Association between Pregnancy Loss and Urinary Phthalate Levels around the Time of Conception

Abstract

Background: Animal studies indicate that some phthalate metabolites may harm female reproductive function.Objectives: We assessed the associations between exposure to phthalate metabolites and pregnancy loss.Methods: Using a previously established cohort of couples planning their first pregnancy, we analyzed four primary and two oxidized secondary phthalate metabolites in urine samples collected on day 10 after the first day of the last menstrual period before conception occurred (n = 128) and during the previous cycle (if any, n = 111). Subclinical embryonal loss was identified by repeated measurement of urinary human chorionic gonadotropin, and information on clinical spontaneous abortions was obtained by telephone interview with the mother.Results: Pregnancy loss (n = 48) was increased among women with urinary concentration of monoethylhexyl phthalate (MEHP) in the upper tertile in the conception sample compared with women in the lowest tertile [adjusted odds ratio (OR) = 2.9; 95% confidence interval (CI): 1.1, 7.6]. The corresponding OR for subclinical embryonal loss (n = 32) was 40.7 (95% CI: 4.5, 369.5).Conclusions: The phthalate metabolite MEHP was associated with higher occurrence of pregnancy loss. Because this is the first human study to show this association and the sample size is small, the findings need to be corroborated in independent studies.

Parental contributions to early embryo development: influences of urinary phthalate and phthalate alternatives among couples undergoing IVF treatment

“…Similar to other EDCs, phthalates display antiandrogenic properties (Chauvigne et al, 2009;Clewell et al, 2010Clewell et al, , 2013. In addition, both male and female preconception phthalate exposure has been associated with a range of adverse pregnancy and birth outcomes (Toft et al, 2012;Buck Louis et al, 2014;Bae et al, 2015;Smarr et al, 2015). The recent rise in the use of replacement phthalates and phthalate alternative compounds is a developing public health concern.…”

Research progress of phthalates' endocrine disrupting properties on humans and their usage in the consumer products

“…Exposure to PAEs in women was associated with pre-mature thelarche (96.5 ± 134.0 ng L −1 ), pregnancy loss (MEHP, 377.6 ng mL −1 ; MBP, 255.1 ng mL −1 ) and other disorders such as smaller pre-ovulatory folli-cles, anovulation or delayed ovulation, longer estrous cycle, decreased synthesis of estradiol, decreased serum progesterone and increased serum follicle-stimulating hormone (FSH) [24,25]. Phthalic acid esters (PAEs) can elicit cellular estrogenic responses and suppress calcium signaling [26][27][28].This is concerning for public health because PAEs were used extensively in a wide variety of commonly used items, such as perfumes, nail polish, whitening products and other cosmetics, resulting in ubiquitous human exposure.…”

Effects of Endocrine-disrupting Chemicals on Female Reproductive Health

“…In humans, in utero DEHP exposures were associated with shorter pregnancy duration [218] and a shortened anogenital distance (AGD) and index in boys [219,220]. Increased incidences of miscarriage were reported in women occupationally exposure to high dose of phthalates [221]. Danish girls with high urinary concentration of phthalate metabolites, including DEHP show delayed puberty [222].…”