Abstract-Bisphenol A (BPA) has been reported to be associated with adverse health effects, including high blood pressure (BP). BPA is also suspected to cross placenta in pregnancy and might affect children's health. The present study was aimed to evaluate the effect of prenatal exposure to BPA on the BP of the child at the age of 4. We followed up 645 children at the age of 4 who were born from women who participated midterm during their pregnancy in a birth cohort study from August 2008 to July 2011. Because BPA and BP showed nonlinear association, we constructed a piecewise regression model to examine the association between urinary BPA concentration of mother at around 20 weeks of gestation and BP of the child at age 4 and to determine threshold level of BPA for the association. Diastolic BP of the children was positively associated with maternal urinary concentration of BPA above the threshold level measured at around 20 weeks of gestation. For 1 log unit increment of prenatal urinary BPA concentration, diastolic BP was increased by 7.9 mm Hg (SE=2.072; P=0.0001) after adjusting potential confounders. Pulse pressure was decreased by −8.0 mm Hg (SE=2.528; P=0.0015). However, systolic BP was not significantly associated with prenatal BPA concentration. The present study suggests that exposure to BPA during pregnancy is associated with higher diastolic BP of the children above a certain threshold (4.5 μg/g creatinine). intima media thickness of adults were positively associated with childhood BP. 26 In light of this, identifying and avoiding the risk factors of high BP in children may lead to prevention of cardiovascular diseases in adulthood.Based on the previous studies reporting associations between BPA exposure and BP in adults and between prenatal BPA exposure and childhood disease, we hypothesized that prenatal exposure of BPA may increase BP in children. In the present study, we aimed to examine the association between maternal urinary BPA concentration at around 20 weeks of gestation and the BP of 4-year-old children.
MethodThe study protocol was reviewed and approved by the Institutional Review Board at College of Medicine, Seoul National University (1201-010-392), and informed consent was provided by each of the participants. The protocol was in accordance with the declaration of Helsinki and institutional guidelines.
Study DesignEDC study (Environment and Development of Children) is a follow-up study of the CAS (Congenital Anomaly Study), a birth cohort to investigate the association between prenatal environmental exposure and occurrence of congenital anomaly. CAS consisted of pregnant women who received prenatal care at 8 hospitals in Seoul and Incheon metropolitan area, Republic of Korea. A total of 13 484 women were enrolled at around 20 weeks of gestation and 11 085 were followed up until they gave birth, from August 2008 to July 2011. At the time of enrollment of the mothers, blood and urine samples were collected after >8 hours of fasting, and a questionnaire regarding demographics and lifestyl...