Organophosphate Flame-Retardant Metabolite Concentrations and Pregnancy Loss Among Women Conceiving with Assisted Reproductive Technology

Details

• Personal Author:
  Butt CM ; Carignan CC ; Ford JB ; Hauser R ; Meeker JD ; Messerlian C ; Mínguez-Alarcón L ; Souter I ; Stapleton HM ; Williams PL
• Corporate Authors:
  Harvard School of Public Health. Environment and Reproductive Health Study Team
• Description:
  Objective: To evaluate whether urinary concentrations of organophosphate flame retardant (PFR) metabolites are associated with pregnancy loss among women conceiving with assisted reproductive technology (ART). Design Prospective preconception cohort of subfertile women. Setting: Academic hospital fertility center in Boston, Massachusetts. Patient(s): A total of 155 women conceiving 179 pregnancies with ART. Intervention(s): None. Mean exposure to each of five PFR metabolites was estimated by averaging the specific-gravity adjusted natural log concentrations from two urine samples collected during the ART cycle of conception. Main Outcome Measure(s): Adjusted risk ratios (RRs) and 95% confidence intervals (CIs) for biochemical and total pregnancy loss (all losses <20 weeks' gestation) by quartiles of PFR metabolite concentrations were estimated using a repeated measures log-binomial model, accounting for multiple pregnancies per woman. Result(s): Of the 179 pregnancies, 31% ended in pregnancy loss (12% in biochemical loss). Among the three metabolites with high detection frequency [bis(1,3-dichloro-2-propyl) phosphate (BDCIPP), diphenyl phosphate (DPHP), and isopropylphenyl phenyl phosphate (ip-PPP)], an increased risk of biochemical loss was observed for women with DPHP concentrations in the fourth vs. first quartile (RR 1.64; 95% CI 0.61-4.39). Also found was an elevated risk of biochemical pregnancy loss among women in the highest quartile of the molar sum of urinary PFR metabolites compared with the lowest (RR 1.89; 95% CI 0.64-5.58). Urinary concentrations of ip-PPP and BDCIPP were not associated with either outcome. Conclusion(s): Among subfertile women, urinary DPHP metabolite concentrations measured during the ART cycle of conception may be associated with early pregnancy loss. Although this study is uniquely designed to investigate early markers of pregnancy success and maintenance, the small sample size likely contributed to imprecision. Given their increasing use as replacement chemicals for traditional flame retardants, exposure to PFRs may increase, and more studies will be needed to investigate their potential to impact pregnancy and reproduction. Main Outcome Measure(s): Adjusted risk ratios (RRs) and 95% confidence intervals (CIs) for biochemical and total pregnancy loss (all losses <20 weeks' gestation) by quartiles of PFR metabolite concentrations were estimated using a repeated measures log-binomial model, accounting for multiple pregnancies per woman. [Description provided by NIOSH]
• Subjects:
  Hazardous Substances Occupational Health Pregnancy Risk Assessment Risk Factors Safety Urogenital System Women
• Keywords:
  Author Keywords: Assisted Reproductive Technology Chemical Hazards Environment Fertility Flame Retardants Infertility Organophosphate Flame Retardants Pregnancy Loss Prenatal Exposure Risk Factors
• ISSN:
  0015-0282
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; Michigan ; North Carolina ; OSHA Region 1 ; OSHA Region 4 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  110
• Issue:
  8
• NIOSHTIC Number:
  nn:20055578
• Citation:
  Fertil Steril 2018 Nov; 110(8):1137-1141.e
• Contact Point Address:
  Carmen Messerlian, Ph.D., Harvard T.H. Chan School of Public Health, Department of Environmental Health, 665 Huntington Avenue, FXB-102A, Boston, Massachusetts 02115
• Email:
  cmesser@hsph.harvard.edu
• Federal Fiscal Year:
  2019
• Performing Organization:
  University of Michigan, Ann Arbor
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Fertility and Sterility
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2a7776a9980477b3a07efeff5a57d8de35e392396bff1f56c254a0ab608a7417e9024f16b619ae316fa262ee3147343810137d3ed88431c1242cfada3199f3aa
• Download URL:
  https://stacks.cdc.gov/view/cdc/213401/cdc_213401_DS1.pdf
• File Type:
  [PDF - 406.63 KB ]