Table 2.
Pregnancy and postpartum EDC exposure and maternal weight/obesity-related outcomes
| Author (year); PMID | Study sample (location) | Study design | Exposure measures and timing | Outcome measures and timing | Main findings |
|---|---|---|---|---|---|
|
| |||||
| • Perng (2020) [54] | 199 (Mexico) | Prospective cohort (ELEMENT) | Urinary BPA and phthalate metabolites in each trimester | Weight at delivery, weight change through 1 year postpartum | • Overall, EDCs associated with lower weight at delivery, but greater weight gain through 1 year postpartum (e.g., IQR increase in ΣDEHP associated with 1.38 (95% CI: 0.44, 2.33) lower weight at delivery and 1.01 (95% CI: 0.41, 1.61) kg/year slower weight loss |
| • Philips (2020) [53] | 1213 (Netherlands) | Prospective cohort (Generation R) | Urinary BPA and phthalate metabolites at median 13 and 20 weeks gestation | Total GWG, highest GWG | • Total bisphenols and BPS associated with lower GWG, especially in normal weight women (−509 g and −398 g, respectively) • Log increase in early total bisphenol and BPA associated with lower GWG (−218, −132, respectively) in mid- to late pregnancy • Mid-pregnancy levels not associated with GWG • No associations with phthalate metabolites. |
| Rodriguez-Carmona (2019) [55] | 178 (Mexico) | Prospective cohort (ELEMENT) | Urinary phthalate metabolites in each trimester | Weight change (per year after delivery) based on weights at 7.1 ± 1.1 years and 9.6 ± 1.5 years postpartum | • A one-unit increase in log-MCPP in pregnancy associated with 0.33 kg (95% CI: 0.09, 0.56) greater weight gain per postpartum year • A one-unit increase in log-MBzP during pregnancy associated with 0.21 kg (95% CI: −0.38, −0.03) lower weight gain per postpartum year |
| Bellavia (2017) [52] | 347 (Boston, USA) | Prospective cohort (LIFECODES) | Urinary phthalate metabolites at median 9.9 weeks gestation | Trimester 1 BMI; early-pregnancy GWG (between 1st and 2nd prenatal visits, median 7.4 weeks) | • Higher MEP, MBzP, MCPP, and ΣDEHP associated with a rightward shift of Trimester 1 BMI • Higher MEP associated with higher GWG • Higher EDEHP associated with lower GWG |
| Wen (2020) [56] | 613 (China) | Prospective cohort (Wuhan) | Urinary parabens in each trimester | GWG rate/week (in each trimester) | • First trimester MeP, EtP, PrP, and Σparabens associated with greater GWG rate in all trimesters (strongest in trimester 1) • Stronger associations in overweight/obese women |
| Shapiro (2018) [57] | 1795 (Canada) | Prospective cohort (MIREC) | Urinary TCS at <14 weeks gestation | Total GWG; GWG category based on IOM recommendations | • No association between TCS and GWG |
| Marks (2019) [58] | 905 (UK) | Prospective cohort (ALSPAC) | Serum PFAS (median 18 weeks gestation) | Absolute GWG; GWG category based on IOM recommendations | • PFOS, PFOA, and PFHxS not associated with GWG in full cohort • In under/normal weight women, higher PFNA associated with higher GWG (e.g., 10% higher PFNA associated with 0.09 kg higher GWG [95% CI: 0.02, 0.16) |
| Jaacks (2016) [59] | 218 (Michigan and Texas, USA) | Prospective cohort (LIFE) | Pre-conception plasma PFAS | Total GWG; GWG category based on IOM recommendations; GWG AUC | • PFOS associated with AUC among women with BMI≤25 kg/m2 • No associations in full cohort, with other outcomes, or with other PFAS |
| • Ashley-Martin (2016) [60] | 2001 (Canada) | Prospective cohort (MIREC) | Maternal (trimester 1) and cord blood PFAS | GWG rate (trimesters 2 and 3), total GWG; GWG category based on IOM recommendations | • Trimester 1 PFOS associated with greater GWG (β=0.39, 95% CI: 0.02, 0.75), particularly in underweight/normal BMI women • IQR increase (7 kg) in GWG associated with elevated cord PFOA (OR: 1.33, 95% CI: 1.13, 1.56) and PFOS (OR: 1.20, 95% CI: 1.03, 1.40) |
AUC, area under the curve; BMI, body mass index; BPA, bisphenol A; BPS, bisphenol S; DEHP, di(2-ethylhexyl) phthalate; EDC, endocrine-disrupting chemicals; EtP, ethyl paraben; GWG, gestational weight gain; IOM, Institute of Medicine; IQR, interquartile range; MBzP, mono-benzyl phthalate; MCPP, mono-(3-carboxypropyl) phthalate; MEP, mono-ethyl phthalate; MeP, methyl paraben; PFAS, perfluoroalkyl substance; PFHxS, perfluorohexanesulfonate; PFNA, perfluorononanoic acid; PFOS, perfluorooctanesulfonic acid; PFOA, perfluorooctanoic acid; PrP, propyl paraben; TCS, triclosan
A bold dot indicates particularly relevant references; these references are also highlighted in the reference list