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Urinary concentrations of phthalate metabolites during gestation and intrahepatic cholestasis of pregnancy: a population-based birth cohort study

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Abstract

Phthalates, a class of widely used endocrine-disrupting chemicals (EDCs), are toxic to various organ systems in animals and humans. Intrahepatic cholestasis of pregnancy (ICP) is a reversible liver dysfunction causing cholestasis in late pregnancy. Evidence on the associations between exposure to phthalates and ICP is still lacking. In the present study, we investigated the relationships between urinary concentrations of phthalate metabolites and the risk of ICP in a Chinese population-based birth cohort. Pregnant women participated in the Ma’anshan Birth Cohort (MABC) study in China. Seven phthalate metabolites were detected in a urine sample in early pregnancy. Chemical concentrations were grouped by quartiles, and associations with outcomes were examined using logistic regression with adjustment for urine creatinine, race, education, poverty status, smoking status, alcohol consumption, maternal age, prepregnancy body mass index (BMI), parity, twin pregnancy, and pregnancy-related liver complications. Of 3474 women recruited into the Ma’anshan Birth Cohort, 2760 met the inclusion criteria and contributed to further analysis and biomonitoring data. Elevated odds ratios (ORs) of ICP were observed in the highest quartiles of monomethyl phthalate (MMP) exposure (OR = 1.59, 95% confidence intervals (CI) = 1.01–2.51) and monobutyl phthalate (MBP) exposure (OR = 1.82, 95% CI = 1.16–2.85) in the adjusted analyses. Our findings add to the evidence that supports the role of maternal phthalate exposure in the first trimester of gestation as a risk factor for ICP.

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Abbreviations

EDCs:

Endocrine-disrupting chemicals

ICP:

Intrahepatic cholestasis of pregnancy

MABC:

Ma’anshan Birth Cohort study

MMP:

Monomethyl phthalate

MEP:

Monoethyl phthalate

MBP:

Mono-n-butyl phthalate

MBzP:

Monobenzyl phthalate

MEHP:

Mono (2-ethylhexyl) phthalate

MEHHP:

Mono (2-ethyl-5-hydroxyl) phthalate

MEOHP:

Mono (2-ethyl-5-oxohexyl) phthalate

LOD:

Limits of detection

BMI:

Body mass index

PVC:

Polyvinylchloride

DEHP:

Di (2-ethylhexyl) phthalate

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Acknowledgments

The work was supported by the National Natural Science Foundation of China (No. 81330068), the China Postdoctoral Science Foundation funded project (2016M592041), and the Postdoctoral Science Foundation funded project of Anhui Province (2016B114). The authors would like to thank the pregnant women who participated in the study, as well as the doctors, nurses and other staff who supported the study.

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Authors and Affiliations

  1. Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Jian-Qing Wang, Hui Gao, Kun Huang, Yun-Wei Zhang, Lei-Jing Mao, Shan-Shan Zhou & Fang-Biao Tao

  2. MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Jian-Qing Wang, Jie Sheng, Xing-Yong Tao, Kun Huang, Zhong-Xiu Jin & Fang-Biao Tao

  3. NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Jian-Qing Wang, Kun Huang & Fang-Biao Tao

  4. Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Jian-Qing Wang, Jie Sheng, Xing-Yong Tao, Kun Huang, Zhong-Xiu Jin & Fang-Biao Tao

  5. The Fourth Affiliated Hospital, Anhui Medical University, Hefei, 230022, Anhui, China

    Jian-Qing Wang

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  1. Jian-Qing Wang
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  2. Hui Gao
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  3. Jie Sheng
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  10. Fang-Biao Tao
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Correspondence to Fang-Biao Tao.

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All participants were fully informed prior to participating in the study, and the study was ethically approved by the Anhui Medical University (number: 20131195) based on the institution’s ethical standards and the ethical standards of the Declaration of Helsinki.

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Wang, JQ., Gao, H., Sheng, J. et al. Urinary concentrations of phthalate metabolites during gestation and intrahepatic cholestasis of pregnancy: a population-based birth cohort study. Environ Sci Pollut Res 27, 11714–11723 (2020). https://doi.org/10.1007/s11356-020-07675-x

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