Maternal Food and Beverage Consumption Behaviors and Discrepant Phthalate Exposure by Race

Int J Environ Res Public Health. 2021 Feb 23;18(4):2190. doi: 10.3390/ijerph18042190.


Background: Differential exposure to endocrine-disrupting chemicals, including phthalate diesters, may contribute to persistent racial/ethnic disparities in women's reproductive health outcomes. We sought to characterize sources of gestational exposure to these agents that may differ according to maternal race. Methods: We enrolled pregnant Black (n = 198), including African American, and White (n = 197) women during the second trimester, and measured eight phthalate monoester metabolites in urine. We assessed confounder-adjusted associations between multiple food and beverage consumption habits, summarized using a principal component analysis, as predictors of maternal urinary phthalate metabolite levels, stratified by race. Results: Whites reported significantly greater unprocessed food consumption (42.5% vs. 32.0%; p < 0.001) and storage of food in clear unbreakable plastic containers (66.5% vs. 49.3%; p < 0.001) than Blacks, while Blacks consumed more canned fruits and vegetables (23.5% vs. 12.2%; p < 0.001) than Whites. Using plastics for food storage, microwaving in plastic containers, and using hard plastic water bottles was associated with urinary phthalate concentrations, especially DEHP metabolites (e.g., mean difference = 5.13%; 95% CI: 3.05, 7.25). These associations were driven primarily by Black pregnant women. Conclusions: Targeted interventions to reduce maternal exposure to phthalates need to be designed with specific attention to differences in food and beverage consumption behaviors among Black and White women.

Keywords: female; phthalic acids/urine; pregnancy; questionnaires; racial groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Beverages
  • Endocrine Disruptors*
  • Environmental Exposure / analysis
  • Environmental Pollutants*
  • Female
  • Humans
  • Maternal Exposure
  • Phthalic Acids* / analysis
  • Pregnancy


  • Endocrine Disruptors
  • Environmental Pollutants
  • Phthalic Acids
  • phthalic acid