Academic journal article Environmental Health Perspectives

Fetal Growth and Prenatal Exposure to Bisphenol A: The Generation R Study

Academic journal article Environmental Health Perspectives

Fetal Growth and Prenatal Exposure to Bisphenol A: The Generation R Study

Article excerpt

BACKGROUND: Prenatal exposure to bisphenol A (BPA) has been associated with adverse birth outcomes, but findings of previous studies have been inconsistent.

OBJECTIVE: We investigated the relation of prenatal BPA exposure with intrauterine growth and evaluated the effect of the number of measurements per subject on observed associations.

METHODS: This study was embedded in a Dutch population-based prospective cohort study, with urine samples collected during early, mid-, and late pregnancy. The study comprised 219 women, of whom 99 had one measurement, 40 had two measurements, and 80 had three measurements of urinary BPA. Fetal growth characteristics were repeatedly measured by ultrasound during pregnancy and combined with measurements at birth. Linear regression models for repeated measurements of both BPA and fetal growth were used to estimate associations between urinary concentrations of creatinine-based BPA (BP[A.sub.CB]) and intrauterine growth.

RESULTS: The relationship between BP[A.sub.CB] and fetal growth was sensitive to the number of BPA measurements per woman. Among 80 women with three BPA measurements, women with BP[A.sub.CB] > 4.22 [micro]g/g crea (creatinine) had lower growth rates for fetal weight and head circumference than did women with BP[A.sub.CB] < 1.54 [micro]g/g crea, with estimated differences in mean values at birth of -683 g (20.3% of mean) and -3.9 cm (11.5% of mean), respectively. When fewer measurements were available per woman, the exposure-response relationship became progressively attenuated and statistically nonsignificant.

CONCLUSION: Our findings suggest that maternal urinary BPA may impair fetal growth. Because previous studies have shown contradictory findings, further evidence is needed to corroborate these findings in the general population.

KEY WORDS: birth weight, bisphenol A, fetal growth, head circumference, pregnancy, urine. Environ Health Perspect 121:393-398 (2013). http://dx.doi.org/10.1289/ehp.1205296 [Online 3 January 2012]

Pregnant women are exposed to a variety of chemicals during pregnancy (Woodruff et al. 2011; Ye et al. 2008), which may increase the risk of adverse health outcomes (Stillerman et al. 2008). Environmental exposures that have been associated with adverse fetal development include heavy metals (Llanos and Ronco 2009; Zhu et al. 2010), phthalates (Latini et al. 2006), and pesticides (Gilden et al. 2010; Perera et al. 2005).

Bisphenol A (BPA) is used to make polycarbonate polymers and epoxy resins, along with other raw materials in plastics production, and is present in dental fillings, plastic food and water containers, baby bottles, food wraps, and the lining of beverage and food cans, presenting a large number of opportunities for human exposure (Kuo and Ding 2004; Le et al. 2008; Munguia-Lopez et al. 2005). Given the ubiquity of BPA in the human environment, exposure to BPA is virtually universal (Woodruff et al. 2011). BPA is known to exert estrogenic activity and is considered an endocrinedisrupting chemical (EDC) (Alonso-Magdalena et al. 2012). Concern about EDCs stems from their potential effects via diverse mechanisms, including estrogenic/antiandrogenic properties, antioxidant actions, inhibition of cell cycles, and effects on cell differentiation (Hotchkiss et al. 2008; McLachlan et al. 2006). Some animal studies have shown that exposure to EDCs that mimic sex steroids/steroids affected fetal growth and organ differentiation (Hardin et al. 1981; Kim et al. 2001).

Animal studies have shown that BPA may reduce sperm quality, disturb hormonal balance, and cause reproductive organ damage and malformations, as reviewed by Richter et al. (2007). In rats, different experiments on BPA dosages have presented inconsistent results with both a reduction and a gain in body weight (Kim et al. 2001; Rubin et al. 2001). Recently, several epidemiological studies have considered the potential effects of prenatal exposure to BPA on reproductive health. …

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