ArticleEnvironmental research2025
Exposure to phthalates and replacements during pregnancy in association with gestational blood pressure and hypertensive disorders of pregnancy.
Article in Environmental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Prenatal exposure to DEHTP replacement metabolites and odds of preeclampsia and gestational hypertension in a diverse nulliparous U.S. cohort.Environmental advances · 2026Article
- Endocrine-Disrupting Chemicals and Hypertension: Mechanisms and Clinical Implications.Journal of cardiovascular development and disease · 2026Review
- Unraveling Plastic-Related Chemical Exposures during Pregnancy and Their Associations with Pregnancy Outcomes Using Suspect Screening Analysis.Environment & health (Washington, D.C.) · 2026Article
- Longitudinal patterns of urinary biomarkers of placental and renal function in pregnancy and associations with early pregnancy exposure to phthalates and replacements.Reproductive toxicology (Elmsford, N.Y.) · 2026Article
- Mediterranean Diet and Oxidative Balance During Pregnancy: Molecular Insights into Mitigating the Impact of Environmental Pollution.Current issues in molecular biology · 2026Review
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Authors and funding
12 authors.
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Abstract
Exposure to endocrine-disrupting chemicals such as phthalates may increase risk of hypertensive disorders of pregnancy (HDP). Prior studies lack investigation of chemical mixtures, phthalate replacements, or key periods of susceptibility including early pregnancy. In the present study, we used a longitudinal approach to evaluate gestational exposure to phthalates and replacements, as both single-pollutants and mixtures, in association with blood pressure and diagnosis of preeclampsia or any HDP. The Human Placenta and Phthalates prospective pregnancy cohort includes 291 participants recruited from two U.S. clinics. Urinary metabolites of ten phthalates and replacements were quantified at up to 8 time points per individual and averaged to create early (12-15 weeks) and overall (12-38 weeks) pregnancy exposure biomarkers. We collected data on gestational blood pressure (mean = 6.2 measures per participant) and diagnosis of preeclampsia (n = 26 cases) or any HDP (n = 44 cases). Linear mixed effects models estimated associations between exposure biomarkers and repeated blood pressure measures. We estimated exposure biomarker associations with preeclampsia and HDP using Cox proportional hazards or logistic regression models, respectively. Quantile g-computation was used to estimate joint effects of a phthalate or replacement mixture with each outcome. Early pregnancy exposure biomarkers demonstrated greater associations with adverse outcomes compared to overall pregnancy. A one-interquartile range increase in early pregnancy di-isononyl phthalate metabolites (ƩDiNP) was associated with a 1.13 mmHg (95 % confidence interval [CI]: 0.25, 2.37) and 0.90 mmHg (CI: 0.16, 1.65) increase in systolic and diastolic blood pressure, respectively. We also found positive but nonsignificant associations of early pregnancy mono-3-carboxypropyl phthalate, di-2-ethylhexyl terephthalate metabolites, and the high molecular weight phthalate mixture with blood pressure. Early pregnancy ƩDiNP was furthermore associated with increased odds of HDP (odds ratio: 1.37, CI: 1.03, 1.82), but not preeclampsia. In sum, early gestational exposure to DiNP and other high molecular weight phthalates may contribute to HDP.
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