Association between phthalate exposures and fecundity in preconception women:a nested case-control study
10.3760/cma.j.cn101441-20220602-00244
- VernacularTitle:孕前女性邻苯二甲酸酯暴露水平与生育力关联的巢式病例对照研究
- Author:
Congcong ZHANG
1
;
Lisha MAO
;
Zhichun ZHANG
;
Xushan CAI
;
Lifeng ZHANG
;
Fengyun YANG
;
Dongxiao YIN
;
Huajun ZHENG
;
Ying ZHOU
;
Hong JIANG
Author Information
1. 复旦大学公共卫生学院妇幼与儿少卫生教研室 国家卫生健康委员会卫生技术评估重点实验室，复旦大学，上海 200032
- Publication Type:Journal Article
- Keywords:
Fertility;
Preconception cohort;
Phthalates;
Nested case-control study
- From:
Chinese Journal of Reproduction and Contraception
2023;43(6):618-626
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association between exposures of seven classic phthalate metabolites and fertility among preconception women before pregnancy.Methods:Based on the preconception cohort, a nested case-control study was carried out. Preconception couples who were recruited from Shanghai Jiading District Maternal and Child Health Hospital from 2016 to 2020 with intention to conception were selected. A total of 100 women whose time to pregnancy (TTP) >12 months were selected as the case group, and 151 women with the TTP≤12 months were randomly selected as control group. The single and joint effects on fertility of phthalate metabolites were analyzed by the comparison between the two groups via the multivariate binary logistic regression model, and the weighted quantile sum regression model.Results:There were significant differences in mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-carboxmethyl)-hexyl phthalate (MCMHP), the sum of the detected concentrations of MEHP, MCMHP, mono-(2-ethyl-5-oxohexyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate and mono-(2-ethyl-5-carboxypentyl) phthalate (∑DEHP), and the sum of the detected concentrations of the seven phthalate metabolites (∑PAE) exposure levels between the case group and control group ( P=0.005, P<0.001, P=0.001, P=0.007). As shown by the multivariate binary logistic regression model, women with MEHP, MCMHP, ∑DEHP, ∑PAE at the highest quartile level were found to have significantly increased risk of infertility compared with women at the lowest quartile level (a OR=2.40, 95% CI: 1.12-5.15, P=0.025; a OR=7.74, 95% CI: 3.14-19.08, P<0.001; a OR=4.35, 95% CI: 1.93-9.79, P<0.001; a OR=2.04, 95% CI: 0.96-4.34, P=0.044). The weighted quantile sum regression model demonstrated that the exposure to seven phthalate metabolite mixtures in preconception was associated with an increased risk of infertility ( P<0.05). Among the seven phthalate metabolites, MCMHP had the largest contribution weight (61.7%). Conclusion:Women of childbearing age should avoid the exposure to phthalates in the environment when preparing for conception, such as to reduce the consumption of highly processed foods and foods packaged with plastic/polyvinyl chloride materials to promote fertility.
