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Reducing Prenatal Phthalate Exposure Through Maternal Dietary Changes: Results from a Pilot Study.

ABSTRACT: Diet is a major source of exposure to certain phthalates, a class of environmental chemicals associated with endocrine disruption in animal models and humans. Several studies have attempted to lower phthalate exposure through carefully designed dietary interventions, with inconsistent results. We conducted a dietary intervention pilot study with the objective to lower phthalate exposure in low-income pregnant women, a particularly vulnerable population. Ten pregnant women consumed a provided diet consisting of mostly fresh, organic foods for 3 days. We collected urine samples before, during, and after the intervention and conducted semi-structured interviews to assess the feasibility and acceptability of the intervention. We used repeated measures ANOVA and paired t-tests to assess differences in urinary phthalate metabolite concentrations across the study, focusing on the metabolites of di-2-ethylhexyl phthalate (DEHP), a phthalate of particular interest, and their molar sum (?DEHP). Phthalate metabolite concentrations did not change appreciably during the intervention period. We observed no significant difference in ?DEHP metabolite concentrations across the three time periods (F = 0.21; adjusted p value = 0.65), and no reduction during the intervention as compared to baseline (t = -1.07, adjusted p value = 0.51). Results of interviews indicated that participants were not motivated to make dietary changes to potentially reduce chemical exposures outside of the study. Despite the small sample size, our results suggest that promoting dietary changes to lower phthalate exposure may not be an effective public health measure. Reducing the use of phthalates in food processing and packaging may be a better solution to lowering exposure on a population level.

SUBMITTER: Barrett ES

PROVIDER: S-EPMC5021302 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Reducing Prenatal Phthalate Exposure Through Maternal Dietary Changes: Results from a Pilot Study.

Barrett Emily S ES Velez Marissa M Qiu Xing X Chen Shaw-Ree SR

Maternal and child health journal 20150901 9

Diet is a major source of exposure to certain phthalates, a class of environmental chemicals associated with endocrine disruption in animal models and humans. Several studies have attempted to lower phthalate exposure through carefully designed dietary interventions, with inconsistent results. We conducted a dietary intervention pilot study with the objective to lower phthalate exposure in low-income pregnant women, a particularly vulnerable population. Ten pregnant women consumed a provided die ...[more]

PMID: 25652062

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Project description:Exposure to phthalates has been shown to impede the human endocrine system, resulting in deleterious effects on pregnant women and their children. Phthalates modify DNA methylation patterns in infant cord blood. We examined the association between prenatal phthalate exposure and DNA methylation patterns in cord blood in a Korean birth cohort. Phthalate levels were measured in 274 maternal urine samples obtained during late pregnancy and 102 neonatal urine samples obtained at birth, and DNA methylation levels were measured in cord blood samples. For each infant in the cohort, associations between CpG methylation and both maternal and neonate phthalate levels were analyzed using linear mixed models. The results were combined with those from a meta-analysis of the levels of phthalates in maternal and neonatal urine samples, which were also analyzed for MEOHP, MEHHP, MnBP, and DEHP. This meta-analysis revealed significant associations between the methylation levels of CpG sites near the CHN2 and CUL3 genes, which were also associated with MEOHP and MnBP in neonatal urine. When the data were stratified by the sex of the infant, MnBP concentration was found to be associated with one CpG site near the OR2A2 and MEGF11 genes in female infants. In contrast, the concentrations of the three maternal phthalates showed no significant association with CpG site methylation. Furthermore, the data identified distinct differentially methylated regions in maternal and neonatal urine samples following exposure to phthalates. The CpGs with methylation levels that were positively associated with phthalate levels (particularly MEOHP and MnBP) were found to be enriched genes and related pathways. These results indicate that prenatal phthalate exposure is significantly associated with DNA methylation at multiple CpG sites. These alterations in DNA methylation may serve as biomarkers of maternal exposure to phthalates in infants and are potential candidates for investigating the mechanisms by which phthalates impact maternal and neonatal health.

Project description:ImportancePrenatal exposure to phthalates has been associated with neurodevelopmental outcomes, but little is known about the association with language development.ObjectiveTo examine the association of prenatal phthalate exposure with language development in children in 2 population-based pregnancy cohort studies.Design, setting, and participantsData for this study were obtained from the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study conducted in prenatal clinics throughout Värmland county in Sweden and The Infant Development and the Environment Study (TIDES) conducted in 4 academic centers in the United States. Participants recruited into both studies were women in their first trimester of pregnancy who had literacy in Swedish (SELMA) or English or Spanish (TIDES). This study included mothers and their children from both the SELMA study (n = 963) and TIDES (n = 370) who had complete data on prenatal urinary phthalate metabolite levels, language delay, and modeled covariables. For SELMA, the data were collected from November 1, 2007, to June 30, 2013, and data analysis was conducted from November 1, 2016, to June 30, 2018. For TIDES, data collection began January 1, 2010, and ended March 29, 2016, and data analysis was performed from September 15, 2016, to June 30, 2018.Main outcomes and measuresMothers completed a language development questionnaire that asked the number of words their children could understand or use at a median of 30 months of age (SELMA) and 37 months of age (TIDES). The responses were categorized as fewer than 25, 25 to 50, and more than 50 words, with 50 words or fewer classified as language delay.ResultsIn the SELMA study, 963 mothers, 455 (47.2%) girls, and 508 (52.8%) boys were included. In TIDES, 370 mothers, 185 (50.0%) girls, and 185 (50.0%) boys were included in this analysis. The prevalence of language delay was 10.0% in both SELMA (96 reported) and TIDES (37 reported), with higher rates of delay in boys than girls (SELMA: 69 [13.5%] vs 27 [6.0%]; TIDES: 23 [12.4%] vs 14 [7.6%]). In crude analyses, the metabolite levels of dibutyl phthalate and butyl benzyl phthalate were statistically significantly associated with language delay in both cohorts. In adjusted analyses, a doubling of prenatal exposure of dibutyl phthalate and butyl benzyl phthalate metabolites increased the odds ratio (OR) for language delay by approximately 25% to 40%, with statistically significant results in the SELMA study (dibutyl phthalate OR, 1.29 [95% CI, 1.03-1.63; P = .03]; butyl benzyl phthalate OR, 1.26 [95% CI, 1.07-1.49; P = .003]). A doubling of prenatal monoethyl phthalate exposure was associated with an approximately 15% increase in the OR for language delay in the SELMA study (OR, 1.14; 95% CI, 1.00-1.31; P = .05), but no such association was found in TIDES (OR, 0.98; 95% CI, 0.79-1.23).Conclusions and relevanceIn findings from this study, prenatal exposure to dibutyl phthalate and butyl benzyl phthalate was statistically significantly associated with language delay in children in both the SELMA study and TIDES. These findings, along with the prevalence of prenatal exposure to phthalates, the importance of language development, and the inconsistent results from a 2017 Danish study, suggest that the association of phthalates with language delay may warrant further examination.

Dataset Information

Reducing Prenatal Phthalate Exposure Through Maternal Dietary Changes: Results from a Pilot Study.

Publications

Reducing Prenatal Phthalate Exposure Through Maternal Dietary Changes: Results from a Pilot Study.

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