Phthalates are the most ubiquitous contaminants that we are exposed to daily due to their wide use as plasticizers in various consumer products. A few studies have suggested that in utero exposure to phthalates can disturb fetal growth and development in humans, because phthalates can interfere with endocrine function. We collected spot urine samples from 291 pregnant women in their first trimester (9.8 ± 2.3 gestational weeks) recruited in an ongoing prospective cohort study in Saudi Arabia. A second urine sample was collected within 1–7 d after enrollment. The aims of this study were to: (1) assess the extent of exposure to phthalates during the first trimester and (2) estimate the risk from single and cumulative exposures to phthalates. Most phthalate metabolites' urinary levels were high, several-fold higher than those reported in relevant studies from other countries. The highest median levels of monoethyl phthalate, mono-n-butyl phthalate (MnBP), mono-iso-butyl phthalate (MiBP), and mono-(2-ethylhexyl) phthalate (MEHP) in μg/l (μg/g creatinine) were 245.62 (197.23), 114.26 (99.45), 39.59 (34.02), and 23.51 (19.92), respectively. The MEHP levels were highest among three di (2-ethylhexyl) phthalate (DEHP) metabolites. %MEHP₄, the ratio of MEHP to four di (2-ethylhexyl) phthalate metabolites (∑₄DEHP), was 44%, indicating interindividual differences in metabolism and excretion. The hazard quotient (HQ) of individual phthalates estimated based on the reference dose (RfD) of the U.S. Environmental Protection Agency indicated that 58% (volume-based) and 37% (creatinine-based) of the women were at risk of exposure to ∑₄DEHP (HQ > 1). Based on the tolerable daily intake (TDI) from the European Food Safety Authority, 35/12% (volume-/creatinine-based data) of the women were at risk of exposure to two dibutyl phthalate (∑DBP) metabolites (MiBP and MnBP). The cumulative risk was assessed using the hazard index (HI), the sum of HQs of all phthalates. The percentages of women (volume-/creatinine-based data) at health risks with an HI > 1 were 64/40% and 42/22% based on RfD and TDI, respectively. In view of these indices for assessing risk, our results for the anti-androgenic effects of exposing pregnant women to ∑₄DEHP and ∑DBP early during pregnancy are alarming.

邻苯二甲酸盐是我们每天都会接触到的最普遍的污染物，因为它们在各种消费产品中被广泛用作增塑剂。一些研究表明，在子宫内接触邻苯二甲酸盐会干扰胎儿的生长发育，因为邻苯二甲酸盐会干扰内分泌功能。在沙特阿拉伯一项正在进行的前瞻性队列研究中，我们收集了291名孕妇在孕早期（9.8±2.3孕周）的尿液样本。入选后1–7 d收集第二份尿液样本。这项研究的目的是：（1）评估在孕早期暴露于邻苯二甲酸盐的程度，以及（2）估算一次和累积暴露于邻苯二甲酸盐的风险。大多数邻苯二甲酸酯代谢物的尿水平很高，比其他国家相关研究报告的几倍。邻苯二甲酸单乙酯，邻苯二甲酸单正丁酯（M n BP），邻苯二甲酸单异丁酯（M iBP）和以μg/ l（μg/ g肌酐）计的邻苯二甲酸单-（2-乙基己基）酯（MEHP）分别为245.62（197.23），114.26（99.45），39.59（34.02）和23.51（19.92）。在三种邻苯二甲酸二（2-乙基己基）酯（DEHP）代谢物中，MEHP含量最高。MEHP ₄与四种邻苯二甲酸二（2-乙基己基）邻苯二甲酸酯代谢物（∑ ₄ DEHP）的比例为％MEHP ₄，为44％，表明个体间在代谢和排泄方面存在差异。根据美国环境保护署的参考剂量（RfD）估算的个别邻苯二甲酸酯的危险度（HQ）表明，有58％（基于体积）和37％（基于肌酸酐）的妇女有暴露于铅的风险。 ∑ ₄DEHP（HQ> 1）。根据欧洲食品安全局的每日容许摄入量（TDI），有35/12％（基于体积/肌酐的数据）的妇女有暴露于两种邻苯二甲酸二丁酯（∑DBP）代谢物的风险（M i BP和M n BP）。使用危害指数（HI），即所有邻苯二甲酸酯的HQ的总和来评估累积风险。基于RfD和TDI，HI> 1的健康风险中的女性百分比（基于体积/肌酐的数据）分别为64/40％和42/22％。鉴于这些评估风险的指标，我们在怀孕早期将孕妇暴露于∑ ₄ DEHP和∑DBP的抗雄激素作用的结果令人震惊。