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Published on: September 20, 2018
Association between prenatal phthalate exposure and ano-genital indices among offsprings in an Israeli cohort
Itai Gueta1,2,3, Jessica Ross4, Revital Sheinberg4
1The Clinical Pharmacology Unit, Tel-Aviv Medical Center, Tel Aviv, Israel.
Insights
Maternal phthalate exposure in Israel was not linked to offspring anogenital distance (AGD) in females. However, higher phthalate levels were associated with a smaller penile width index in male newborns.
Area of Science:
- Environmental Health
- Reproductive Toxicology
- Pediatric Endocrinology
Background:
- In-utero phthalate exposure is linked to shortened anogenital distance (AGD) in males, but female associations are inconsistent.
- Phthalate exposure is common among pregnant women in Israel, yet its effect on offspring AGD remains unstudied.
- This study investigated maternal urinary phthalate concentrations and their association with offspring AGD in an Israeli birth cohort.
Purpose of the Study:
- To examine the relationship between maternal urinary phthalate levels and offspring anogenital distance (AGD) at birth.
- To determine if specific phthalate metabolites correlate with AGD measurements in newborns.
- To assess potential sex-specific effects of in-utero phthalate exposure on AGD.
Main Methods:
- Urinary phthalate metabolites (MBP, MBzP, MECPP, MEHHP, MEOHP) were measured in 193 mothers at delivery.
- Newborns' birth weight, length, and AGD were measured and adjusted for weight (ano-genital index).
- Univariate and multivariate regression analyses controlled for confounders to assess phthalate-AGD associations.
Main Results:
- No significant association was found between maternal urinary phthalates and female offspring AGD.
- Higher urinary monobenzyl phthalate (MBzP) concentrations correlated with increased ano-fourchetteal index (AFI) and ano-clitoral index (ACI) in univariate analysis.
- Total urinary phthalates were inversely associated with penile width index (PWI) in males, and this remained significant after multivariate regression.
Conclusions:
- Maternal urinary phthalate concentrations at delivery were not associated with female offspring AGD.
- Total urinary phthalate levels showed an inverse association with penile width in male newborns.
- Further research is needed to clarify the impact of phthalates on male genital development.
Background:
In-utero phthalate exposure was shown to be associated with shortened anogenital distance (AGD) in male newborns, but findings among female are inconsistent. While phthalate exposure among pregnant women in Israel is widespread, no study has examined the association with offspring AGD. The objective of the current study was to investigate the association between maternal phthalates urinary concentration and offspring AGD at time of delivery among a birth cohort in Israel.
Methods:
We measured spot urinary concentration of monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP), mono-2-ethyl-5-hydroxyhexylphthalate (MEHHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP) among women presenting to the delivery room at Shamir Medical Center in Israel. Birthweight, length and AGD were measured in all newborns using a standardized protocol. Each AGD measurement was adjusted to weight (ano-genital index). Confounders included socio-demographic characteristics, comorbidities and obstetrical history. Univariate and multivariate analyses assessed the associations between phthalates, confounders and AGD.
Results:
Overall, 193 mother and infant were analyzed. All newborns were born at term and had normal Apgar scores. Mean maternal age was 32 ± 4.7 years old. Mean birth weight and pregnancy week were 3183 ± 498 g and 39 ± 1.3, respectively. Median (IQR) urinary phthalate concentration adjusted to creatinine (ug/g) were 3.96 (2.2-6.6), 1.22 (0.7-2), 10.84 (7-20.4), 6.36 (3.3-11.2) and 0.64 (0.4-1.1) for MBP, MBzP, MECPP, MEHHP and MEOHP, respectively. Univariate comparison showed a significant association between higher than median MBzP concentration, higher Ano-Fourchetal index (AFI: 4.4 vs. 4.1, p = 0.037) and Ano-clitoral index (ACI: 11.5 vs. 10.4, p = 0.032) in infants. Total urinary phthalates concentration ≥26.25 μg/g was significantly associated with smaller penile width index (3.5 vs. 3.7, p = 0.022), higher ACI (11.6 vs. 10.3, p = 0.013) and a trend towards significance for higher AFI (4.3 vs. 4.1, p = 0.055). Following multivariate linear regression only PWI remained significantly associated with total phthalate urinary concentration.
Conclusions:
Maternal urinary phthalates concentration at delivery were not associated with female AGD, but total urinary phthalate concentration were inversely associated with penile width.
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