The Journal of Pediatrics
Volume 155, Issue 4 , Pages 500-504, October 2009

Phthalate Levels and Low Birth Weight: A Nested Case-Control Study of Chinese Newborns

  • Yunhui Zhang, PhD

      Affiliations

    • Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
    • Center for Biomedical Research, Population Council and Rockefeller University, New York, NY
    • ,
  • Ling Lin, MD

      Affiliations

    • Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
    • ,
  • Yang Cao, PhD

      Affiliations

    • Department of Health Statistics, Second Military Medical University, Shanghai, China
    • ,
  • Bingheng Chen, MD

      Affiliations

    • Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
    • ,
  • Lixing Zheng, MSC

      Affiliations

    • Key Laboratory of Ministry of Education on Public Health, Fudan University, Shanghai, China
    • ,
  • Ren-Shan Ge, MD

      Affiliations

    • Center for Biomedical Research, Population Council and Rockefeller University, New York, NY
    • Corresponding Author InformationReprint requests: Renshan Ge, MD, Box 273, Population Council, 1230 York Avenue, New York, NY 10021.

Received 24 July 2008; received in revised form 10 March 2009; accepted 6 April 2009. published online 25 June 2009.

Objective

To assess maternal–fetal exposure to phthalates and investigate whether in utero phthalate exposure is associated with low birth weight (LBW).

Study design

A total of 201 newborn–mother pairs (88 LBW cases and 113 controls) residing in Shanghai were enrolled in this nested case-control study during 2005-2006. Maternal blood, cord blood, and meconium specimens were collected and analyzed for phthalates by high-performance liquid chromatography–mass spectrometry. Nonparametric tests were used to compare demographic characteristics in cases and controls. Conditional logistic regression and Spearman correlation were used to analyze the association between phthalate exposure and LBW.

Results

No significant differences in gestational age, prepregnancy body mass index, prenatal care, vitamin supplementation, or socioeconomic levels were found between the LBW and control infants. More than 70% of the biosamples had quantifiable levels of phthalates, with higher levels in the LBW infants compared with the controls. Prenatal di-n-butyl phthalate (DBP) exposure was associated with LBW, and di-2-ethylhexyl phthalate (DEHP) was negatively associated with birth length. After adjusting for the potential confounders, DBP concentrations in the highest quartile were associated with an increased risk of LBW.

Conclusions

Newborns in China are ubiquitously exposed to phthalates; significantly higher phthalate levels were detected in LBW cases compared with controls. In utero DBP and DEHP exposures were associated with LBW in a dose-dependent manner. Prenatal phthalate exposure may be a risk factor for LBW.

BMI, Body mass index, DBP, Di-n-butyl phthalate, DEHP, Di-2-ethylhexyl phthalate, DEP, Di-ethyl phthalate, HPLC, High-performance liquid chromatography, LBW, Low birth weight, LOD, Limit of detection, MBP, Monobutyl phthalate, MEHP, Mono-2-ethylhexyl phthalate, MS, Mass spectrometry, OR, Odds ratio

 

 Supported in part by the Population Council (Fred H. Bixby Fellowship [2007-2009], to Y.Z.) and the Natural Science Foundation of China (Grant 30500397, to Y.Z.). The authors declare no conflicts of interest.

PII: S0022-3476(09)00367-9

doi:10.1016/j.jpeds.2009.04.007

The Journal of Pediatrics
Volume 155, Issue 4 , Pages 500-504, October 2009

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