Sains Malaysiana 53(10)(2024): 3455-3464

http://doi.org/10.17576/jsm-2024-5310-18

Association between Gestational Bisphenol A Exposure and Maternofoetal Outcomes: A Cohort Study in a Single Tertiary Hospital in Klang Valley

(Perkaitan antara Dedahan Bisfenol A Gestational dan Hasil Maternofoetal: Suatu Kajian Kohort di Hospital Tertiari Tunggal di Lembah Klang)

JULIANA YUSOF^1#, SARAH ZULKIFLI^2#, MOHD SHAHRIL AHMAD SAMAN³, DANIAL EFENDY GOON⁴, NURLIANA ABD MUTALIB⁵, NUR IZZATY YUSNAZERY⁶, IZZUAN KHIRMAN ADNAN⁶ & SITI HAMIMAH SHEIKH ABDUL KADIR^2,*

¹Department of Obstetrics and Gynaecology, Hospital Al Sultan Abdullah, Universiti Teknologi MARA (UiTM), 42300 Puncak Alam, Selangor, Malaysia

²Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia

³Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia

⁴Novo Nordisk Pharma (M) Sdn. Bhd., Jalan Tun Sambanthan, 50470 Kuala Lumpur, Malaysia

⁵Atta-Ur-Rahman Institute for Natural Product Discovery (AuRIns), Universiti Teknologi MARA (UiTM), 42300 Puncak Alam, Selangor, Malaysia

⁶National Institute of Health, Ministry of Health Malaysia, 40170 Shah Alam, Selangor, Malaysia

Diserahkan: 16 Januari 2024/Diterima: 29 Ogos 2024

Abstract

A growing body of literature has documented the adverse effects of bisphenol A (BPA) exposure on pregnancy and birth outcomes. Regardless, how gestational BPA exposure affects mother-newborn pairs in Malaysia is yet to be explored. Hence, this study aimed to investigate urinary BPA levels of pregnant women living in Klang Valley and their associations with adverse obstetric and birth outcomes. This cross-sectional study involved pregnant women in their third trimester attending antenatal clinic in Hospital Al Sultan Abdullah (HASA), UiTM Puncak Alam, who planned to have their delivery in HASA. Information on maternal age, parity, education, household income, gestational age, and obstetric complications, such as Gestational Diabetes Mellitus (GDM), preeclampsia, preterm labour, and foetal growth restriction (FGR) were collected. Maternal urine samples were also obtained and evaluated using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Additionally, the neonatal outcomes including mode of delivery, gestational age, birth weight and need for NICU admission were documented. Our LC-MS/MS analysis showed that BPA was present in all the urine samples, with levels varying from 4.42 to 30.86 ng/mL. The median level was 15.96 ng/mL. Urinary BPA level has no significant correlation with gestational hypertension (GHTN), preterm labour and low birth weight babies. Babies who need NICU admission were born to mothers who exhibited significantly different urinary BPA levels compared to those whose babies were not admitted (p=0.049). Finding from this study suggestive of further investigation on level of gestational urinary BPA with NICU admission, ideally with a larger sample size to validate these results.

Keywords: Bisphenol A (BPA); foetal outcome; pregnancy outcome

Abstrak

Badan kepustakaanyang semakin meningkat telah mendokumentasikan kesan buruk bisfenol A (BPA) terhadap kehamilan dan kelahiran. Namun begitu, bagaimana pendedahan BPA semasa kehamilan memberi kesan terhadap pasangan ibu dan bayi baru lahir di Malaysia masih belum diterokai. Oleh itu, penyelidikan ini bertujuan untuk mengkaji tahap BPA dalam air kencing wanita hamil yang tinggal di Lembah Klang dan kaitannya dengan kesan buruk obstetrik dan kelahiran. Kajian keratan rentas ini melibatkan wanita hamil dalam trimester ketiga yang menghadiri klinik antenatal di Hospital Al Sultan Abdullah (HASA), UiTM Puncak Alam, yang merancang untuk bersalin di HASA. Maklumat mengenai umur ibu, pariti, pendidikan, pendapatan isi rumah, usia kehamilan dan komplikasi obstetrik, seperti Gestational Diabetes Mellitus (GDM), preeklampsia, kelahiran pramatang dan sekatan pertumbuhan janin (FGR) telah dikumpulkan. Sampel air kencing pesakit juga diambil dan dianalisis menggunakan kromatografi cecair spektrometri jisim tandem (LC-MS/MS). Di samping itu, hasil neonatal termasuk cara melahirkan, umur kehamilan, berat bayi ketika lahir dan keperluan untuk kemasukan NICU telah didokumenkan. Semua sampel air kencing didapati mengandungi BPA dan parasnya adalah antara 4.42 hingga 30.86 ng/mL. Tahap median ialah 15.96 ng/mL. Tahap BPA kencing tidak mempunyai korelasi yang signifikan dengan hipertensi semasa hamil (GHTN), kelahiran pramatang dan berat lahir bayi yang rendah. Bayi yang memerlukan kemasukan NICU dilahirkan oleh ibu yang menunjukkan tahap BPA kencing yang berbeza secara ketara berbanding mereka yang bayinya tidak dimasukkan (p = 0.049). Penemuan daripada kajian ini mencadangkan kajian lanjut mengenai tahap BPA dalam air kencing semasa kehamilan dengan kemasukan NICU, idealnya dengan saiz sampel yang lebih besar untuk mengesahkan keputusan ini.

Kata kunci: Bisfenol A (BPA); hasil kehamilan; hasil kelahiran

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*Pengarang untuk surat-menyurat; email: sitih587@uitm.edu.my