Human biomonitoring of bisphenol A along pregnancy: An exposure reconstruction of the EXHES-Spain cohort
Introduction
Bisphenol A (BPA) is a monomer widely used in polycarbonate synthesis, plasticizer in the production of epoxy resins, an additive to eliminate the excess of hydrochloric acid during the production of polyvinyl chloride (PVC) (Konieczna et al., 2015). BPA is not only used in the fabrication of plastics to be in direct contact with food, such as food containers or baby bottles, but also in inner coatings of cans and jar caps (Fiege et al., 2012; Acconcia et al., 2015). Even though polycarbonates and epoxy resins account for the 95% of the total production of BPA (Careghini et al., 2015), other materials, like dental sealants or thermal paper, may contain BPA (Ma et al., 2019).
Diet is the main pathway of exposure to BPA (Martínez et al., 2018; González et al., 2020a; Gys et al., 2020). However, dust inhalation or dermal absorption should not be disregarded as other potential routes of exposure (Geens et al., 2012; Mustieles et al., 2020). Once BPA is ingested, it suffers a rapid process of glucuronidation in the liver, followed by its excretion through urine (Ma et al., 2019). Most of the BPA ingested is actually excreted through the urine within 24 h (Csanády et al., 2002; Martínez et al., 2018; Thayer et al., 2015), although it can be partly accumulated in fat tissues (Bellavia et al., 2018; Casas et al., 2013). In any case, it has been largely agreed that urine is the most suitable biomonitoring tool to assess the exposure to BPA (Genuis et al., 2012; González et al., 2020b).
BPA is a well-known endocrine disruptor interfering in the downregulation of the endocrine system by binding to the oestrogens receptors (Kim and Park, 2019). The exposure to BPA is a topic of concern because it might lead to several adverse health effects such as obesity, metabolic disorders, altered reproduction and neurodevelopment, and cancer (Seachrist et al., 2016; Wang et al., 2017; Dumitrascu et al., 2020; Ma et al., 2019; Martínez et al., 2020a; Mustieles et al., 2020).
BPA exposure during pregnancy has a direct negative impact on maternal, foetal, and neonatal outcomes. Unconjugated BPA, as well as BPA-G at a smaller proportion, are able to cross the human placenta (Ginsberg and Rice, 2009; Balakrishnan et al., 2010). Moreover, because foetuses do not own a completely developed glucuronidation system, BPA is accumulated (Fenichel et al., 2013). Perinatal exposure to BPA has been linked to low birth weight (Huo et al., 2015), and to birth length and head circumference (Lee et al., 2014; Snijder et al., 2013). In turn, developmental defects (i.e.: anogenital distance, nervous system abnormalities, chromosomal anomalies) and recurrent miscarriage has been also reported (Miao et al., 2011; Guida et al., 2015). On the other hand, the potential effect of BPA on preeclampsia and gestational diabetes mellitus is a topic of recent concern, but as current research is very limited, results are still inconclusive (Pergialiotis et al., 2018).
This study was aimed at performing a biomonitoring study of BPA levels in urine samples from 60 pregnant women recruited within the EXHES-Spain cohort. The associations between maternal exposure to BPA with lifestyle habits and personal data were also explored.
Section snippets
Study population
The study population comprised a group of pregnant women from the European Exposure and Health Examination Survey (EXHES-Spain) Spanish cohort (Martínez et al., 2020b), which was recruited during the first trimester of pregnancy as part of the Health and Environment-wide Associations based on large population surveys (HEALS) project (Bocca et al., 2019). The recruitment of pregnant women started in March 2016, being here included 60 pregnant women and their newborn children. Women were informed
Urinary BPA concentrations
The concentration of BPA in urine from 60 pregnant women from the EXHES-Spain cohort are summarized in Table 2. BPA was detected in 76% of the samples. Mean BPA levels were 2.85, 2.77 and 1.86 μg/L in the first (T1), second (T2) and third (T3) trimester, respectively. When considering the amount of creatinine, adjusted BPA mean levels were 4.64, 4.84 and 2.51 μg/g creatinine in T1, T2 and T3, respectively. No changes of BPA urinary levels were noted between the 12th and 20th GW. In turn, a
Conclusions
A biomonitoring study was performed to determine the levels of BPA in urine samples from 60 pregnant women recruited within the EXHES-Spain cohort along the three trimesters of pregnancy. BPA was detected in 76% of the samples, whose creatinine-adjusted BPA mean concentrations were 4.64, 4.84 and 2.51 μg/g in T1, T2 and T3, respectively. A decrease of urinary BPA levels was found with time, being the levels of BPA in T3 significantly reduced compared with those found in T1 and T2. No
Credit roles
M.Á Martinez: Methodology, Investigation, Writing – original draft; Neus González: Methodology, Investigation, Writing – original draft; Anna Martí;: Methodology, Investigation; Writing – review & editing; Montse Marquès: Writing – review & editing; Joaquim Rovira: Conceptualization, Visualization; Writing – review & editing; Vikas Kumar: Methodology, Investigation, Writing – review & editing; Martí Nadal: Funding acquisition, Writing – review & editing, Supervision.
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgements
We would like to thank all pregnant women who volunteered to participate in this study. This study was financially supported by the Spanish Ministry of Economy and Competitiveness, through MODELBIS Project (AGL2016-78942-R), as well as by the European Community under Grant Agreements no. 603946–2 (HEALS FP7 project) and 733032 (HBM4EU H2020 project). J. Rovira received a postdoctoral fellowship from “Juan de la Cierva-incorporación” program of the Spanish “Ministerio de Ciencia, Innovación y
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These authors contributed equally to this work, and they should be listed as the first co-authors.