Association between prenatal exposure to bisphenols and preterm birth: the interaction effect of anemia

Maternal exposure to bisphenols (BPs) during pregnancy may negatively impact birth outcomes. However, research on the interaction between anemia and exposure in relation to preterm birth (PTB) is limited. A prospective birth cohort was used to assess the relationship between prenatal exposure to BPs...

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Main Authors: Ya-ling Li, Hong-yu Mao, Lu-ming Yan, Zi-yi Liu, Shu Sun, Ting-ting Jiang, Le-yan Xu, Xin-yi Zhang, Bo-lin Liu, Min Zhu, Ji-an Xie, Jia-hu Hao, Chao Zhang
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Environment International
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Online Access:http://www.sciencedirect.com/science/article/pii/S0160412025004751
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author Ya-ling Li
Hong-yu Mao
Lu-ming Yan
Zi-yi Liu
Shu Sun
Ting-ting Jiang
Le-yan Xu
Xin-yi Zhang
Bo-lin Liu
Min Zhu
Ji-an Xie
Jia-hu Hao
Chao Zhang
author_facet Ya-ling Li
Hong-yu Mao
Lu-ming Yan
Zi-yi Liu
Shu Sun
Ting-ting Jiang
Le-yan Xu
Xin-yi Zhang
Bo-lin Liu
Min Zhu
Ji-an Xie
Jia-hu Hao
Chao Zhang
author_sort Ya-ling Li
collection DOAJ
description Maternal exposure to bisphenols (BPs) during pregnancy may negatively impact birth outcomes. However, research on the interaction between anemia and exposure in relation to preterm birth (PTB) is limited. A prospective birth cohort was used to assess the relationship between prenatal exposure to BPs and PTB, and to explore potential effect modification by maternal anemia. The maternal urine samples were collected during each trimester to measure BPs concentrations. The associations between individual BPs and PTB were assessed using generalized linear model (GLM). Generalized estimating equations (GEEs) identified critical exposure windows. Multiple statistical methods—including quantile g-computation (q-gcomp), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR)—were employed to evaluate cumulative and mixture effects. Interaction analyses on both additive and multiplicative scales were performed for selected BPs linked to PTB and time windows of maternal anemia sensitivity. Significant associations were observed between BPs exposure and PTB, particularly for BPAF and BPP in early pregnancy (OR = 1.222, 95 % CI: 1.006–1.486 and OR = 1.454, 95 % CI: 1.054–2.007), and for BPB in both mid (OR = 1.651) and late pregnancy (OR = 1.952). GEEs confirmed early and late pregnancy as critical windows. Cumulative exposure analyses indicated that higher BPs levels in these periods significantly increased PTB odds. Significant additive and multiplicative interactions were identified between the third trimester BPB exposure and maternal anemia, suggesting a potential synergistic effect on PTB. The study found that prenatal exposure to specific BPs is significantly associated with increased risk of PTB, with critical exposure windows identified in early and late pregnancy, and reveals that maternal anemia may amplify these effects through synergistic interactions.
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spelling doaj-art-28919f3a9c024c8f93dca0559394178f2025-08-20T05:04:12ZengElsevierEnvironment International0160-41202025-09-0120310972410.1016/j.envint.2025.109724Association between prenatal exposure to bisphenols and preterm birth: the interaction effect of anemiaYa-ling Li0Hong-yu Mao1Lu-ming Yan2Zi-yi Liu3Shu Sun4Ting-ting Jiang5Le-yan Xu6Xin-yi Zhang7Bo-lin Liu8Min Zhu9Ji-an Xie10Jia-hu Hao11Chao Zhang12Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaAnhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaAnhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, ChinaWuhu Maternal and Child Health (MCH) Center, Wuhu, Anhui Province, ChinaAnhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui Province, China; Corresponding authors at: School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui Province, China; Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Corresponding authors at: School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.Maternal exposure to bisphenols (BPs) during pregnancy may negatively impact birth outcomes. However, research on the interaction between anemia and exposure in relation to preterm birth (PTB) is limited. A prospective birth cohort was used to assess the relationship between prenatal exposure to BPs and PTB, and to explore potential effect modification by maternal anemia. The maternal urine samples were collected during each trimester to measure BPs concentrations. The associations between individual BPs and PTB were assessed using generalized linear model (GLM). Generalized estimating equations (GEEs) identified critical exposure windows. Multiple statistical methods—including quantile g-computation (q-gcomp), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR)—were employed to evaluate cumulative and mixture effects. Interaction analyses on both additive and multiplicative scales were performed for selected BPs linked to PTB and time windows of maternal anemia sensitivity. Significant associations were observed between BPs exposure and PTB, particularly for BPAF and BPP in early pregnancy (OR = 1.222, 95 % CI: 1.006–1.486 and OR = 1.454, 95 % CI: 1.054–2.007), and for BPB in both mid (OR = 1.651) and late pregnancy (OR = 1.952). GEEs confirmed early and late pregnancy as critical windows. Cumulative exposure analyses indicated that higher BPs levels in these periods significantly increased PTB odds. Significant additive and multiplicative interactions were identified between the third trimester BPB exposure and maternal anemia, suggesting a potential synergistic effect on PTB. The study found that prenatal exposure to specific BPs is significantly associated with increased risk of PTB, with critical exposure windows identified in early and late pregnancy, and reveals that maternal anemia may amplify these effects through synergistic interactions.http://www.sciencedirect.com/science/article/pii/S0160412025004751Prenatal exposureBisphenolsPreterm birthBirth cohortAnemia
spellingShingle Ya-ling Li
Hong-yu Mao
Lu-ming Yan
Zi-yi Liu
Shu Sun
Ting-ting Jiang
Le-yan Xu
Xin-yi Zhang
Bo-lin Liu
Min Zhu
Ji-an Xie
Jia-hu Hao
Chao Zhang
Association between prenatal exposure to bisphenols and preterm birth: the interaction effect of anemia
Environment International
Prenatal exposure
Bisphenols
Preterm birth
Birth cohort
Anemia
title Association between prenatal exposure to bisphenols and preterm birth: the interaction effect of anemia
title_full Association between prenatal exposure to bisphenols and preterm birth: the interaction effect of anemia
title_fullStr Association between prenatal exposure to bisphenols and preterm birth: the interaction effect of anemia
title_full_unstemmed Association between prenatal exposure to bisphenols and preterm birth: the interaction effect of anemia
title_short Association between prenatal exposure to bisphenols and preterm birth: the interaction effect of anemia
title_sort association between prenatal exposure to bisphenols and preterm birth the interaction effect of anemia
topic Prenatal exposure
Bisphenols
Preterm birth
Birth cohort
Anemia
url http://www.sciencedirect.com/science/article/pii/S0160412025004751
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