Relationship Between Serum Exposure Of Nonylphenol And Octylphenol In Early Pregnant Women Of Zhuang Nationality And Pregnancy Complications And Perinatal Outcomes

Objective:To analyze the exposure level of nonylphenols and octylphenols in the serum of Zhuang early pregnant women in Guangxi and its influencing factors,and to investigate the relationship between the exposure level and pregnancy hypertension,gestational diabetes mellitus,birth weight and premature delivery.Methods:The participants were from the birth cohort of Zhuang nationality in Guangxi.2035 pregnant women and their neonatus were enrolled in the cohort study in Pingguo County,Tiandong County,Debao County,Longan County,Wuming and Jingxi City of Guangxi from 2015 to 2018.The general demographic characteristics,past pregnancy history,smoking history,drinking history and family history of the subjects were collected by face-to-face questionnaire,and the antenatal examination information and delivery information of the subjects were followed up through the Guangxi Women and Children Health Service Information Management system.The peripheral venous blood samples of pregnant women in first trimester were collected and the concentration of NP,4-N-NP,4-T-OP,4-N-OP in serum of pregnant women was determined by liquid-liquid extraction-ultra-high performance liquid chromatography-mass spectrometry(UPLC-MS).The influencing factors of exposure concentration and birth weight of newborn children were analyzed by cross section,and the effects of exposure level on gestational hypertension,gestational diabetes mellitus and preterm delivery were analyzed by nesting case control study.SPSS22.0 was used to describe and analyze the data statistically.The concentrations below the limits of detections were replaced by the detection limit divided by █,and the median and interquartile range were used to describe their distribution characteristics.Kruskal-Wallis H test and Mann-Whitney U test were used to analyze the concentration differences of nonylphenols and octylphenols in serum of pregnant women with different characteristics.After all serum concentrations of nonylphenols and octylphenols were transformed to natural log-transformed concentrations,multiple linear regression analysis was used to analyze the factors affecting the exposure level of nonylphenols and octylphenols in the serum of pregnant women in the early pregnancy and the effect of exposure level on the birth weight and BMI,birth weight Z score of parturients.Chi-square test and binary Logistic regression were used to analyze the relationship between exposure level and gestational hypertension,gestational diabetes mellitus and premature delivery.The effects of combined exposure to NP,4-N-NP,4-T-OP,4-N-OP on gestational age and body weight of pregnant women were analyzed by R language elastic network(R x64 3.5.3).Results:A total of 2035 pregnant women were recruited in this study.The actual median content of NP,4-N-NP,4-T-OP,4-N-OP in serum were 103.9156 ng/mL,1.7376 ng/mL,.39.8546ng/mL,0.8472ng/mL respectively.The LOD were 97.3%,61.9%,91.9%and 64.1%,respectively.The factors affecting the exposure concentration of NP in the serum of pregnant women were secondhand smoke(β=0.145,P<0.001).The factors affecting the exposure concentration of 4-N-NP in the serum of pregnant women in the early stage of pregnancy were drinking(β=0.061,P ≤0.001),permed hair(β=0.048,P<0.001),and secondhand smoke(β=-0.020,P ≤0.041).The factors affecting the exposure concentration of 4-T-OP in serum of pregnant women in early pregnancy were ventilation in living environment(β=0.161,P=0.004).The factors affecting the exposure concentration of 4-N-OP in serum of pregnant women were drinking(β=0.059,P=0.014)and secondhand smoke(β=-0.027,P=0.039).After adjusting the age,BMI before pregnant,parity of pregnant women,the high level of serum lgNP exposure in early pregnancy was related to gestational diabetes mellitus and hypertensive disorder complicating pregnancy.The OR(95%CI)values were 1.807(1.140,2.863)and 0.631(0.404,0.987),respectively.Maternal serum concentration of NP was negatively associated with birth weight of parturients(β=-14.763,P=0.046),especially on the birth weight of male neonatus,and the regression coefficient was-26.020(-47.191,-4.850).There was significant statistical significance.NP、4-N-NP、4-T-OP、4-N-OP may be related to birth weight,and their coefficients were-12.492,-19.042,-3.085 and-14.410,respectively.Conclusion:The exposure level of NP and 4-T-OP in the serum of early pregnant women in Guangxi Zhuang are high,but the level of 4-N-NP and 4-N-OP are low.And the exposure level are relation with the pregnant women who has hot dyed hair,secondhand smoke and alcohol in the early pregnancy.Our findings suggest that the exposure level of NP in early pregnancy is positively associated with the risk of gestational diabetes mellitus.The exposure level of NP is negatively associated with the birth weight of parturients,especially on the birth weight of male parturients,but the relationship with preterm birth is not statistically significant.