Abstract

Background:

Prenatal phthalate exposure has been associated with lower birth weight but also higher weight in childhood. Few studies have examined weight or adiposity from birth to childhood and thus cannot assess growth trajectories associated with exposure.

Objective:

We assessed associations between maternal phthalate exposures in pregnancy and child weight and adiposity measured prenatally through childhood (3–6 years of age).

Methods:

Within The Infant Development and the Environment Study (TIDES), a prospective pregnancy cohort, we analyzed a panel of phthalate metabolites in urine collected at two visits from early and late gestation ($N=780$). We estimated average phthalate metabolite associations with child weight $z$-scores from $\sim 20\mathrm{wk}$ gestation (estimated by ultrasound), birth, and 1, 3, 4, and 6 years of age using linear mixed-effects (LME) models. We also modeled associations with adiposity $z$-scores from birth (weight for length) and 1, 3, 4, and 6 years of age [body mass index (BMI)] using LME models.

Results:

For weight, we observed inverse associations between several phthalate metabolites and birth weight $z$-scores, but no associations were observed with postnatal weight $z$-scores in LME models. Regarding adiposity, we observed inverse associations between phthalate metabolites and weight-for-length $z$-scores at birth, but positive associations were observed with BMI $z$-scores at 3–4 years of age in LME models. For example, mono-ethyl phthalate was associated with a 0.17-unit decrease in birth weight-for-length $z$-score [95% confidence interval (CI): $–0.29$, $–0.05$] and a 0.18-unit increase in 4-years-of-age BMI $z$-score (95% CI: 0.04, 0.32).

Discussion:

We observed associations between prenatal exposure to phthalates and lower weight at birth but not at childhood follow-up visits. However, for adiposity, we observed an interesting pattern of association with low adiposity at delivery as well as high adiposity at 3–4 years of age. Although it is not clear from our results whether these associations occur within the same children, such a pattern of adiposity in early life has been linked to cardiometabolic disease in adulthood and deserves special attention as an outcome in the study of prenatal exposures in the developmental origins of health and disease. https://doi.org/10.1289/EHP10077

中文翻译：

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从子宫内到 6 岁的产前邻苯二甲酸盐暴露与儿童体重和肥胖

摘要

背景：

产前接触邻苯二甲酸盐与较低的出生体重有关，但也与儿童时期较高的体重有关。很少有研究检查从出生到童年的体重或肥胖，因此无法评估与暴露相关的生长轨迹。

客观的：

我们评估了母亲在怀孕期间接触邻苯二甲酸酯与儿童体重和肥胖之间的关联，这些体重和肥胖是从产前到儿童期（3-6 岁）测量的。

方法：

在婴儿发育与环境研究 (TIDES) 中，一项前瞻性妊娠队列研究中，我们分析了在妊娠早期和晚期两次就诊时收集的一组尿液中的邻苯二甲酸酯代谢物（$否=780$). 我们估计了平均邻苯二甲酸酯代谢物与儿童体重的关联$z$-分数来自$～20\mathrm{周}$使用线性混合效应 (LME) 模型的妊娠（通过超声估计）、出生以及 1、3、4 和 6 岁。我们还模拟了与肥胖的关联$z$-使用 LME 模型从出生（身长别体重）和 1、3、4 和 6 岁 [身体质量指数 (BMI)] 得出的分数。

结果：

对于体重，我们观察到几种邻苯二甲酸酯代谢物与出生体重之间存在负相关$z$-分数，但未观察到与出生后体重的关联$z$-LME 模型中的分数。关于肥胖，我们观察到邻苯二甲酸酯代谢物与身长别体重之间存在负相关$z$-出生时得分，但观察到与 BMI 呈正相关$z$-LME 模型中 3-4 岁时的分数。例如，邻苯二甲酸单乙酯与出生身长别体重降低 0.17 个单位有关$z$-得分 [95% 置信区间 (CI)：$–0.29$,$–0.05$] 和 4 岁 BMI 增加 0.18 个单位$z$-得分（95% CI：0.04，0.32）。

讨论：

我们观察到产前接触邻苯二甲酸盐与出生时体重较轻之间的关联，但在儿童随访时没有关联。然而，对于肥胖，我们观察到一种有趣的模式，它与分娩时的低肥胖以及 3-4 岁时的高肥胖有关。虽然从我们的结果中不清楚这些关联是否发生在同一个孩子身上，但生命早期的这种肥胖模式与成年期的心脏代谢疾病有关，作为发育起源的产前暴露研究的结果值得特别关注的健康和疾病。https://doi.org/10.1289/EHP10077