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      Prenatal Phenol and Paraben Exposures and Adverse Birth Outcomes: A Prospective Analysis of U.S. Births

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          Abstract

          Background:

          Synthetic chemicals are increasingly being recognized for potential independent contributions to preterm birth (PTB) and low birth weight (LBW). Bisphenols, parabens, and triclosan are consumer product chemicals that act via similar mechanisms including estrogen, androgen, and thyroid disruption and oxidative stress. Multiple cohort studies have endeavored to examine effects on birth outcomes, and systematic reviews have been limited due to measurement of 1–2 spot samples during pregnancy and limited diversity of populations.

          Objective:

          To study the effects of prenatal phenols and parabens on birth size and gestational age (GA) in 3,619 mother-infant pairs from 11 cohorts in the NIH Environmental influences on Child Health Outcomes program.

          Results:

          While many associations were modest and statistically imprecise, a 1-unit increase in log 10 pregnancy averaged concentration of benzophenone-3 and methylparaben were associated with decreases in birthweight, birthweight adjusted for gestational age and SGA. Increases in the odds of being SGA were 29% (95% CI: 5%, 58%) and 32% (95% CI: 3%, 70%), respectively. Bisphenol S in third trimester was also associated with SGA (OR 1.52, 95% CI 1.08, 2.13). Associations of benzophenone-3 and methylparaben with PTB and LBW were null. In addition, a 1-unit increase in log 10 pregnancy averaged concentration of 2,4-dichlorophenol was associated with 43% lower (95% CI: − 67%, − 2%) odds of low birthweight; the direction of effect was the same for the highly correlated 2,5-dichlorophenol, but with a smaller magnitude (−29%, 95% CI: − 53%, 8%).

          Discussion:

          In a large and diverse sample generally representative of the United States, benzophenone-3 and methylparaben were associated with lower birthweight as well as birthweight adjusted for gestational age and higher odds of SGA, while 2,4-dichlorophenol. These associations with smaller size at birth are concerning in light of the known consequences of intrauterine growth restriction for multiple important health outcomes emerging later in life.

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          Most cited references61

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            Outcomes in young adulthood for very-low-birth-weight infants.

            Very-low-birth-weight infants (those weighing less than 1500 g) born during the initial years of neonatal intensive care have now reached young adulthood. We compared a cohort of 242 survivors among very-low-birth-weight infants born between 1977 and 1979 (mean birth weight, 1179 g; mean gestational age at birth, 29.7 weeks) with 233 controls from the same population in Cleveland who had normal birth weights. We assessed the level of education, cognitive and academic achievement, and rates of chronic illness and risk-taking behavior at 20 years of age. Outcomes were adjusted for sex and sociodemographic status. Fewer very-low-birth-weight young adults than normal-birth-weight young adults had graduated from high school (74 percent vs. 83 percent, P=0.04). Very-low-birth-weight men, but not women, were significantly less likely than normal-birth-weight controls to be enrolled in postsecondary study (30 percent vs. 53 percent, P=0.002). Very-low-birth-weight participants had a lower mean IQ (87 vs. 92) and lower academic achievement scores (P<0.001 for both comparisons). They had higher rates of neurosensory impairments (10 percent vs. <1 percent, P<0.001) and subnormal height (10 percent vs. 5 percent, P=0.04). The very-low-birth-weight group reported less alcohol and drug use and had lower rates of pregnancy than normal-birth-weight controls; these differences persisted when comparisons were restricted to the participants without neurosensory impairment. Educational disadvantage associated with very low birth weight persists into early adulthood.
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              Triclosan: environmental exposure, toxicity and mechanisms of action.

              Triclosan [5-chloro-2-(2,4-dichlorophenoxy)phenol; TCS] is a broad spectrum antibacterial agent used in personal care, veterinary, industrial and household products. TCS is commonly detected in aquatic ecosystems, as it is only partially removed during the wastewater treatment process. Sorption, biodegradation and photolytic degradation mitigate the availability of TCS to aquatic biota; however the by-products such as methyltriclosan and other chlorinated phenols may be more resistant to degradation and have higher toxicity than the parent compound. The continuous exposure of aquatic organisms to TCS, coupled with its bioaccumulation potential, have led to detectable levels of the antimicrobial in a number of aquatic species. TCS has been also detected in breast milk, urine and plasma, with levels of TCS in the blood correlating with consumer use patterns of the antimicrobial. Mammalian systemic toxicity studies indicate that TCS is neither acutely toxic, mutagenic, carcinogenic, nor a developmental toxicant. Recently, however, concern has been raised over TCS's potential for endocrine disruption, as the antimicrobial has been shown to disrupt thyroid hormone homeostasis and possibly the reproductive axis. Moreover, there is strong evidence that aquatic species such as algae, invertebrates and certain types of fish are much more sensitive to TCS than mammals. TCS is highly toxic to algae and exerts reproductive and developmental effects in some fish. The potential for endocrine disruption and antibiotic cross-resistance highlights the importance of the judicious use of TCS, whereby the use of TCS should be limited to applications where it has been shown to be effective. Copyright © 2011 John Wiley & Sons, Ltd.
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                Author and article information

                Journal
                7807270
                22115
                Environ Int
                Environ Int
                Environment international
                0160-4120
                1873-6750
                8 May 2024
                January 2024
                12 December 2023
                30 May 2024
                : 183
                : 108378
                Affiliations
                [a ]Department of Pediatrics, Division of Environmental Pediatrics, NYU Grossman School of Medicine, New York, NY, USA
                [b ]Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
                [c ]NYU Wagner School of Public Service, New York, NY, USA
                [d ]RTI International, Research Triangle Park, NC, USA
                [e ]Northeastern University, Boston, MA, USA
                [f ]Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Piscataway, NJ, USA
                [g ]Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
                [h ]Lifecourse Epidemiology Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
                [i ]Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
                [j ]Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
                [k ]Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
                [l ]College of Human Health and Development, Penn State University, Hershey, PA, USA
                [m ]Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
                [n ]Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
                [o ]Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI 48201
                [p ]Seattle Children’s Research Institute, Seattle, WA, USA
                [q ]Department of Pediatrics, University of Washington, Seattle, WA, USA
                [r ]Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL
                [s ]Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
                [t ]Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
                Author notes
                [* ]Corresponding author at: Department of Pediatrics, New York University School of Medicine, 227 East 30th Street Rm 807, New York, NY 10016, USA. leonardo.trasande@ 123456nyulangone.org (L. Trasande).
                Article
                NIHMS1960848
                10.1016/j.envint.2023.108378
                11138125
                38181479
                ba802183-3d99-4d67-9665-9905f85db683

                This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/).

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