Association between Pregnancy Loss and Urinary Phthalate Levels around the Time of Conception

• Published in: Environmental health perspectives Vol. 120; no. 3; pp. 458 - 463
• Main Authors: Toft, Gunnar, Jönsson, Bo A.G., Lindh, Christian H., Jensen, Tina Kold, Hjoltund, Niels H., Vested, Anne, Bonde, Jens Peter
• Format: Journal Article
• Language: English
• Published: Research Triangle Park, NC National Institute of Environmental Health Sciences 01-03-2012; US Department of Health and Human Services
• Subjects: Abortion; Abortion, Spontaneous - chemically induced; Abortion, Spontaneous - epidemiology; Adult; Arbetsmedicin och miljömedicin; Biological and medical sciences; Chemical hazards; Children's Health; Cohort Studies; Conception; Denmark - epidemiology; Diseases of mother, fetus and pregnancy; Environment. Living conditions; Environmental Exposure; Environmental health; Environmental Health and Occupational Health; Environmental Pollutants - toxicity; Environmental Pollutants - urine; Female; Female animals; Fertilization; Gynecology. Andrology. Obstetrics; Health aspects; Health Sciences; Humans; Hälsovetenskap; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; MEHP; Menstrual cycle; Metabolites; Phthalates; Phthalic Acids - metabolism; Phthalic Acids - toxicity; Phthalic Acids - urine; Physiological aspects; Pregnancy; pregnancy loss; Pregnancy. Fetus. Placenta; Pregnant women; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk factors; Spontaneous abortion; Toxicology; University hospitals; Urine; Young Adult; Denmark; Sweden; Urine; Association; Health and environment; Pregnancy disorders; MEHP; pregnancy loss; phthalates; Abortion
• ISSN: 0091-6765; 1552-9924; 1552-9924
• DOI: 10.1289/ehp.1103552

Background: Animal studies indicate that some phthalate metabolites may harm female reproductive function. Objectives: We assessed the associations between exposure to phthalate metabolites and pregnancy loss. Methods: Using a previously established cohort of couples planning their first pregnancy, we analyzed four primary and two oxidized secondary phthalate metabolites in urine samples collected on day 10 after the first day of the last menstrual period before conception occurred (n = 128) and during the previous cycle (if any, n = 111). Subclinical embryonal loss was identified by repeated measurement of urinary human chorionic gonadotropin, and information on clinical spontaneous abortions was obtained by telephone interview with the mother. Results: Pregnancy loss (n = 48) was increased among women with urinary concentration of monoethylhexyl phthalate (MEHP) in the upper tertile in the conception sample compared with women in the lowest tertile [adjusted odds ratio (OR) = 2.9; 95% confidence interval (CI): 1.1, 7.6]. The corresponding OR for subclinical embryonal loss (n = 32) was 40.7 (95% CI: 4.5,369.5). Conclusions: The phthalate metabolite MEHP was associated with higher occurrence of pregnancy loss. Because this is the first human study to show this association and the sample size is small, the findings need to be corroborated in independent studies.