First-Trimester Urinary Bisphenol A Concentration in Relation to Anogenital Distance, an Androgen-Sensitive Measure of Reproductive Development, in Infant Girls

Barrett, Emily S.; Sathyanarayana, Sheela; Mbowe, Omar; Thurston, Sally W.; Redmon, J. Bruce; Nguyen, Ruby H.N.; Swan, Shanna H.

doi:10.1289/ehp875

Cited by 50 publications

(16 citation statements)

References 82 publications

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“…Second, prenatal exposure to bisphenol A (BPA), an estrogenic chemical acquired in the diet, leads to shorter AGD in female rats [ 89 ], and is associated with earlier first estrus and the generation of endometriosis-like lesions in mice [ 90–92 ]. In humans, prenatal BPA leads to shorter AGD in female offspring, when exposure occurs during the first trimester [ 93 ].…”

Section: Mechanismsmentioning

confidence: 99%

The evolutionary biology of endometriosis

Dinsdale

Nepomnaschy

Crespi

2021

Evolution, Medicine, and Public Health

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We provide the first analysis and synthesis of the evolutionary and mechanistic bases for risk of endometriosis in humans, structured around Niko Tinbergen's four questions about phenotypes: phylogenetic history, development, mechanism, and adaptive significance. Endometriosis, which is characterized by the proliferation of endometrial tissue outside of the uterus, has its phylogenetic roots in the evolution of three causally-linked traits: (1) highly-invasive placentation, (2) spontaneous rather than implantation-driven endometrial decidualization, and (3) frequent extensive estrogen-driven endometrial proliferation and inflammation, followed by heavy menstrual bleeding. Endometriosis is potentiated by these traits, and appears to be driven, proximately, by relatively low levels of prenatal and postnatal testosterone. Testosterone affects the developing HPO (hypothalamic-pituitary-ovarian) axis and at low levels it can result in an altered trajectory of reproductive and physiological phenotypes that in extreme cases can mediate the symptoms of endometriosis. Polycystic ovary syndrome, by contrast, is known from previous work to be caused primarily by high prenatal and postnatal testosterone, and it demonstrates a set of phenotypes opposite to those found in endometriosis. The hypothesis that endometriosis risk is driven by low prenatal testosterone, and involves extreme expression of some reproductive phenotypes, is supported by a suite of evidence from genetics, development, endocrinology, morphology and life history. The hypothesis also provides insights into why these two diametric, fitness-reducing disorders are maintained at such high frequencies in human populations. Finally, the hypotheses described and evaluated here lead to numerous testable predictions, and have direct implications for the treatment and study of endometriosis.

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Section: Mechanismsmentioning

confidence: 99%

The evolutionary biology of endometriosis

Dinsdale

Nepomnaschy

Crespi

2021

Evolution, Medicine, and Public Health

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“…The effects of environmental endocrine disrupting chemicals on the developing genitalia in newborn females have been observed. Shorter ano-genital distances (AGD) were documented in infants of mothers with high bisphenol A in early trimester [20] while longer AGD was reported in those with maternal polycystic ovarian syndrome (PCOS) [21]. Therefore, the evaluation for abnormal clitoral sizes and AGD in the newborn requires detailed maternal history.…”

Section: Discussionmentioning

confidence: 99%

Clitoral sizes and anogenital distances in term newborns in Nigeria

Adekoya

Fetuga

Jarrett

et al. 2019

Int J Pediatr Endocrinol

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BackgroundPrevious studies suggest significant ethnic and racial differences in clitoral sizes and anogenital distances in the newborn. This study aimed to document normative data on clitoral sizes and anogenital distances of apparently normal term female infants in Sagamu.MethodsThe study was a multi-center, cross-sectional descriptive research carried out among 317 female term infants within the first 72 h of life. Interviewer-based questionnaire was applied to obtain sociodemographic data, pregnancy and birth history. A sliding digital caliper was used for measurement. Data analysis was with SPSS version 20.0.ResultsThe mean clitoral length was 6.7 ± 1.6 mm while the mean clitoral width was 5.6 ± 0.8 mm. The mean fourchette-clitoris distance, anus-clitoris distance and anus-fourchette distance were 21.9 ± 2.1 mm, 35.5 ± 2.5 mm and 17.0 ± 2.6 mm respectively. The anus-clitoris and anus-fourchette distances significantly correlated with the anthropometric parameters while the clitoral measurements did not.ConclusionThe mean values recorded in this study were higher than observed in most previous studies. This simple, affordable and non-invasive evaluation could aid early diagnosis and treatment of female infants with potentially harmful conditions such as congenital adrenal hyperplasia.

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“…In mammals, AGD is longer in males and reflects in utero masculinization. Endocrine-disrupting chemicals such as polybrominated diphenyl ethers, phthalates, polychlorinated biphenyls, and bisphenol A have been linked to shorter AGD in male children [ 28 , 32 , 33 , 34 , 35 , 36 , 37 ]. Furthermore, AGD may be a biomarker of hyperandrogenemia in women [ 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

Prenatal Exposure to Cigarette Smoke and Anogenital Distance at 4 Years in the INMA-Asturias Cohort

García-Villarino

Fernández-Iglesias

Riaño‐Galán

et al. 2021

IJERPH

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Smoking by women is associated with adverse pregnancy outcomes such as spontaneous abortion, preterm delivery, low birth weight, infertility, and prolonged time to pregnancy. Anogenital distance (AGD) is a sensitive biomarker of prenatal androgen and antiandrogen exposure. We investigated the effect of smoking and passive smoke exposure during pregnancy on anogenital distance in offspring at 4 years in the INMA-Asturias cohort (Spain). Women were interviewed during pregnancy to collect information on tobacco consumption, and anogenital distance was measured in 381 children: anoscrotal distance in boys and anofourchetal distance in girls. We also measured maternal urinary cotinine levels at 32 weeks of pregnancy. We constructed linear regression models to analyze the association between prenatal smoke exposure and anogenital distance and adjusted the models by relevant covariates. Reported prenatal smoke exposure was associated with statistically significant increased anogenital index (AGI), both at week 12 of pregnancy (β = 0.31, 95% confidence interval: 0.00, 0.63) and at week 32 of pregnancy (β = 0.31, 95% confidence interval: 0.00, 0.63) in male children, suggesting altered androgenic signaling.

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First-Trimester Urinary Bisphenol A Concentration in Relation to Anogenital Distance, an Androgen-Sensitive Measure of Reproductive Development, in Infant Girls

Cited by 50 publications

References 82 publications

The evolutionary biology of endometriosis

The evolutionary biology of endometriosis

Clitoral sizes and anogenital distances in term newborns in Nigeria

Prenatal Exposure to Cigarette Smoke and Anogenital Distance at 4 Years in the INMA-Asturias Cohort

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