Trimester-specific phthalate concentrations and glucose levels among women from a fertility clinic

Abstract

BackgroundSubfertile women are at increased risk of glucose intolerance in pregnancy. Based on epidemiologic studies, exposure to certain phthalates is associated with diabetes, elevated glucose, and increased insulin resistance.ObjectivesTo evaluate the association between urinary phthalate metabolites and pregnancy glucose levels in women seeking medically assisted reproduction.MethodsWe evaluated 245 women participating in a prospective cohort study based at a large fertility clinic who delivered live births and had data on pregnancy urinary phthalate metabolite concentrations and blood glucose levels. Urinary phthalate metabolite concentrations were from single spot urine samples collected in 1st and 2nd trimesters. Blood glucose data was abstracted from medical records for non-fasting 50-g glucose challenge tests at 24–28 weeks gestation. Multivariable linear regression models were used to evaluate associations between 7 urinary phthalate metabolites in quartiles and mean glucose adjusted for potential confounders.ResultsEighteen percent of women had glucose levels ≥ 140 mg/dL. Second trimester monoethyl phthalate (MEP) concentrations were positively associated with glucose levels, with adjusted mean (95%CI) glucose levels of 121 mg/dl (114, 128) vs. 109 mg/dL (103, 116) for women in highest and lowest quartiles, respectively. Women in the highest quartile of second trimester mono-isobutyl phthalate (MiBP) concentrations had a mean glucose level 14 mg/dL lower compared to women in the lowest quartile. No other urinary phthalate metabolites were associated with glucose levels.ConclusionsMEP and MiBP—metabolites of diethyl phthalate and dibutyl phthalate, respectively—were associated with higher pregnancy glucose in subfertile women—a population at high risk of glucose intolerance in pregnancy.Electronic supplementary materialThe online version of this article (10.1186/s12940-018-0399-5) contains supplementary material, which is available to authorized users.

Biological changes in the pregnancy‐postpartum period and subsequent cardiometabolic risk—UPSIDE MOMS: A research protocol

“…Investigation of environmental exposures on maternal cardiometabolic risk development is another future investigation: increasingly, evidence shows that exposure to metabolism disrupting environmental chemicals such as phthalates and per‐ and polyfluoroalkyl substances (PFAS), can dysregulate the body's ability to adapt to the demands of pregnancy (Borghese et al, 2020; James‐Todd et al, 2018; Varshavsky et al, 2019). Furthermore, elevated concentrations of certain phthalate metabolites and PFAS are associated with adverse cardiometabolic outcomes including excessive gestational weight gain (Bellavia et al, 2017), gestational diabetes mellitus (Zhang et al, 2015), and impaired glucose tolerance (James‐Todd et al, 2018). In postpartum readjustment to the nonpregnant state may be a second critical period of heightened vulnerability to endocrine disruption…”

Meconium Exposure to Phthalates, Sex and Thyroid Hormones, Birth Size and Pregnancy Outcomes in 251 Mother–Infant Pairs from Shanghai

“…Several studies have reported an association between phthalate metabolite concentrations and diabetes in non-pregnant populations [ 45 , 46 ], finding associations between certain phthalate metabolites and diabetes. Few studies have evaluated the role of phthalates on GDM, and they found some associations between different gestation period exposures to phthalates and impaired glucose tolerance [ 47 ]. As far as we know, we are the first study that is trying to look into the association between in-utero exposure to phthalates and GDM.…”

Perinatal urinary benzophenone-3 concentrations and glucose levels among women from a fertility clinic

“…Serum POPs concentrations were found to be positively associated with GDM risk [9]. In addition, previous studies conducted among pregnant women from the EARTH Study showed that urinary bisphenol A was positively associated with glucose levels [10], urinary butylparaben was positively while propylparaben inversely associated with glucose levels [11], and urinary phthalates also showed associations with glucose levels in mixed directions where a positive association was seen between monoethyl phthalate and glucose but an inverse association was seen between mono-isobutyl phthalate and glucose [12]. The association between BP-3 concentrations and pregnancy glucose levels, however, remains unclear.…”

“…For example, persistent organic pollutants (POPs) were found to increase GDM risk in average-risk populations [9]. In addition, we previously found associations between pregnancy glucose levels and certain non-persistent chemicals, including bisphenol A [10], certain parabens [11], and certain phthalates [12], in higher-risk (i.e. subfertile) populations from the same study cohort.…”