Racial and Ethnic Disparities in Phthalate Exposure and Preterm Birth: A Pooled Study of Sixteen U.S. Cohorts
Barrett M. Welch, Alexander P. Keil, Jessie P. Buckley, Stephanie M. Engel, Tamarra James‐Todd, Ami R. Zota, Akram N. Alshawabkeh, Emily S. Barrett, Michael S. Bloom, Nicole R. Bush, José F. Cordero, Dana Dabelea, Brenda Eskenazi, Bruce P. Lanphear, Vasantha Padmanabhan, Sheela Sathyanarayana, Shanna H. Swan, Jenny Aalborg, Donna D. Baird, Alexandra M. Binder, Asa Bradman, Joseph M. Braun, Antonia M. Calafat, David E. Cantonwine, Kate E. Christenbury, Pam Factor‐Litvak, Kim G. Harley, Russ Hauser, Julie B. Herbstman, Irva Hertz‐Picciotto, Nina Holland, Anne Marie Z. Jukic, Thomas F. McElrath, John D. Meeker, Carmen Messerlian, Karin B. Michels, Roger Newman, Ruby H.N. Nguyen, Katie M. O’Brien, Virginia Rauh, J. Bruce Redmon, David Q. Rich, Emma M. Rosen, Rebecca J. Schmidt, Amy E. Sparks, Anne P. Starling, Christina Wang, Deborah J. Watkins, Clarice R. Weinberg, Birgit Weinberger, Abby G. Wenzel, Allen J. Wilcox, Kimberly Yolton, Yu Zhang, Kelly K. Ferguson
Abstract
BACKGROUND: Phthalate exposures are ubiquitous during pregnancy and may contribute to racial and ethnic disparities in preterm birth. OBJECTIVES: ) exposure-response models stratified by race and ethnicity. METHODS: We pooled individual-level data on 6,045 pregnancies from 16 U.S. cohorts. We investigated covariate-adjusted differences in nine urinary phthalate metabolite concentrations by race and ethnicity [non-Hispanic White (White, 43%), non-Hispanic Black (Black, 13%), Hispanic/Latina (38%), and Asian/Pacific Islander (3%)]. Using g-computation, we estimated changes in the probability of preterm birth under hypothetical interventions to eliminate disparities in levels of urinary phthalate metabolites by proportionally lowering average concentrations in Black and Hispanic/Latina participants to be approximately equal to the averages in White participants. We also used race and ethnicity-stratified logistic regression to characterize associations between phthalate metabolites and preterm birth. RESULTS: -butyl and monoisobutyl phthalate), with positive associations that were larger in magnitude observed among Black or Hispanic/Latina participants. CONCLUSIONS: Phthalate metabolite concentrations differed substantially by race and ethnicity. Our results show hypothetical interventions to reduce population-level racial and ethnic disparities in biomarkers of phthalate exposure could potentially reduce the probability of preterm birth. https://doi.org/10.1289/EHP12831.