title: Pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors.
abstract: Epidemiologic studies suggest phthalate metabolite concentrations are associated with type 2 diabetes. GDM is a strong risk factor for type 2 diabetes. Little is known about phthalates and GDM risk factors (i.e. 1st trimester body mass index (BMI), gestational weight gain (GWG), and 2nd trimester glucose levels).
  
  
  
  A total of 350 women participating in Lifecodes pregnancy cohort (Boston, MA), delivered at term and had pregnancy urinary phthalate metabolite concentrations. Nine specific gravity-adjusted urinary phthalate metabolites were evaluated. General linear regression was used to assess associations between quartiles of phthalate metabolites and continuous 1st trimester BMI and late 2nd trimester blood glucose. Linear mixed models were used for total GWG. Multivariable logistic regression was used for phthalate concentrations and categorized GWG and impaired glucose tolerance defined as glucose≥140mg/dL based on a 50-gram glucose load test. Models were adjusted for potential confounders.
  
  
  
  There were no associations between 1st trimester urinary phthalate metabolite concentrations and 1st trimester BMI. Mono-ethyl phthalate concentrations averaged across pregnancy were associated with a 2.17 increased odds of excessive GWG (95% CI: 0.98, 4.79). Second trimester mono-ethyl phthalate was associated with increased odds of impaired glucose tolerance (adj. OR: 7.18; 95% CI: 1.97, 26.15). A summary measure of di-2-ethylhexyl phthalate metabolite concentrations were inversely associated with impaired glucose tolerance (adj. OR: 0.25; adj. 95% CI: 0.08, 0.85).
  
  
  
  Higher exposure to mono-ethyl phthalate, a metabolite of the parent compound of di-ethyl phthalate, may be associated with excessive GWG and impaired glucose tolerance; higher di-2-ethylhexyl phthalate was associated with reduced odds of impaired glucose tolerance.
authors.affiliation: Departments of Environmental Health and Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA; Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA. Electronic address: tjtodd@hsph.harvard.edu.
authors.forename: Tamarra M
authors.initials: TM
authors.lastname: James-Todd
authors.affiliation: Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Meeker
authors.affiliation: Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Tianyi
authors.initials: T
authors.lastname: Huang
authors.affiliation: Departments of Environmental Health and Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Russ
authors.initials: R
authors.lastname: Hauser
authors.affiliation: Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Ferguson
authors.affiliation: Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA.
authors.forename: Janet W
authors.initials: JW
authors.lastname: Rich-Edwards
authors.affiliation: Division of Maternal Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: McElrath
authors.affiliation: Division of Endocrine, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Seely
mesh_terms: D000328:Adult; D001786:Blood Glucose; D015992:Body Mass Index; D001900:Boston; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000097:blood / Q000139:chemically induced / Q000652:urine*; D004051:Diethylhexyl Phthalate; D005260:Female; D018149:Glucose Intolerance / Q000652:urine*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D010795:Phthalic Acids / Q000009:adverse effects / Q000652:urine*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood / Q000652:urine*; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D010795:Phthalic Acids; C032279:phthalic acid; D004051:Diethylhexyl Phthalate
keywords: Body mass index; Gestational diabetes; Gestational weight gain; Impaired glucose tolerance; Phthalates; Pregnancy