Increased risk of phthalates exposure for recurrent pregnancy loss in reproductive-aged women

Kai Wei Liao, Pao Lin Kuo, Han Bin Huang, Jung Wei Chang, Hung Che Chiang, Po Chin Huang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Recurrent pregnancy loss (RPL) is the termination of pregnancies, usually before 20 weeks of gestation, and is defined as the loss of two or more pregnancies. In Taiwan, after 2011 di-2-ethylhexyl phthalate (DEHP) exposure episode, more reproductive-aged women still expose to high levels of DEHP and di-butyl phthalate (DBP) than have women of other age groups. Phthalates might be involved in the RPL pathogenesis. This study assessed the association of phthalate exposure with RPL risk in reproductive-aged Taiwanese women. This study recruited 103 patients diagnosed by a physician with RPL of unknown etiology and 76 controls from the Department of Obstetrics and Gynecology at a medical center in southern Taiwan between August 2013 and August 2017. Urine samples were analyzed for 11 phthalate metabolites through liquid chromatography–tandem mass spectrometry; subsequently, principal component analysis (PCA) and hierarchical clustering analysis were performed to determine the main sources of phthalate exposure. Finally, multivariate logistic regression was used to determine the RPL risk. The creatinine-unadjusted median levels of mono-iso-butyl phthalate (MiBP), mono-n-butyl phthalate (MnBP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) in RPL/control were 9.8/5.3, 27.2/13.1, 11.4/8.1, and 12.9/9.5 ng/mL, respectively; furthermore, ΣDBPm and ΣDEHPm in RPL/control were 0.18/0.10 and 0.15/0.12 nmol/mL, respectively. PCA revealed three primary components of phthalate exposure: diethyl phthalates (DEP), DEHP, and DBP. Plastic food container use and medication were identified as the main phthalate exposure sources. After adjustment for potential confounding factors (urinary creatinine, age, age at menarche, education, and plastic food container use), we found that the urinary level of ΣDBPm was significantly associated with elevated risk for RPL (OR = 2.85, p = 0.045). Our findings supported the hypothesis that exposure to phthalates increases RPL risk. The development of a strategy to reduce phthalate exposure among reproductive-aged women should be emphasized. Phthalates exposure increase the risk of recurrent pregnancy loss.

Original languageEnglish
Pages (from-to)969-977
Number of pages9
JournalEnvironmental Pollution
Volume241
DOIs
Publication statusPublished - Oct 1 2018
Externally publishedYes

Fingerprint

Pregnancy
Dibutyl Phthalate
Food Packaging
Principal component analysis
Containers
Principal Component Analysis
Taiwan
Creatinine
phthalic acid
Gynecology
Plastics
Obstetrics
Hospital Obstetrics and Gynecology Department
Metabolites
Menarche
Mass spectrometry
Logistics
Education
Cluster Analysis
Mass Spectrometry

Keywords

  • Phthalate metabolites
  • Recurrent pregnancy loss
  • Reproductive-aged women
  • Risk
  • Urine

ASJC Scopus subject areas

  • Toxicology
  • Pollution
  • Health, Toxicology and Mutagenesis

Cite this

Increased risk of phthalates exposure for recurrent pregnancy loss in reproductive-aged women. / Liao, Kai Wei; Kuo, Pao Lin; Huang, Han Bin; Chang, Jung Wei; Chiang, Hung Che; Huang, Po Chin.

In: Environmental Pollution, Vol. 241, 01.10.2018, p. 969-977.

Research output: Contribution to journalArticle

Liao, Kai Wei ; Kuo, Pao Lin ; Huang, Han Bin ; Chang, Jung Wei ; Chiang, Hung Che ; Huang, Po Chin. / Increased risk of phthalates exposure for recurrent pregnancy loss in reproductive-aged women. In: Environmental Pollution. 2018 ; Vol. 241. pp. 969-977.
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