ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume: 16 Issue: 1 Year: 2024
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Turkish Society for Pediatric Endocrinology and Diabetes
Hidden Toxicity in Neonatal Intensive Care Units: Phthalate Exposure in Very Low Birth Weight Infants [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2016; 8(3): 298-304 | DOI: 10.4274/jcrpe.3027

Hidden Toxicity in Neonatal Intensive Care Units: Phthalate Exposure in Very Low Birth Weight Infants

Atalay Demirel1, Asuman Çoban1, Şükran Yıldırım1, Canan Doğan2, Rukiye Sancı2, Zeynep İnce1
1İstanbul University İstanbul Faculty Of Medicine, Department Of Pediatrics, Division Of Neonatology, İstanbul, Turkey
2Tübitak Marmara Research Center, Food Institute, İstanbul, Turkey

Objective: To determine exposure to endocrine-disrupting phthalates in preterm infants in neonatal intensive care units (NICU). Methods: Urine samples (n=151) from 36 preterm infants (<32 weeks of gestation and/or <1500 g of birth weight) were collected on the first 3 days of admission to the NICU and biweekly thereafter. Diethylhexyl phthalate contents of indwelling medical devices used in various procedures and the concentrations of phthalate metabolites in the urine samples were analyzed. The relationships between urinary excretion, exposure intensity, postnatal age and birth weight were examined.
Results: The mean gestational age and mean birth weight of the study infants were 28.9±1.5 weeks and 1024±262 g, respectively. Diethylhexyl phthalate was detected in umbilical catheters, endotracheal tubes, nasogastric tubes, and nasal cannula. Monoethylhydroxyhexyl phthalate (MEHHP) was the most frequently detected metabolite (81.4%); its concentration increased during the first 4 weeks and then started to decrease but never disappeared. Patients who did not need indwelling catheters (except nasogastric tubes) after 2 weeks were classified as group 1 and those who continued to have indwelling catheters as group 2. Although not of statistical significance, MEHHP levels decreased in group 1 but continued to stay high in group 2 (in the 4th week, group 1: 65.9 ng/mL and group 2: 255.3 ng/mL). Levels of MEHHP in the first urinary samples were significantly higher in infants with a birth weight <1000 g (<1000 g: 63.2±93.8 ng/mL, ?1000 g: 10.9±22.9 ng/mL, p=0.001).
Conclusion: Phthalate metabolites were detected even in the first urine samples of very low birth weight newborns. Phthalate levels were higher in the first weeks of intensive invasive procedures and in preterm infants with a birth weight less than 1000 g. MEHHP was the most frequently detected metabolite and could be a suitable biomarker for the detection of phthalate exposure in preterm infants.

Keywords: newborn,Preterm,phthalate,exposure,neonatal intensive care units

Atalay Demirel, Asuman Çoban, Şükran Yıldırım, Canan Doğan, Rukiye Sancı, Zeynep İnce. Hidden Toxicity in Neonatal Intensive Care Units: Phthalate Exposure in Very Low Birth Weight Infants. J Clin Res Pediatr Endocrinol. 2016; 8(3): 298-304
Manuscript Language: English
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