Study On Influencing Factors Of Serum Bisphenols Levels In Pregnant Women And Its Relationship With The Risk Of Low Birth Weight

Objective:This study aims to evaluate the bisphenols levels in pregnant women and analyze their influencing factors,and to examine the relationship between pregnant women bisphenols exposure and the risk of low birth weight(LBW).Methods:The participants were extracted from the Guangxi Zhuang Birth Cohort.From 2015 to 2018,qualified pregnant women and their newborns were included in the study.The basic demographic information,behavior life style,antenatal examination data and delivery information were collected by a standardized questionnaire and the Guangxi Women and Children Health Service Information Management System.Peripheral venous blood samples of pregnant women were collected in the first trimester.The liquid-liquid extraction combined with ultra performance liquid chromatograph-tandem mass spectrometry(UPLC-MS)was performed to determine the serum concentrations of five kinds of bisphenols,including bisphenol A(BPA),bisphenol B(BPB),bisphenol F(BPF),bisphenol S(BPS),and tetrabromobisphenol A(TBBPA).The cross sectional study was used to analyze the levels of bisphenols in pregnant women serum and its influencing factors.The serum concentrations of bisphenols below the limit of detection(LOD)were replaced by the value of LOD divided by 2.Since the concentration distributions of bisphenols were skewed,the median and(inter-quartile range,IQR)were performed to describe their distribution characteristics.And the nonparametric rank sum test was performed to examine the concentration differences of bisphenols in pregnant women with different characteristics.After the bisphenols levels were natural logarithm(Ln)transformed,Pearson correlation analysis was performed to explore the correlation between different kinds of serum bisphenol levels in pregnant women,and multiple linear regressions were performed to evaluate the influencing factors of serum bisphenol concentrations.The historical cohort study was conducted to analyze the relationship between serum bisphenols levels in pregnant women and LBW.The t-test and chi-square test were performed to compare the differences in basic demographics between the two groups.After the bisphenols levels were Ln transformed or converted into a categorical variable,multivariate logistic regression models were performed to exmine the relationship between bisphenols levels and the risk of LBW.The Restricted Cubic Splines(RCS)method was used to analyze the dose-response relationship between Ln-converted bisphenols concentrations in serum and the risk of LBW.The weighted quantile sum(WQS)regression was used to examine the mixed effects of exposure to various bisphenols on the risk of LBW.SPSS22.0 and R 4.0 were used for statistic analysis.A two-tailed and P < 0.05 was used as the statistical significance level.Results:1.A total of 2023 pregnant women were included in this study.The detection rate of all bisphenols in maternal serum samples were all exceeded60.0%.The detection rate of BPA,BPB,BPF,BPS,and TBBPA were 96.0%,83.1%,61.7%,85.3%,and 76.3%,respectively.The median concentration of BPA,BPB,BPF,BPS,and TBBPA were 2.145 ng/m L,0.234 ng/m L,0.605ng/m L,0.097 ng/m L,and 0.481 ng/m L,respectively.There was a negative correlation between BPA and BPS(r =-0.11,P < 0.05),and positively correlated with TBBPA(r = 0.20,P < 0.05).There were positive correlations between BPF,BPS and TBBPA.2.There was a negative correlation between maternal age and serum BPA levels(β =-0.013;95%CI:-0.025,-0.001),and positively correlated with serum BPS exposure(β = 0.009;95%CI: 0.001,0.017).Women who engaged in non-agricultural occupation had higher serum levels of BPF(β = 0.060;95%CI:0.008,0.112),and those who lived in the last five years of renovation of living houses also had relatively higher serum BPA levels(β = 0.195;95%CI: 0.034,0.356).Women who exposured to occupational hazards had relatively higher serum levels of BPA(β = 0.195;95%CI: 0.034,0.356)and BPF(β = 0.060;95%CI: 0.008,0.112).The serum of multipara had significantly higher concentrations of BPA(β = 0.150;95%CI: 0.022,0.278)and BPF(β = 0.052;95%CI: 0.004,0.100)than those of primipara.Pregnant women who were active or passive smokers had higher serum BPS levels(β = 0.088;95%CI: 0.009,0.166).However,the influencing factor of BPB and TBBPA exposure in pregnant women has not been found.3.After adjusting for covariates,one Ln-unit increase in serum BPA and BPS levels were correlated with 1.380 times(95%CI: 1.100,1.733)and 1.334times(95%CI: 1.010,1.763)increase the risk of occurring LBW for all newborns,and the associations were only observed in female newborns when stratified analysis by gender.After LBW as divided into preterm LBW and full-term LBW,multiple Logistic regression was used to evaluate the effect of serum bisphenols levels on delivering preterm LBW and full-term LBW in pregnant women.After adjusting for covariates,one Ln-unit increase in serum BPA and BPS levels was associated with 1.411 times(95%CI: 1.076,1.852)and1.485 times(95%CI: 1.107,1.992)increase the risk of occurring full-term LBW.In addiction,we didn’t found any association between prenatal exposure to BPB BPF and TBBPA and LBW.4.In WQS analysis,the WQS index was significantly correlated with the risk of LBW(OR = 2.679;95%CI: 1.318,5.640),and the main contributing factor of bisphenols was BPS(0.387).After stratifying by gender,the relationship between the WQS index and the risk of LBW was only found in female newborns(OR = 5.248;95%CI: 1.621,20.581).Conclusion:1.The pregnant women were generally exposed to bisphenols and may have the same exposure sources,with BPA levels in serum were relatively higher than those of its analogues.2.A variety of factors were related to the exposure levels of bisphenols during pregnancy,include age,active or passive smoking,house renovation in the past five years,occupation,occupational hazard exposure,and parity.3.Prenatal exposure to BPA and BPS increased the risk of LBW,which may be more pronounced in female newborns and full-term newborns.4.Combined exposure to multiple bisphenols was related to the increased risk of LBW,and this increased risk was mainly driven by BPS.