Influence of race on prenatal phthalate exposure and anogenital measurements among boys and girls

Abby G Wenzel; Michael S Bloom; Celeste D Butts; Rebecca J Wineland; John W Brock; Lori Cruze; Elizabeth R Unal; John R Kucklick; Stephen E Somerville; Roger B Newman

doi:10.1016/j.envint.2017.10.007

Influence of race on prenatal phthalate exposure and anogenital measurements among boys and girls

Environ Int. 2018 Jan:110:61-70. doi: 10.1016/j.envint.2017.10.007. Epub 2017 Nov 1.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA; National Institute of Standards and Technology, Hollings Marine Laboratory, Charleston, SC, USA.
² Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, USA. Electronic address: mbloom@albany.edu.
³ Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA.
⁴ Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
⁵ Department of Chemistry, University of North Carolina Asheville, Asheville, NC, USA.
⁶ Department of Biology, Wofford College, Spartanburg, SC, USA.
⁷ Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine, Springfield, IL, USA.
⁸ National Institute of Standards and Technology, Hollings Marine Laboratory, Charleston, SC, USA.

PMID: 29097052
DOI: 10.1016/j.envint.2017.10.007

Abstract

Background: Select phthalates have antiandrogenic activity, which raises concern for adverse developmental outcomes given widespread exposure of pregnant women. Investigators have reported associations between maternal urinary phthalates and altered anogenital distance (AGD), a marker of in utero androgen activity, among offspring. However, data assessing the impact of race on these associations is sparse.

Objectives: To evaluate associations between prenatal phthalate exposure and AGD in a racially diverse newborn population.

Methods: We prospectively collected second trimester urine from 187 African American and 193 white mothers, and used liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) to measure eight phthalate metabolites and calculate molar sums. We measured anopenile (APD) and anoscrotal (ASD) distances of 171 boys and anoclitoral (ACD) and anofourchette (AFD) distances of 128 girls at delivery. We collected sociodemographic and clinical data from questionnaires and delivery records.

Results: We identified a statistically significant inverse association for mono-2-ethylhexyl phthalate (MEHP) and APD in boys (B=-1.57mm, p=0.02), which was stronger for African Americans (B=-2.07mm, p=0.04) than for whites (B=-1.23mm, p=0.22), although the racial interaction was not statistically significant (p=0.56). We found a longer ASD for higher molar sums of dibutyl phthalate (∑DBP; B=0.99mm, p=0.04), with stronger associations for whites (B=1.30mm, p=0.04) than for African Americans (B=0.39mm, p=0.59), again without a statistically significant racial interaction (p=0.34). Among girls, we found inverse associations for tertiles of MEHP with AFD and ACD, and statistically significant race-based interactions, in which ACD was longer for whites and shorter for African Americans, following exposure to monoethyl phthalate (MEP; p=0.01) and ∑DBP (p=0.08).

Conclusions: Our findings suggest race and sex play important roles in phthalate-associated reproductive developmental toxicity, with important implications for designing future investigations and health interventions.

Keywords: Anogenital distance; Birth outcomes; Environmental chemicals; Phthalate; Prenatal development; Prenatal exposure.

MeSH terms

Abnormalities, Drug-Induced / epidemiology*
Abnormalities, Drug-Induced / ethnology
Adult
Biomarkers / urine
Ethnicity
Female
Genitalia, Female / drug effects
Genitalia, Male / drug effects
Humans
Infant, Newborn
Male
Maternal Exposure / adverse effects*
Phthalic Acids / toxicity*
Phthalic Acids / urine
Pregnancy
Prospective Studies
South Carolina / epidemiology
Tandem Mass Spectrometry

Substances

Biomarkers
Phthalic Acids
phthalic acid