Association between phthalate exposure and blood pressure during pregnancy

Ecotoxicol Environ Saf. 2020 Feb;189:109944. doi: 10.1016/j.ecoenv.2019.109944. Epub 2019 Nov 20.


Background: Phthalates are endocrine disrupting chemicals (EDCs) that pose a serious hazard to the human health. Many epidemiological studies revealed a relationship between phthalates exposure and blood pressure in general population, while the relationship in pregnant women remains unknown.

Objectives: Aimed to elucidate whether phthalate exposure is associated with blood pressure among pregnant women.

Methods: This study included 636 participants from Wuhan, China. Urine samples were conducted repeatedly in three trimesters, and 9 phthalates were measured in these samples. After each urine was sampled, all the participants completed blood pressure measurements. Associations between repeated measurements of phthalate concentration and blood pressure were evaluated by using generalized estimating equations. Stratified analysis by fetus gender was conducted.

Results: Among the pregnant women with male fetuses, mono-i-butyl phthalate (MiBP) exposed in the 1st trimester was associated with the increased diastolic blood pressure (DBP) measured in the 2nd trimester, while the environmental risk score (ERS) measured in the 1st and 2nd trimester was positively associated with systolic blood pressure (SBP) and DBP in the 2nd trimester. No significant relationships were observed among all the population or pregnant women with female fetuses.

Conclusions: Exposure to higher levels of MiBP may be related to increased blood pressure during pregnancy in pregnant women with male fetuses.

Keywords: Blood pressure; Fetus gender; Phthalates; Pregnancy.

MeSH terms

  • Blood Pressure / drug effects*
  • China
  • Endocrine Disruptors / toxicity*
  • Endocrine Disruptors / urine
  • Female
  • Humans
  • Male
  • Maternal Exposure*
  • Phthalic Acids / toxicity*
  • Phthalic Acids / urine
  • Pregnancy


  • Endocrine Disruptors
  • Phthalic Acids