An Analysis of the Effects of Lifestyle Factors and Positive Marijuana Drug Screen upon Maternal Phthalate Exposure Open Access

Duke, Natalie (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/r207tq23n?locale=en
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Abstract

Abstract

An Analysis of the Effects of Lifestyle Factors and Positive Marijuana Drug Screen upon Maternal Phthalate Exposure

By

Natalie Duke

Introduction: Phthalates are a ubiquitous environmental exposure in the United States. Maternal exposure to these compounds have been previously stated to cause adverse health effects to developing children. African American women have historically been faced with environmental injustice and may have higher prevalence of this exposure. The aim of this study is to explore the nature of the relationship between maternal phthalate exposure, positive marijuana drug screens along with other lifestyle factors present in an Atlanta, Georgia cohort of pregnant African American women through analysis of maternal urine.

Methods: Pregnant African American women were recruited at Emory University Hospital, Emory University Hospital Midtown, and Grady Memorial Hospital during the eight to fourteenth week of pregnancy. All participants provided written informed consent in accordance with the requirements of the Institutional Review Board of Emory University. Each participant was given a self-administered survey that inquired about lifestyle factors, previous health history and concerns. A spot maternal urine sample was collected from each of the study participants. This urine sample was then analyzed with high performance liquid chromatography and tandem mass spectrometry. Each sample had proper quality control methods to control for error. Correlations were assessed between covariates, and then each covariate was assessed for an association with phthalate concentrations at the bivariate level. Multivariable linear models were used to investigate the relationship of each phthalate concentration to each covariate controlled for all others.

Results: Low maternal income was positively correlated with a positive urine drug screen (P=0.01). Condom usage during vaginal intercourse was a significant predictor of MiBP concentration at the bivariate level and the full adjusted model (P=0.01). Vitamin usage was also found to be a significant predictor for MECPP (P=0.01), MEHHP (P=0.01), MEOHP (P= 0.02), and MEHP (0.01). Maternal BMI was a significant predictor for MEP (P=0.05) concentration in the fully adjusted model. Maternal income was also a significant predictor of MBZP concentration (P=0.04) in the bivariate analysis and marginally significant in the fully adjusted analysis (P=0.09).

Conclusion: There are significant relationships between maternal phthalate levels and certain covariates, many of which represent environmental justice concerns. Positive marijuana urine drug screens are correlated to other covariates that are significant predictors for phthalate concentration, which implies a complicated relationship and a need for additional research to understand the true effects. Phthalate exposure has implications in child health and associations between covariates must be explored to fully understand its effects.

Table of Contents

Table of Contents

I. Introduction……………………………………………………………..1

II. Methods………………………………………………………………....5

Subjects…………………………………………………………5

Measures………………………………………………………..6

Analysis Methods…………………………………………….…7

III. Results…………………………………………………………………8

IV. Discussion……………………………………………………………..10

V. Public Health Message and Conclusion……………………………….14

VI. Tables and Figures………………………………………………….....15

VII. References……………………………………………………………..26

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