title: Increased levels of phthalates in very low birth weight infants with septicemia and bronchopulmonary dysplasia.
abstract: Very low birth weight infants (VLBW; birth weight<1500g) are exposed to potentially harmful phthalates from medical devices during their hospital stay. We measured urinary phthalate concentrations among hospitalized VLBW infants participating in a nutritional study. Possible associations between different phthalates and birth weight (BW), septicemia and bronchopulmonary dysplasia (BPD) were evaluated. Forty-six VLBW infants were enrolled in this randomized controlled nutritional study. The intervention group (n=24) received increased quantities of energy, protein, fat, essential fatty acids and vitamin A, as compared to the control group (n=22). The concentrations of 12 urinary phthalate metabolites were measured, using high-performance liquid chromatography coupled to tandem mass spectrometry, at 3 time points during the first 5weeks of life. During this study, the levels of di (2-ethylhexyl) phthalate (DEHP) metabolites decreased, whereas an increasing trend was seen regarding metabolites of di-iso-nonyl phthalate (DiNP). Significantly higher levels of phthalate metabolites were seen in infants with lower BW and those diagnosed with late onset septicemia or BPD. A significant positive correlation between the duration of respiratory support and DEHP metabolites was observed (p≤0.01) at 2.9weeks of age. Birth weight was negatively associated with urinary phthalate metabolite concentrations. Infants with lower BW and those diagnosed with septicemia or BPD experienced prolonged exposure from medical equipment containing phthalates, with subsequent higher levels of phthalate metabolites detected. Clinical Trial Registration no.: NCT01103219.
authors.affiliation: Department of Neonatal Intensive Care, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Norway; Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway. Electronic address: Kenneth.Strommen@medisin.uio.no.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Strømmen
authors.affiliation: Department of Food and Safety and Infection Biology, Norwegian University of Life Science, Oslo, Norway.
authors.forename: Jan Ludvig
authors.initials: JL
authors.lastname: Lyche
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway; Department of Pediatric and Adolescent Medicine, Akershus University Hospital and Institute for Clinical Medicine, Campus Ahus, University of Oslo, Nordbyhagen, Norway.
authors.forename: Elin Wahl
authors.initials: EW
authors.lastname: Blakstad
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway; Department of Neonatal Intensive Care, Women and Children's Division, Oslo University Hospital, Ullevål, Norway.
authors.forename: Sissel Jennifer
authors.initials: SJ
authors.lastname: Moltu
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway; Oslo Centre of Biostatistics and Epidemiology, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
authors.forename: Marit Bragelien
authors.initials: MB
authors.lastname: Veierød
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway; Department of Pediatric and Adolescent Medicine, Akershus University Hospital and Institute for Clinical Medicine, Campus Ahus, University of Oslo, Nordbyhagen, Norway.
authors.forename: Astrid Nylander
authors.initials: AN
authors.lastname: Almaas
authors.affiliation: Department of Exposure and Risk Assessment, Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Amrit Kaur
authors.initials: AK
authors.lastname: Sakhi
authors.affiliation: Department of Exposure and Risk Assessment, Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Cathrine
authors.initials: C
authors.lastname: Thomsen
authors.affiliation: Department of Pediatric and Adolescent Medicine, Akershus University Hospital and Institute for Clinical Medicine, Campus Ahus, University of Oslo, Nordbyhagen, Norway.
authors.forename: Britt
authors.initials: B
authors.lastname: Nakstad
authors.affiliation: Department of Neonatal Intensive Care, Women and Children's Division, Oslo University Hospital, Ullevål, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Brække
authors.affiliation: Department of Neonatal Intensive Care, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Arild Erlend
authors.initials: AE
authors.lastname: Rønnestad
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
authors.forename: Christian André
authors.initials: CA
authors.lastname: Drevon
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
authors.forename: Per Ole
authors.initials: PO
authors.lastname: Iversen
mesh_terms: D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000652:urine*; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000652:urine*; D008297:Male; D010795:Phthalic Acids / Q000652:urine*; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000652:urine*; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D010795:Phthalic Acids
keywords: Bronchopulmonary dysplasia; Exposure; Phthalate metabolites; Preterm infants; Septicemia; Urine