title: Prenatal exposure to bisphenol A and phthalates and childhood respiratory tract infections and allergy.
abstract: BACKGROUND
  There is growing concern that prenatal exposure to bisphenol A (BPA) and phthalates, which are widely used in consumer products, might affect susceptibility to infections and the development of allergy and asthma in children, but there are currently very few prospective studies.
  
  
  OBJECTIVE
  We sought to evaluate whether prenatal exposure to BPA and phthalates increases the risk of respiratory and allergic outcomes in children at various ages from birth to 7 years.
  
  
  METHODS
  We measured BPA and metabolites of high-molecular-weight phthalates, 4 di-(2-ethylhexyl) phthalate (DEHP) metabolites (Σ4DEHP) and mono-benzyl phthalate (MBzP), and 3 low-molecular-weight phthalate (LMWP) metabolites (Σ3LMWP) in urine samples collected during the first and third trimesters in pregnant women participating in the Infancia y Medio Ambiente-Sabadell birth cohort study. The occurrence of chest infections, bronchitis, wheeze, and eczema in children was assessed at ages 6 and 14 months and 4 and 7 years through questionnaires given to the mothers. Atopy (specific IgE measurement) and asthma (questionnaire) were assessed at ages 4 and 7 years, respectively.
  
  
  RESULTS
  The relative risks (RRs) of wheeze (RR, 1.20; 95% CI, 1.03-1.40; P = .02), chest infections (RR, 1.15; 95% CI, 1.00-1.32; P = .05), and bronchitis (RR, 1.18; 95% CI, 1.01-1.37; P = .04) at any age increased for each doubling in concentration of maternal urinary BPA. Σ4DEHP metabolites were associated with the same outcomes (wheeze: RR, 1.25; 95% CI, 1.04-1.50, P = .02; chest infections: RR, 1.15; 95% CI, 0.97-1.35; P = .11; bronchitis: RR, 1.20; 95% CI, 1.01-1.43; P = .04). MBzP was associated with higher risk of wheeze (RR, 1.15; 95% CI, 1.00-1.33; P = .05). The risk of asthma at age 7 years was also increased with increasing prenatal BPA, Σ4DEHP, and MBzP exposure. There were no other exposure-outcome associations.
  
  
  CONCLUSIONS
  Prenatal exposure to BPA and high-molecular-weight phthalates might increase the risk of asthma symptoms and respiratory tract infections throughout childhood.
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. Electronic address: mgascon@creal.cat.
authors.forename: Mireia
authors.initials: M
authors.lastname: Gascon
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Maribel
authors.initials: M
authors.lastname: Casas
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Morales
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Damaskini
authors.initials: D
authors.lastname: Valvi
authors.affiliation: Departamento de Química Analítica, Universidad de Córdoba, Córdoba, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Ballesteros-Gómez
authors.affiliation: Departamento de Química Analítica, Universidad de Córdoba, Córdoba, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Luque
authors.affiliation: Departamento de Química Analítica, Universidad de Córdoba, Córdoba, Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: Rubio
authors.affiliation: IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Monfort
authors.affiliation: Universitat Pompeu Fabra (UPF), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ventura
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Martínez
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Martine
authors.initials: M
authors.lastname: Vrijheid
mesh_terms: D001559:Benzhydryl Compounds / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D063868:Patient Outcome Assessment; D010636:Phenols / Q000009:adverse effects*; D010795:Phthalic Acids / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D062486:Public Health Surveillance; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D010636:Phenols; D010795:Phthalic Acids; C032279:phthalic acid; C006780:bisphenol A; D000098826:Bisphenol A Compounds
keywords: Bisphenol A; asthma; atopy; bronchitis; chest infections; children; eczema; phthalates; specific IgE; wheeze