Observational studyPediatric nephrology (Berlin, Germany)2019
Phthalate-associated hypertension in premature infants: a prospective mechanistic cohort study.
Observational study in Pediatric nephrology (Berlin, Germany), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 44 citations in OpenAlex.
- Effects of Di(2-ethylhexyl) phthalate (DEHP) and hyperoxia on cardiovascular development in newborn rats.Pediatric research · 2026Article
- Determination of the half-life of di(2-ethylhexyl) phthalate (DEHP) in a preterm neonate using blood transfusion as the source of intravenous exposure.Current research in toxicology · 2026Article
- Nephrotoxicity of Phthalates: A Review Based on Epidemiological and Toxicological Evidence.Toxics · 2025Review
- Disruptive effects of phthalates and their substitutes on adrenal steroidogenesis.Frontiers in endocrinology · 2025Article
- Consumption of Bottled Water and Chronic Diseases: A Nationwide Cross-Sectional Study.International journal of environmental research and public health · 2024Article
- The Impact of Chronic Phthalate Exposure on Rodent Anxiety and Cognition.Biological psychiatry global open science · 2024Review
- Phthalate exposure in the neonatal intensive care unit is associated with development of bronchopulmonary dysplasia.Environment international · 2023Article
- Phthalates cause a low-renin phenotype commonly found in premature infants with idiopathic neonatal hypertension.Pediatric nephrology (Berlin, Germany) · 2023Review
- Article
- Urine Di-(2-ethylhexyl) Phthalate Metabolites Are Independently Related to Body Fluid Status in Adults: Results from a U.S. Nationally Representative Survey.International journal of environmental research and public health · 2022Article
- Assessment of Exposure to Di-(2-ethylhexyl) Phthalate (DEHP) Metabolites and Bisphenol A (BPA) and Its Importance for the Prevention of Cardiometabolic Diseases.Metabolites · 2022Article
- Maternal Phthalates Exposure and Blood Pressure during and after Pregnancy in the PROGRESS Study.Environmental health perspectives · 2021Article
- Article
- Article
- Bisphenols and phthalates: Plastic chemical exposures can contribute to adverse cardiovascular health outcomes.Birth defects research · 2020Review
- Phthalates Implications in the Cardiovascular System.Journal of cardiovascular development and disease · 2020Review
- The changing spectrum of hypertension in premature infants.Journal of perinatology : official journal of the California Perinatal Association · 2019Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPhthalates are associated with increased blood pressure in children. Large exposures to di-(2-ethylhexyl) phthalate (DEHP) among premature infants have been a cause for concern.
methodsWe conducted a prospective observational cohort study to determine if DEHP exposures are related to systolic blood pressure (SBP) in premature infants, and if this exposure is associated with activation of the mineralocorticoid receptor (MR). Infants were monitored longitudinally for 8 months from birth. Those who developed idiopathic hypertension were compared with normotensive infants for DEHP exposures. Appearance of urinary metabolites after exposure was documented. Linear regression evaluated the relationship between DEHP exposures and SBP index and whether urinary cortisol/cortisone ratio (a surrogate marker for 11β-HSD2 activity) mediated those relationships. Urinary exosomes were quantified for sodium transporter/channel expression and interrogated against SBP index.
resultsEighteen patients met the study criteria, nine developed transient idiopathic hypertension at a postmenstrual age of 40.6 ± 3.4 weeks. The presence of urinary DEHP metabolites was associated with prior IV and respiratory tubing DEHP exposures (p < 0.05). Both IV and respiratory DEHP exposures were greater in hypertensive infants (p < 0.05). SBP index was related to DEHP exposure from IV fluid (p = 0.018), but not respiratory DEHP. Urinary cortisol/cortisone ratio was related to IV DEHP and SBP index (p < 0.05). Sodium transporter/channel expression was also related to SBP index (p < 0.05).
conclusionsIncreased blood pressure and hypertension in premature infants are associated with postnatal DEHP exposure. The mechanism of action appears to be activation of the MR through inhibition of 11β-HSD2.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.