Background

Phthalates are a group of endocrine disrupting chemicals that are heavily used throughout industry in flexible plastic and personal-care products. As a result, detectable levels of their metabolites are readily found in humans. Some studies have shown associations of phthalates with diabetes, but associations with gestational diabetes mellitus (GDM) are less clear.

Objective

To investigate the association of 11 prenatal urinary phthalate metabolites and development of GDM, impaired glucose tolerance (IGT), continuous plasma glucose level, and excessive gestational weight gain (GWG) in a population of pregnant Latina women (N=415) enrolled in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) cohort study.

Methods

Phthalate metabolite levels were measured via mass spectrometry from two urine samples collected in the end of the first and second trimester. Maternal plasma glucose levels, prior diabetes diagnosis, GDM diagnosis, and weight gain were abstracted from medical records. Multiple regression was used to evaluate the association between the average of the two urinary phthalate metabolites levels and maternal metabolic outcomes. In our sensitivity analysis, phthalate levels were categorized by level (as quartiles of exposure) and by timing of urine sample collection (as taken in first and second half of pregnancy).

Results

Consistent with findings from a nationally representative sample, all of the individual phthalate metabolites were detected in majority of mothers. Thirty-one mothers (7.5%) were diagnosed with GDM, 49 mothers (14.7%) displayed IGT, and 223 mothers (55.1%) gained an excessive amount of weight during their pregnancy. MEP concentrations were associated with an increased odds of excessive GWG (OR: 1.1, 95% CI: 1.0 to 1.3). We did not find an association between any phthalate metabolite and any maternal glucose outcome.

Conclusion

Contrary to previous studies, our findings do not support an association of prenatal phthalate levels and increased odds for hyperglycemia, IGT, or GDM. But, we did find an increased odds of excessive GWG, a well-known risk factor for GDM.

中文翻译：

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高危拉丁裔孕妇的产前接触邻苯二甲酸盐和母体代谢结果

背景

邻苯二甲酸盐是一组内分泌干扰化学品，在整个行业中大量用于柔性塑料和个人护理产品。因此，在人体中很容易发现其代谢物的可检测水平。一些研究表明邻苯二甲酸盐与糖尿病有关，但与妊娠期糖尿病 (GDM) 的关系尚不清楚。

客观的

研究 11 种产前尿中邻苯二甲酸酯代谢物与 GDM、葡萄糖耐量降低 (IGT)、持续血浆葡萄糖水平和妊娠期体重过度增加 (GWG) 的关系，该人群为拉丁裔孕妇 (N=415)。萨利纳斯母亲和儿童健康评估中心 (CHAMACOS) 队列研究。

方法

邻苯二甲酸盐代谢物水平是通过质谱法从在妊娠早期和中期末收集的两个尿液样本中测量的。从医疗记录中提取母亲血浆葡萄糖水平、先前的糖尿病诊断、GDM 诊断和体重增加。多元回归用于评估两种尿邻苯二甲酸酯代谢物水平的平均值与母体代谢结果之间的关联。在我们的敏感性分析中，邻苯二甲酸酯水平按水平（作为暴露的四分位数）和尿液样本收集时间（在怀孕的前半期和后半期采集）进行分类。

结果

与来自全国代表性样本的结果一致，在大多数母亲中检测到所有单独的邻苯二甲酸酯代谢物。31 名母亲（7.5%）被诊断出患有 GDM，49 名母亲（14.7%）出现 IGT，223 名母亲（55.1%）在怀孕期间体重增加过多。MEP 浓度与过度 GWG 的几率增加相关（OR：1.1，95% CI：1.0 至 1.3）。我们没有发现任何邻苯二甲酸酯代谢物与任何母体葡萄糖结果之间存在关联。

结论

与之前的研究相反，我们的研究结果不支持产前邻苯二甲酸酯水平与高血糖、IGT 或 GDM 几率增加之间的关联。但是，我们确实发现 GDM 过多的几率增加，这是 GDM 的一个众所周知的风险因素。