RT Journal Article
T1 Parental preconception exposure to phenol and phthalate mixtures and the risk of preterm birth
A1 Zhang, Yu
A1 Mustieles, Vicente
A1 Williams, Paige L.
A1 Wylie, Blair J.
A1 Souter, Irene
A1 Calafat, Antonia M.
A1 Demokritou, Melina
A1 Lee, Alexandria
A1 Vagios, Stylianos
A1 Hauser, Russ
A1 Messerlian, Carmen
K1 DEHP
K1 BPA
K1 Preterm
K1 Singleton
K1 Subfertile
K1 Couple
K1 Dietilhexil ftalato
K1 Fenoles
K1 Nacimiento prematuro
K1 Matrimonio
K1 Fertilidad
K1 Atención preconceptiva
AB Background: Parental preconception exposure to select phenols and phthalates was previously associated with increased risk of preterm birth in single chemical analyses. However, the joint effect of phenol and phthalate mixtures on preterm birth is unknown. Methods: We included 384 female and 211 male (203 couples) participants seeking infertility treatment in the Environment and Reproductive Health (EARTH) Study who gave birth to 384 singleton infants between 2005 and 2018. Mean preconception urinary concentrations of bisphenol A (BPA), parabens, and eleven phthalate bio markers, including di(2-ethylhexyl) phthalate (DEHP) metabolites, were examined. We used principal compo nent analysis (PCA) with log-Poisson regression and Probit Bayesian Kernel Machine Regression (BKMR) with hierarchical variable selection to examine maternal and paternal phenol and phthalate mixtures in relation to preterm birth. Couple-based BKMR model was fit to assess couples’ joint mixtures in relation to preterm birth.  Results: PCA identified the same four factors for maternal and paternal preconception mixtures. Each unit in crease in PCA scores of maternal (adjusted Risk Ratio (aRR): 1.36, 95%CI: 1.00, 1.84) and paternal (aRR: 1.47, 95%CI: 0.90, 2.42) preconception DEHP-BPA factor was positively associated with preterm birth. Maternal and paternal BKMR models consistently presented the DEHP-BPA factor with the highest group Posterior Inclusion Probability (PIP). BKMR models further showed that maternal preconception BPA and mono(2-ethyl-5- hydroxyhexyl) phthalate, and paternal preconception mono(2-ethylhexyl) phthalate were positively associated with preterm birth when the remaining mixture components were held at their median concentrations. Couple based BKMR models showed a similar relative contribution of paternal (PIP: 61%) and maternal (PIP: 77%) preconception mixtures on preterm birth. We found a positive joint effect on preterm birth across increasing quantiles of couples’ total mixture concentrations. Conclusion: In this prospective cohort of subfertile couples, maternal BPA and DEHP, and paternal DEHP expo sure before conception were positively associated with preterm birth. Both parental windows jointly contributed to the outcome. These results suggest that preterm birth may be a couple-based pregnancy outcome.
PB Elsevier
SN 0160-4120
YR 2021
FD 2021-02-25
LK http://hdl.handle.net/10668/4603
UL http://hdl.handle.net/10668/4603
LA en
NO Zhang Y, Mustieles V, Williams PL, Wylie BJ, Souter I, Calafat AM, et al. Parental preconception exposure to phenol and phthalate mixtures and the risk of preterm birth. Environ Int. 2021 Jun;151:106440
DS RISalud
RD Aug 21, 2025