Prenatal Exposure to Bisphenols and Phthalates and Postpartum Depression: The Role of Neurosteroid Hormone Disruption

• Published in: The journal of clinical endocrinology and metabolism Vol. 106; no. 7; pp. 1887 - 1899
• Main Authors: Jacobson, Melanie H, Stein, Cheryl R, Liu, Mengling, Ackerman, Marra G, Blakemore, Jennifer K, Long, Sara E, Pinna, Graziano, Romay-Tallon, Raquel, Kannan, Kurunthachalam, Zhu, Hongkai, Trasande, Leonardo
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.07.2021
• Subjects: Adult; Benzhydryl Compounds - toxicity; Clinical s; Depression, Postpartum - chemically induced; Diisononyl phthalate; Endocrine disruptors; Endocrine Disruptors - toxicity; Esters; Female; Humans; Maternal Exposure - adverse effects; Mental depression; Metabolites; Neurosteroids - blood; Phenols; Phenols - toxicity; Phthalate esters; Phthalic Acids - toxicity; Postpartum; Postpartum depression; Postpartum Period - blood; Postpartum Period - psychology; Pregnancy; Pregnancy Trimesters - blood; Pregnanolone; Pregnanolone - blood; Pregnant women; Pregnenolone; Pregnenolone - blood; Prenatal experience; Progesterone; Progesterone - blood; Prospective Studies; Psychiatric Status Rating Scales; Serum levels; Sex hormones; New York; bisphenol; Postpartum depression; allopregnanolone; phthalate; progesterone
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgab199

Abstract Context Postpartum depression (PPD) is a serious psychiatric disorder. While causes remain poorly understood, perinatal sex hormone fluctuations are an important factor, and allopregnanolone in particular has emerged as a key determinant. Although synthetic environmental chemicals such as bisphenols and phthalates are known to affect sex hormones, no studies have measured allopregnanolone and the consequences of these hormonal changes on PPD have not been interrogated. Objective To investigate associations of repeated measures of urinary bisphenols and phthalates in early and midpregnancy with serum pregnenolone, progesterone, allopregnanolone, and pregnanolone concentrations in midpregnancy and PPD symptoms at 4 months postpartum. Methods Prospective cohort study of 139 pregnant women recruited between 2016 and 2018. Bisphenols and phthalates were measured in early and midpregnancy urine samples. Serum sex steroid hormone concentrations were measured in midpregnancy. PPD was assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Multiple informant models were fit using generalized estimating equations. Serum levels of allopregnanolone, progesterone, pregnanolone, and pregnenolone were examined as log-transformed continuous variables. PPD symptoms were examined as continuous EPDS scores and dichotomously with scores ≥10 defined as PPD. Results Di-n-octyl phthalate (DnOP) and diisononyl phthalate (DiNP) metabolites were associated with reduced progesterone concentrations. Log-unit increases in ∑DnOP and ∑DiNP predicted 8.1% (95% CI –15.2%, –0.4%) and 7.7% (95% CI –13.3%, –1.7%) lower progesterone, respectively. ∑DnOP was associated with increased odds of PPD (odds ratio 1.48; 95% CI 1.04, 2.11). Conclusion Endocrine disrupting chemicals may influence hormonal shifts during pregnancy as well as contribute to PPD.