Association between prenatal synthetic phenolic antioxidant exposure and gestational blood pressure: Evidence from a prospective cohort study.
Abstract
Background
Synthetic phenolic antioxidants (SPAs) are widely used industrial additives. This prospective cohort study aimed to explore the associations between maternal SPA exposure and blood pressure level throughout pregnancy.
Methods
Based on a prospective birth cohort enrolling 1368 pregnant women from Ma'anshan, China, we quantified urinary concentrations of nine SPA congeners across all three trimesters and collected serial maternal blood pressure measurements concurrently. Linear mixed-effects models, multivariable logistic regression, quantile-based g-computation, and Bayesian kernel machine regression were applied to assess relationships between SPA exposure and gestational blood pressure. We further explored whether prenatal vitamin supplementation in early and mid-pregnancy acted as an effect modifier for these associations.
Results
Pregnant women were universally exposed to SPAs, with detection frequencies ranging from 1.37% to 91.94% for individual congeners, among which BHA and BHT-CHO were the predominant substances detected in urine during pregnancy. First-trimester exposure to BHT-CHO and 4-TOP was positively associated with elevated diastolic blood pressure (DBP) and mean arterial pressure (MAP). Conversely, second-trimester exposure to BHA and 4-TOP was inversely associated with DBP (P < 0.05). Notably, first-trimester BHA exposure was associated with an elevated risk of gestational hypertension. Stratified analyses revealed that the effects of first-trimester BHT-CHO on systolic blood pressure (SBP), DBP, and MAP were statistically significant only among pregnant women without vitamin supplementation.
Conclusions
Exposure to specific SPAs during pregnancy disrupts blood pressure homeostasis, with identifiable critical windows of susceptibility. Adequate prenatal vitamin supplementation exerts protective effects against cardiovascular toxicity induced by environmental toxicants.