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Paternal and maternal urinary phthalate metabolite concentrations and birth weight of singletons conceived by

Carmen Messerlian¹, Joseph M Braun², Lidia Mínguez-Alarcón¹

¹Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Environment International

|July 1, 2017

Insights

Paternal exposure to certain phthalates before conception may lower infant birth weight, particularly for in-vitro fertilization (IVF) conceived babies. This highlights the importance of parental preconception health for successful pregnancy outcomes.

Area of Science:

Environmental health
Reproductive toxicology
Perinatal epidemiology

Background:

Prenatal phthalate exposure is inconsistently linked to fetal growth and birth weight.
The impact of paternal and maternal preconception phthalate exposure on birth weight is understudied.

Purpose of the Study:

To investigate associations between paternal/maternal preconception and maternal prenatal phthalate metabolite concentrations and birth weight.
To examine these associations separately for in-vitro fertilization (IVF) and non-IVF conception.

Main Methods:

Prospective cohort study (EARTH Study) of 364 couples.
Measured urinary phthalate metabolites in maternal and paternal preconception and maternal prenatal samples.
Used multivariable linear regression to assess associations with birth weight, adjusting for covariates and by mode of conception.

Main Results:

Paternal preconception urinary sum of di(2-ethylhexyl) phthalate (ΣDEHP) metabolites was associated with a 90g decrease in birth weight for IVF singletons.
No significant association was observed for non-IVF singletons.
Maternal prenatal phthalate associations with birth weight were attenuated after adjusting for paternal phthalates.

Conclusions:

Paternal preconception ΣDEHP metabolite concentration is linked to reduced birth weight in IVF-conceived singletons.
Findings underscore the significance of preconception health, particularly for subfertile couples.
Further research is needed to replicate these findings.

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Abstract

Background:

Prenatal phthalate exposure has been inconsistently associated with fetal growth and infant birth weight. However, the effect of exposure during the paternal and maternal preconception period remains understudied.

Objectives:

To investigate associations of paternal and maternal preconception and maternal prenatal urinary phthalate metabolite concentrations with birth weight.

Methods:

The study comprised 364 singletons born to 364 mothers and 195 fathers (195 couples) from the EARTH Study, a prospective cohort of couples from Boston, MA. Births were categorized by mode of conception: in-vitro fertilization based (IVF) (n=208) or non-IVF based (n=156, intrauterine insemination or non-medically assisted/natural conception). We measured urinary concentrations of eleven phthalate metabolites in maternal (n=1425) and paternal (n=489) preconception and maternal prenatal (n=781) samples. Birth weight was abstracted from delivery records. Covariate-adjusted associations between log_e-phthalate metabolite concentrations and birth weight were evaluated separately by mode of conception using multivariable linear regression.

Results:

Each log_e-unit increase in paternal urinary concentration of the sum of di(2-ethylhexyl) phthalate (ΣDEHP) metabolites was associated with a 90 gram (95% CI: -165, -15) decrease in birth weight among IVF singletons, but not among non-IVF singletons (18g; 95% CI: -76, 113). Additional adjustment for maternal prenatal ΣDEHP concentrations modestly strengthened findings among IVF singletons. While few associations were found with maternal preconception phthalate metabolites, we observed an inverse relationship between several maternal prenatal urinary phthalate metabolite concentrations and birth weight among IVF singletons in covariate-adjusted models. However, with further adjustment for specific paternal phthalate metabolite concentrations, these associations were attenuated and no longer significant.

Conclusions:

Paternal preconception urinary concentration of ΣDEHP metabolites was associated with a decrease in birth weight among IVF-conceived singletons. These results, if replicated, highlight the importance of preconception health, especially among subfertile couples.

Keywords:

Birth weight Maternal exposure Paternal exposure Phthalates Preconception

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