First- and Third-Trimester Urinary Phthalate Metabolites in the Development of Hypertensive Diseases of Pregnancy

Sabrina M. Bedell, Grace R. Lyden, Sheela Sathyanarayana, Emily S. Barrett, Kelly K. Ferguson, Ashley Santilli, Nicole R. Bush, Shanna H. Swan, Thomas F. McElrath and Ruby H.N. Nguyen
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Sabrina M. Bedell: Department of Women’s Health, Obstetrics and Gynecology, University of Minnesota, Minneapolis, MN 55454, USA
Grace R. Lyden: Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
Sheela Sathyanarayana: Department of Pediatrics, Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98145, USA
Emily S. Barrett: Department of Biostatistics and Epidemiology, Rutgers School of Public Health and Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ 08854, USA
Kelly K. Ferguson: Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC 27709, USA
Ashley Santilli: Department of Neurology, Mayo Clinic, Rochester, MN 55904, USA
Nicole R. Bush: Departments of Psychiatry and Behavioral Sciences and of Pediatrics, University of California at San Francisco, San Francisco, CA 94143, USA
Shanna H. Swan: Department of Preventive Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Thomas F. McElrath: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Division of Maternal-Fetal Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
Ruby H.N. Nguyen: Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA

IJERPH, 2021, vol. 18, issue 20, 1-13

Abstract: The purpose of this study was to determine whether maternal urinary phthalate metabolite concentrations are associated with the development of higher blood pressure or pregnancy-induced hypertension (PIH). Participants were women without chronic hypertension who enrolled in The Infant Development and the Environment Study, a prospective pregnancy cohort conducted at four U.S. academic medical centers from 2010–2012. Prenatal records were reviewed to obtain blood pressure measurements and diagnoses of PIH (gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome, defined as hemolysis, elevated liver enzymes, and low platelet count). Complete-case analyses used multivariable linear and logistic regression for analysis of blood pressure measurements and PIH diagnoses, respectively. In the final dataset (N = 668), higher concentrations of first-trimester monoethyl phthalate (MEP) and mono-3-carboxypropyl phthalate (MCPP) and third-trimester mono-isobutyl phthalate (MiBP) were significantly associated with a medical chart diagnosis of PIH. First-trimester mono-n-butyl phthalate (MBP) and MEP along with the sum of di-(2-ethylhexyl) phthalate metabolites (?DEHP) were each associated with increased systolic blood pressure across pregnancy. In conclusion, several phthalate metabolite concentrations were significantly associated with PIH and greater increases in systolic blood pressure across pregnancy.

Keywords: phthalates; hypertension; pregnancy; blood pressure; preeclampsia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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