Abstract：Objective To explore the effect of first-trimester phthalates (PAEs) exposure on pregnancy outcomes of patients with subclinical hypothyroidism (SCH) during pregnancy. Methods From January 2019 to May 2021, 188 pregnant women (a gestational age of 0-12 weeks) with SCH who underwent first-trimester screening in Suzhou Science and Technology Town Hospital Affiliated to Nanjing Medical University served as subjects for a prospective study. General information of the pregnant women was collected through the hospital information system for obstetric patients, and their pregnancy outcomes were recorded. Urine samples collected from obstetric patients undergoing prenatal diagnosis for the first time were measured by LC-MS/MS technology, and the levels of 10 PAEs metabolites were converted into the daily exposure doses of PAEs. The effects of PAEs exposure on Apgar score were analyzed by multiple linear regression. The impact of PAEs exposure on pregnancy outcomes like spontaneous preterm birth (SPTB) and small for gestational age (SGA) was analyzed by multi-factor logistic regression. Results The detection rates of 10 PAEs metabolites in urine of the SCH patients were all more than 90%, among which the detection rates of mono-methyl phthalate (MMP), mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), monoisobutyl phthalate (MiBP) and mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP) were 100.00%. Multiple linear regression analysis showed that neonatal Apgar score was negatively correlated with DEHP exposure (β'=-0.331, 95%CI:-0.617--0.045). Logistic regression analysis displayed that DMP (OR=1.445, 95%CI:1.230-1.697), DEP (OR=1.606, 95%CI:1.204-2.143), DiBP (OR=1.766, 95%CI:1.301-2.399) and DEHP (OR=1.473, 95%CI:1.105-1.963) were risk factors for the occurrence of SPTB, and DMP (OR=1.583, 95%CI:1.132-2.212) and DEHP (OR=1.627, 95%CI:1.238-2.139) were risk factors for the occurrence of SGA. Conclusion Pregnant women with SCH in Suzhou are generally exposed to PAEs, and PAEs exposure will affectpregnancy outcome and fetal development, increase the risk of premature delivery and reduce the birth weight of newborns.
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ZHAI Fen, MA Bai, LI Hui-fen, SHEN Hong. Impact of first-trimester exposure to phthalates on pregnancy outcomes of patients with subclinical hypothyroidism during pregnancy. , 2023, 30(3): 291-295.
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