BACKGROUND Phthalates and bisphenol A (BPA) are environmental contaminants that may affect early embryonic development. OBJECTIVE To assess the association between phthalate metabolites and BPA with early pregnancy endpoints in a cohort of women followed from before conception. METHODS We quantified 11 phthalate metabolites and BPA in 137 conception cycles from naturally conceived clinical pregnancies. Phthalate metabolites and BPA concentrations were measured in a pooled sample of three daily morning urine specimens. Daily urinary hormone measurements had previously been used to define ovulation, implantation, and corpus luteum rescue. We assessed associations between conception cycle exposures (phthalate biomarkers and BPA) and 1) time from ovulation to implantation; 2) type of corpus luteum rescue (timing and pattern of rise in progesterone: early, late, or no rise); and 3) rate of initial rise in hCG. RESULTS Mono(3-carboxypropyl) phthalate (MCPP) and mono-isobutyl phthalate (MiBP) were associated with earlier implantation (6-8 days vs. 9 days (the most commonly observed); per natural log-unit, OR (95% CI) = 2.8 (1.2, 6.7) and OR (CI) = 2.1 (1.2, 3.7), respectively). Monoethyl phthalate (MEP) was associated with later implantation (10-12 days vs. 9 days); OR (CI) = 1.5 (1.0, 2.1). Compared with implantation on day 9, BPA was significantly associated with both earlier and later implantation (OR=2.2 for both). Women with concentrations above the median of monobenzyl phthalate (MBzP) (p = 0.04) or above the median of the molar sum of four di(2-ethylhexyl) phthalate metabolites (∑DEHP) (p = 0.08) had a slower initial rise in hCG. Increasing MCPP was associated with an increased odds of a late rise rescue (OR (CI) = 2.9 (1.0, 8.5); late rise vs. early rise), while increasing MEP was associated with a no rise rescue (OR (CI) = 1.6 (0.9, 2.8); no rise vs. early rise). CONCLUSIONS The reported associations varied in their direction of effect, some potentially protective, others adverse. This may reflect the complexity with which these potential endocrine disrupting chemicals can be acting, but chance findings are also possible. Given that women continue to be exposed to these compounds (or their precursors), continued research on the effects they may have on pregnancy is warranted.

中文翻译：

---

尿中邻苯二甲酸酯代谢物和双酚A的浓度与妊娠早期终点的关系。

背景技术邻苯二甲酸盐和双酚A（BPA）是可能影响早期胚胎发育的环境污染物。目的评估一组妇女从受孕前开始的邻苯二甲酸酯代谢物和双酚A与妊娠早期终点的关系。方法我们在137个受孕周期中从自然怀孕的临床妊娠中定量了11种邻苯二甲酸酯代谢物和BPA。在三个每日早晨尿液样本的合并样本中测量邻苯二甲酸酯代谢物和BPA浓度。以前已经使用每日尿激素测量来定义排卵，着床和黄体拯救。我们评估了受孕周期暴露（邻苯二甲酸酯生物标志物和BPA）与1）从排卵到着床的时间之间的关联；2）黄体拯救的类型（孕酮升高的时机和方式：早，晚或没有上升）；3）hCG的初始上升率。结果邻苯二甲酸单（3-羧丙基）酯（MCPP）和邻苯二甲酸单异丁酯（MiBP）与早期植入有关（6-8天比9天（最常见））；每个自然对数单位或（95％） CI）= 2.8（1.2，6.7）和OR（CI）= 2.1（1.2，3.7）。邻苯二甲酸单乙酯（MEP）与后期植入有关（10-12天vs. 9天）；或（CI）= 1.5（1.0，2.1）。与第9天植入相比，BPA与早期植入和晚期植入均显着相关（两者的OR = 2.2）。浓度高于邻苯二甲酸单苄酯（MBzP）中位数（p = 0.04）或高于四种邻苯二甲酸二（2-乙基己基）酯代谢物（∑DEHP）摩尔总和（p = 0.08）的女性。 hCG。MCPP的增加与后期上升救助的机率增加（OR（CI）= 2.9（1.0，8.5）；后期上升与早期上升的机率）相关，而MEP的增加与无上升救助的机率（OR（CI）= 1.6（0.9，2.8）；无上升vs.上升。结论所报道的关联在其作用方向上有所不同，有些可能具有保护作用，有些则不利。这可能反映出这些潜在的破坏内分泌的化学物质发挥作用的复杂性，但偶然发现也是可能的。鉴于妇女继续接触这些化合物（或其前体），因此有必要继续研究其对怀孕的影响。结论所报道的关联在其作用方向上有所不同，有些可能具有保护作用，有些则不利。这可能反映出这些潜在的破坏内分泌的化学物质发挥作用的复杂性，但偶然发现也是可能的。鉴于妇女继续接触这些化合物（或其前体），因此有必要继续研究其对怀孕的影响。结论所报道的关联在其作用方向上有所不同，有些具有潜在的保护作用，有些则不利。这可能反映出这些潜在的破坏内分泌的化学物质发挥作用的复杂性，但偶然发现也是可能的。鉴于妇女继续接触这些化合物（或其前体），因此有必要继续研究其对怀孕的影响。