Fetal Growth and Prenatal Exposure to Bisphenol A: The Generation R Study
Claudia A. Snijder,1,2 Dick Heederik,3 Frank H. Pierik,4 Albert Hofman,1,5 Vincent W. Jaddoe,1,5,6 Holger M. Koch,7 Matthew P. Longnecker,8 and Alex Burdorf2
1The Generation R Study Group, and 2Department of Public Health, Erasmus MC, Rotterdam, the Netherlands; 3Institute of Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; 4Department of Urban Environment and Safety, TNO (Netherlands Organization for Applied Scientific Research), Utrecht, the Netherlands; 5Department of Epidemiology, and 6Department of Pediatrics, Erasmus MC, Rotterdam, the Netherlands; 7Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Institute of the Ruhr-Universitat, Bochum, Germany (IPA); 8Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
Background: Prenatal exposure to bisphenol A (BPA) has been associated with adverse birth outcomes, but findings of previous studies have been inconsistent.
Objective: We investigated the relation of prenatal BPA exposure with intrauterine growth and evaluated the effect of the number of measurements per subject on observed associations.
Methods: This study was embedded in a Dutch population-based prospective cohort study, with urine samples collected during early, mid-, and late pregnancy. The study comprised 219 women, of whom 99 had one measurement, 40 had two measurements, and 80 had three measurements of urinary BPA. Fetal growth characteristics were repeatedly measured by ultrasound during pregnancy and combined with measurements at birth. Linear regression models for repeated measurements of both BPA and fetal growth were used to estimate associations between urinary concentrations of creatinine-based BPA (BPACB) and intrauterine growth.
Results: The relationship between BPACB and fetal growth was sensitive to the number of BPA measurements per woman. Among 80 women with three BPA measurements, women with BPACB > 4.22 μg/g crea (creatinine) had lower growth rates for fetal weight and head circumference than did women with BPACB < 1.54 μg/g crea, with estimated differences in mean values at birth of –683 g (20.3% of mean) and –3.9 cm (11.5% of mean), respectively. When fewer measurements were available per woman, the exposure–response relationship became progressively attenuated and statistically nonsignificant.
Conclusion: Our findings suggest that maternal urinary BPA may impair fetal growth. Because previous studies have shown contradictory findings, further evidence is needed to corroborate these findings in the general population.
Key words: birth weight, bisphenol A, fetal growth, head circumference, pregnancy, urine.
Environ Health Perspect 121:393–398 (2013). http://dx.doi.org/10.1289/ehp.1205296 [Online 3 January 2012]
Address correspondence to A. Burdorf, Department of Public Health, Erasmus MC, PO Box 2040, 3000CA Rotterdam, the Netherlands. Telephone: 31107038469. E-mail: email@example.com
Supplemental Material is available online (http://dx.doi.org/10.1289/ehp.1205296).
We are grateful to R. Hauser of Harvard University for the suggestion to collect multiple urine specimens from subjects. The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the Erasmus University Rotterdam, School of Law and Faculty of Social Sciences; the Municipal Health Service Rotterdam area, Rotterdam; the Rotterdam Homecare Foundation, Rotterdam; and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR), Rotterdam. We gratefully acknowledge the contribution of general practitioners, hospitals, midwives, and pharmacies in Rotterdam.
The present study was conducted in commission of the European project CONTAMED with funding from the European Union’s Seventh Framework Programme (FP7) for Research and Technology Development (EU grant agreement 212502). This research was supported in part by the intramural research program of the U.S. National Institutes of Health, National Institute of Environmental Health Sciences.
The views expressed in this paper are those of the authors alone.
The authors declare they have no actual or potential competing financial interests
Received 2 April 2012; Accepted 21 December 2012; Online 3 January 2012.
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