title: Maternal urinary bisphenol A levels and infant low birth weight: A nested case-control study of the Health Baby Cohort in China.
abstract: BACKGROUND
  Exposure to bisphenol A (BPA), a known endocrine disruptor, has been demonstrated to affect fetal development in animal studies, but findings in human studies have been inconsistent.
  
  
  OBJECTIVE
  We investigated whether maternal exposure to BPA during pregnancy is associated with an increased risk of infant low birth weight (LBW).
  
  
  METHODS
  A total 452 mother-infant pairs (113 LBW cases and 339 matched controls) were selected from the participants enrolled in the prospective Health Baby Cohort (HBC) in Wuhan city, China, during 2012-2014. BPA concentrations were measured in maternal urine samples collected at delivery, and the information of birth outcomes was retrieved from the medical records. A conditional logistic regression was used to evaluate the relationship between urinary BPA levels and LBW.
  
  
  RESULTS
  Mothers with LBW infants had significantly higher urinary BPA levels (median: 4.70μg/L) than the control mothers (median: 2.25μg/L) (p<0.05). Increased risk of LBW was associated with higher maternal urinary levels of BPA [adjusted odds ratio (OR)=3.13 for the medium tertile, 95% confidence interval (CI): 1.21, 8.08; adjusted OR=2.49 for the highest tertile, 95% CI: 0.98, 6.36]. The association was more pronounced among female infants than among male infants, with a statistical evidence of heterogeneity in risk (p=0.03).
  
  
  CONCLUSIONS
  Prenatal exposure to higher levels of BPA may potentially increase the risk of delivering LBW infants, especially for female infants. This is the first case-control study to examine the association in China.
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Wenqian
authors.initials: W
authors.lastname: Huo
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xia
authors.affiliation: CDC of Yangtze River Administration and Navigational Affairs, General Hospital of the Yangtze River Shipping, Wuhan 430019, China.
authors.forename: Yanjian
authors.initials: Y
authors.lastname: Wan
authors.affiliation: Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, China.
authors.forename: Aifen
authors.initials: A
authors.lastname: Zhou
authors.affiliation: Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Huang
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Yingshuang
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Chuansha
authors.initials: C
authors.lastname: Wu
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Minmin
authors.initials: M
authors.lastname: Jiang
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Hu
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Huailong
authors.initials: H
authors.lastname: Chang
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Xu
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Electronic address: liyuanyuan@hust.edu.cn.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Electronic address: xust@hust.edu.cn.
authors.forename: Shunqing
authors.initials: S
authors.lastname: Xu
mesh_terms: D001559:Benzhydryl Compounds / Q000652:urine*; D016022:Case-Control Studies; D002681:China; D052244:Endocrine Disruptors / Q000652:urine*; D005260:Female; D047109:Fetal Development / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D010636:Phenols / Q000652:urine*; D011247:Pregnancy; D011446:Prospective Studies; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D052244:Endocrine Disruptors; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds
keywords: Bisphenol A; Case–control; Low birth weight; Pregnancy; Urine