Abstract
OBJECTIVE: To evaluate the association between prenatal exposures to phthalates and phenols and adverse pregnancy outcomes, including preterm birth (PTB), small-for-gestational-age (SGA) birth weight, and gestational diabetes mellitus (GDM). METHODS: This study analyzed data from the Environmental Influences on Child Health Outcomes consortium, which harmonized longitudinal data on more than 30,000 pregnancies and 57,000 children from 69 cohorts across the United States and Puerto Rico. Pregnancy outcomes included PTB, SGA, and GDM, identified from medical records or self-reports. Generalized estimating equations models with Poisson distribution and robust variance were used to estimate relative risks (RRs) and 95% CIs per interquartile range increase in urinary chemical concentrations. RESULTS: Participants included 5,749 pregnant individuals with urinary concentrations of 13 phthalates and 8 phenols measured at least once during pregnancy. Among participants, 543 (9.4%) experienced PTB, 401 (7.0%) had GDM, and 335 (5.8%) had neonates with SGA birth weight. Higher concentrations of mono (3-carboxypropyl) phthalate (RR 1.24, 95% CI, 1.17-1.32), di-isodecyl phthalate (RR 1.22, 95% CI, 1.14-1.30), di-2-ethylhexyl phthalate (RR 1.21, 95% CI, 1.14-1.28), and bisphenols (RR 1.15, 95% CI, 1.08-1.22) were associated with increased risk of PTB. Bisphenols were also associated with SGA (RR 1.14, 95% CI, 1.05-1.26), and oxybenzone (RR 1.10, 95% CI, 1.00-1.20) and phthalates were associated with GDM. CONCLUSION: Prenatal exposure to phthalates and phenols is associated with an increased risk of PTB, SGA, and GDM. Reducing exposure through individual behaviors and regulatory measures may mitigate these risks.