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. 2023 Nov 5;13(11):1616. doi: 10.3390/biom13111616

Table 1.

Summary of epidemiological studies reporting associations between maternal urinary concentrations of BPA alternatives (BPS and BPF) and health outcomes in offspring.

Study Design/Location BPs Exposure Level
MUC (µg/L)/DR (%) 		Main Outcomes Reference
Participant Characteristics
Cohort/China
n = 1197 mother–newborn pairs
(mothers’ age > 18 years;
during the late gestation period, 35–47 weeks; singleton pregnancy)		 BPS: 0.40 */47.9
BPF: 0.57 */77.1		 BPF in the 3rd TM was associated with:
  ↓ birth length by 0.21 cm in female newborns;
    [95% CI: −0.36, −0.07; p < 0.01].
  ↑ ponderal index by 0.04 g/cm3 × 100;
    [95% CI: 0.01, 0.08; p = 0.02].
BPS in the 3rd TM was associated with:
  ↓ gestational age by 0.20 weeks (linear dose
  ↓ dependent association in women carrying
  ↓ female fetuses);
    [95% CI: −0.37, −0.03; p = 0.02]. 		[15]
Cohort/China
n = 845 mother–infant pairs
(mothers’ median age in years, < 25 (12.4%), 26–35 (83%), and ≥ 36 (4.9%); during full gestation; singleton pregnancy)		 In the 1st, 2nd, and 3rd TMs,
respectively/average DR:
BPS: 0.3, 0.4, and 0.4/86.8
BPF: 0.6, 0.7, and 0.7/98.3		 BPF in the 1st TM was associated with:
  ↓ birth weight (grams);
    [β: −27; 95% CI: −55, 0; p < 0.05].
BPF in the 3rd TM was associated with:
  ↓ ponderal index (kg/m3 × 100);
    [β: −0:17; 95% CI: −0.32, −0.02; p < 0.05]
with each increase in exposure quartiles.
BPS in the 1st TM was associated with:
  ↓ birth weight (grams);
    [β: −38; 95% CI: −65, −11; p < 0.05].
  ↓ ponderal index (kg/m3 × 100);
    [β: −0:18; 95% CI: −0.34, −0.02; p < 0.05].
BPS in the 2nd TM was associated with:
  ↓ birth weight (grams);
    [β: −43; 95% CI: −71, −15; p < 0.05].
  ↓ birth length (cm);
    [β: −0.12; 95% CI: −0.23, −0.02; p < 0.05].		 [16]
Cohort/China
n = 322 mother–newborn pairs
(mothers’ age ≥ 18 years;
during the late gestation period, ≥35 weeks; singleton pregnancy)		 BPS: 0.03/52.5
BPF: 0.08/79.8		 BPS and BPF in the 3rd TM:
No significant associations with fetal growth
parameters were observed compared to BPA exposure. 		[17]
Cohort/Netherlands
n = 1379 mother–newborn pairs
(mothers’ median age 30.5 years; during full gestation; singleton pregnancy)		 In the 1st, 2nd, and 3rd TMs,
respectively:
BPS: 0.17, 0.03, and ND/-
BPF: 0.13, ND, and 0.13/-		 BPS across all three TMs was associated with:
  ↑ fetal head circumference (mm);
    [difference: 0.18; 95% CI: 0.01, 0.34; p < 0.05].
BPS in the 1st TM was associated with:
  ↑ fetal head circumference (mm) in 2nd and 3rd TMs;
    [difference: 0.15; 95% CI: 0.05, 0.26
    and 0.12; 95% CI: 0.02, 0.23, respectively; p < 0.02].
  ↑ fetal weight (g) in 2nd and 3rd TMs;
    [difference: 0.12; 95% CI: 0.02, 0.22 and 0.16;
    95% CI: 0.06, 0.26, respectively; p < 0.02].		 [18]
Cohort/China
n = 2023 mother–infant pairs
(mothers’ median age 28.2 years; during full gestation; singleton pregnancy)		 BPS: 0.09 **/86.9
BPF: 0.44 **/61.8		 BPF mean serum concentrations were associated with:
  ↓ birth weight (grams) in boys;
    [β: −72.51; 95% CI: −136.59, −8.43; p = 0.031].
  ↓ ponderal index (kg/m3 × 100) with BPF,
  observed more in boys;
    [β: −0.71; 95% CI: −1.31, −0.10; p = 0.021].
BPS exposure had no significant associations. 		[19]
Cohort/South Korea
n = 180 mother–infant pairs
(mothers’ median age < 30 years (22.8%) and ≥ 30 years (77.2%); 96% during late gestation period, ≥37 weeks; singleton pregnancy)		 BPS: 0.1 */-
BPF: 0.2 */-		 BPS exposure was associated with:
  ↓ birth weight (grams) for each 10-fold
  increase in adjusted models ***;
    [β: −44.2; 95% CI: −92.7, 4.4; p = 0.07].
BPF exposure was associated with:
  ↑ birth weight (grams);
    [β: 125.5; 95% CI: 45.0, 205.9; p = 0.003].		 [20]
Cohort/China
n = 289 mother–twin pairs
(mothers’ median age 30.06 years; during full gestation;
twin pregnancy)		 BPS: 0.80/-
BPF: 2.52/-		 BPF in the 2nd TM was associated with:
  ↑ birth weight (grams);
    [difference: 72.77; 95% CI: 0.84, 144.7; p < 0.05].
BPS exposure had no significant associations. 		[21]
Case–control/United States
n = 130 preterm birth cases and 350 random control pregnancy
(mothers’ median age 25–35 years; during late gestation ≥ 37 weeks; singleton pregnancy)		 In the 3rd TM:
BPS: -/20		 BPS was associated with:
  ↑ odds of overall preterm birth (spontaneous
  and placental);
    [OR: 2.05; 95% CI: 1.09, 3.89; p = 0.03].		 [22]
Cohort/China
n = 850 mother–infant pairs
(mothers’ median age 25–35 years; 97.5% during late pregnancy, ≥ 37 weeks; singleton pregnancy) 		In the 1st, 2nd, and 3rd TMs,
respectively:
BPS: 0.45, 0.44, and 0.50 */62 – 68 ^		 BPS had a nonsignificant association with gestation period or preterm birth (in adjusted models). [23]
Cohort/China
n = 2023 mother–infant pairs
(mothers’ median age 29 years; during full gestation; singleton pregnancy)		 BPS: 0.10/-
BPF: 0.60/-		 BPs mixture was associated with:
  ↑ preterm birth;
    [OR: 1.52; 95% CI: 1.04, 2.21; p < 0.05].
    % of contribution:
    BPF (43.7%), BPS (29.6%) and BPA (26.8%).		 [24]
Cohort/Sweden
n = 803 mother–child pairs
(mothers’ median age, 31.4 years; during full gestation; singleton pregnancy)		 BPS: 0.07/-
BPF: 0.13/-		 BPF was associated with:
  ↓ in full IQ scale, more noted in boys;
    [β: −2.86; 95% CI: −4.54, −1.18; p = 0.001].
BPS exposure had no significant associations. 		[25]
Cohort/China
n = 463 mother–child pairs
(mothers’ median age 25–34 years; gestational median age, 39 weeks; 87.7% singleton pregnancy)		 BPS: 0.37/81–88 ^
BPF: 0.68/98–98.5 ^		 BPS highest exposure level vs. lowest was associated with:
  ↓ in psychomotor development index;
    [β: −5.52; 95% CI: −10.06, −0.99; p = 0.02]
    observed more in boys;
    [β: −7.61; 95% CI: −13.99, −1.24; p = 0.02].
BPF exposure had no significant associations. 		[26]
Cohort/Netherlands
n = 1362 mother–child pairs (mothers’ median age 30.6 years; during full gestation; singleton pregnancy) 		In 1st, 2nd, and 3rd TMs:
BPS: 0.17, 0.03, and 0.03/-
BPF: 0.13, ND, and 0.13/-		 BPS in the 1st TM was associated with:
  ↓ bone mineral density at 10 years old;
    [β: −6.08; 95% CI: −9.97, −2.19; p < 0.01].		 [27]
Cohort/China
n = 762 mother–newborn pairs
(mothers’ median age 28.6 years; during full gestation; singleton pregnancy)		 In 1st, 2nd, and 3rd TMs:
BPS: 0.32, 0.34, and 0.36/-		 BPS in the 1st TM was associated with:
  ↓ mtDNAcn of male newborns by 59%;
    [95% CI: −75.16, −32.58; p < 0.001].		 [28]
Cohort/China
n = 801 mother–infant pairs
(mothers’ median age 28.3 years; gestational age < 13 weeks; singleton pregnancy)		 BPS: 0.10 */90.9
BPF: 0.46 */65.4		 BPS was associated with:
  ↓ cord blood telomere length by 3.19%;
    [95% CI: −6.08, −0.21; p < 0.05].		 [29]

Abbreviations. ave: average; BPs: bisphenols; BPS: bisphenol S; BPF: bisphenol F; MUC: median urinary concentrations; DR: detection rate (the percentage of urinary samples containing the tested bisphenol); TM: trimester; mtDNAcn: mitochondrial DNA copy number; (↑): increase; (↓): decrease; OR: odds ratio; HR: hazard ratio; CI: confidence interval; ND: not detected because of over 80% of concentrations were below limit of detection; *: presented as geometric mean (arithmetic average) not median; **: geometric mean of serum samples not urine; ***: models adjusted for different factors, including maternal age, education, smoking and drinking status, body mass index, exercise, infant sex, and gestational weeks; ^: range across pregnancy.