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Exposure to phthalates during pregnancy increased risk for preterm birth

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Women who are exposed to phthalates during pregnancy are more likely to deliver preterm, according to data. Phthalates are a class of chemicals found commonly in personal care products such as lotions, perfumes and deodorants, according to Kelly K. Ferguson, MPH, of the department of environmental health sciences at the University of Michigan School of Public Health, and colleagues.

“Exposure in women has been linked to disrupted thyroid hormone levels, increased systemic levels of oxidative stress and inflammation, and adverse health endpoints such as endometriosis and breast cancer,” researchers wrote. “These data provide strong support for taking action in the prevention or reduction of phthalate exposure during pregnancy.”

Patients were included in a nested case-control study at Brigham and Women’s Hospital. The researchers selected 130 cases of preterm births and 352 randomly assigned control patients. Each phthalate metabolite was detected in at least 95% of urine samples, researchers wrote.

“Significantly elevated levels of mono-(2-ethyl)-hexyl phthalate (MEHP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), [sigma] DEHP, and MBP were observed in preterm cases compared with control participants (P<.05). Suggestively elevated levels of mono-(3-carboxypropyl) phthalate (MCPP) were also noted (P<.10),” the researchers wrote.

The results indicate a significant association between exposure to phthalates during pregnancy and preterm birth, consistent with previous studies.

In an accompanying editorial, Shanna H. Swan, PhD, of the department of preventive medicine at Icahn School of Medicine at Mount Sinai wrote that Ferguson and colleagues make an important public health contribution by demonstrating a sizable effect of phthalates.

“This article is important because of the public health significance of the outcome, the ubiquity of the exposure, the large sample size, and the mechanistic insights the analysis provides,” Swan wrote.

For more information:

Ferguson KK. JAMA Pediatr. 2013;doi:10.1001/jamapediatrics.2013.3699.

Swan SH. JAMA Pediatr. 2013;doi:10.1001/jamapediatrics.2013.4215.

Disclosure: The researchers report no relevant financial disclosures.