A combined cohort analysis of prenatal exposure to phthalate mixtures and childhood asthma

Environment International

Marnie F. Hazlehurst¹  Kecia N. Carroll²  Nicole R. Bush³  Frances A. Tylavsky⁴  Emily S. Barrett⁵  Adam A. Szpiro⁶  Catherine J. Karr⁷  Kaja Z. LeWinn⁷  Christine T. Loftus⁸  Margaret A. Adgent⁸  Kurunthachalam Kannan⁹  Sheela Sathyanarayana⁹ 

[1] Corresponding author at: 1500 21st Ave S, Suite 2600, Nashville, TN 37212, USA.;Department of Health Policy, Vanderbilt University Medical Center, 1500 21st Ave S, Suite 2600, Nashville TN 37212, USA;Department of Pediatrics, Box 356320, University of Washington, Seattle, WA 98195-6320, USA;Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA;Department of Biostatistics, Box 35732, University of Washington, Seattle, WA 98195-7232, USA;Department of Epidemiology, Box 357236, University of Washington, Seattle, WA 98195-7236, USA;Department of Occupational and Environmental Health Sciences, Box 357234, University of Washington, Seattle, WA 98195-7234, USA;Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Avenue, Nashville TN 37212, USA;Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, USA;

关键词: Phthalate;    Prenatal;    Mixtures;    Asthma;    Respiratory;    Pregnancy;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Previous studies of prenatal phthalate exposure and childhood asthma are inconsistent. These studies typically model phthalates as individual, rather than co-occurring, exposures. We investigated whether prenatal phthalates are associated with childhood wheeze and asthma using a mixtures approach. Methods: We studied dyads from two prenatal cohorts in the ECHO-PATHWAYS consortium: CANDLE, recruited 2006–2011 and TIDES, recruited 2011–2013. Parents reported child respiratory outcomes at age 4–6 years: ever asthma, current wheeze (symptoms in past 12 months) and current asthma (two affirmative responses from ever asthma, recent asthma-specific medication use, and/or current wheeze). We quantified 11 phthalate metabolites in third trimester urine and estimated associations with child respiratory outcomes using weighted quantile sum (WQS) logistic regression, using separate models to estimate protective and adverse associations, adjusting for covariates. We examined effect modification by child sex and maternal asthma. Results: Of 1481 women, most identified as White (46.6%) or Black (44.6%); 17% reported an asthma history. Prevalence of ever asthma, current wheeze and current asthma in children was 12.3%, 15.8% and 12.3%, respectively. Overall, there was no adverse association with respiratory outcomes. In sex-stratified analyses, boys’ phthalate index was adversely associated with all outcomes (e.g., boys’ ever asthma: adjusted odds ratio per one quintile increase in WQS phthalate index (AOR): 1.42; 95% confidence interval (CI): 1.08, 1.85, with mono-ethyl phthalate (MEP) weighted highest). Adverse associations were also observed in dyads without maternal asthma history, driven by MEP and mono-butyl phthalate (MBP), but not in those with maternal asthma history. We observed protective associations between the phthalate index and respiratory outcomes in analysis of all participants (e.g., ever asthma: AOR; 95% CI: 0.81; 0.68, 0.96), with di(2-ethylhexyl)phthalate (DEHP) metabolites weighted highest. Conclusions: Results suggest effect modification by child sex and maternal asthma in associations between prenatal phthalate mixtures and child asthma and wheeze.

【 授权许可】

Unknown