*, Prospective Studies, PubMed Abstract, Risk Assessment, Yuan-Yuan Xu, doi:10.1016/j.envpol.2016.11.026, pmid:28024814},
	pages = {549--556},
}

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