Repeated measurements and mixture effects of urinary bisphenols, parabens, polycyclic aromatic hydrocarbons, and other chemicals on biomarkers of oxidative stress in pre- and postpartum women.

The association between oxidative stress and exposure to bisphenols, parabens, phenols, polycyclic aromatic hydrocarbons (PAH), and volatile organic compounds (VOCs) has been investigated by many in vitro and in vivo studies. However, most of these findings are based on cross-sectional studies, as a result of which the combined effects of these compounds have been rarely analyzed. In this study, our objective was to assess urinary bisphenols, parabens, PAHs, and VOCs, in relation to oxidative stress during pre-and postpartum periods, analyze the association between these chemicals and oxidative stress via repeated measurements using a linear mixed model (LMM), and evaluate the combined effects exerted by these chemicals on oxidative stress using Bayesian Kernel Machine Regression (BKMR). A total 529 urine samples were collected from 242 pregnant women during the 1st and 2nd trimesters, as well as postpartum follow-ups. Three bisphenols, four parabens, benzopheone-3 (BP-3), triclosan (TCS), four PAHs, two VOCs, and 3- phenoxy-benzoic acid (3-PBA) were analyzed. We also measured 8-hydroxydeoxyguanosine (8-OHdG) and malondialdehyde (MDA), which serve as oxidative stress biomarkers in maternal urine samples. During this period, 8-OHdG decreased steadily, whereas MDA increased during pregnancy and decreased after childbirth. LMM indicated that Bisphenol A, Prophyl-paraben, BP-3, and 1-hydroxypyrene (1-OHP) showed a significant association with increased MDA levels. The BKMR models revealed that the mixture effect exerted by these 16 chemicals had changed MDA levels, which indicate oxidative stress, and that both Butyl Paraben (BP) and 1-hydroxypyrene (1-OHP) had contributed to such oxidative stress. Mixtures of each subgroup (bisphenols, parabens, and PAHs) were associated with increased MDA levels. These findings suggest that exposure to some phenols and PAHs during pre- and post-partum stages may cause oxidative stress, and that exposure to these chemicals should be minimized during this period.

Effects of postnatal exposure to phthalate, bisphenol a, triclosan, parabens, and per- and poly-fluoroalkyl substances on maternal postpartum depression and infant neurodevelopment: a korean mother-infant pair cohort study.

Exposure to endocrine-disrupting chemicals (EDCs) can promote infant neurodevelopmental impairment and maternal postpartum depression (PPD). However, the associations between lactation exposure to EDCs, maternal PPD, and infant neurodevelopment are unclear. Hence, we investigated these relationships in infants aged 36-42 months. We recruited 221 Korean mothers and analyzed 29 EDCs. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess maternal PPD. Bayley scales of infant development; the Swanson, Nolan, and Pelham rating scale (SNAP); and the Child Behavior Checklist (CBCL) were used to assess neurodevelopment in infants exposed to the top 30% of EDC over three years. Multiple regression analyses were adjusted for maternal age, pre-pregnancy body mass index, education, income, employment, residence, and infant age and sex. The rates of infants with clinically abnormal diagnoses on neurologic developmental tests (Balyey, SNAP, and CBCL scales) ranged from 7.7 to 38.5% in this study, with the motor and hyperactivity/impulsivity areas scoring the highest among 65 boys and girls. Mono-2-ethylhexyl phthalate (MEHP) and mono-isononyl phthalate (MiNP) levels in breast milk significantly correlated with infant inattention and hyperactivity. Perfluorononanoic acid (PFNA) and perfluorooctyl sulfonate (PFOS) levels correlated significantly with motor development of BSID-III and total CBCL score which mean infant might have lower developmental status. EDC concentrations in breast milk were not associated with maternal PPD. Overall, lactational exposure to EDCs during the postpartum period can exert a negative effect on maternal PPD and infant neurodevelopment.

Pregnancy complications and endometrial cancer in women with polycystic ovarian syndrome: a Korean National Health Insurance Service study.

OBJECTIVE: Polycystic ovarian syndrome is associated with diverse pregnancy related complications and endometrial cancer. However, research on the relationship between pregnancy complications and endometrial cancer in women with polycystic ovarian syndrome is scarce. We aimed to examine the association between gestational diabetes mellitus, pregnancy induced hypertension, and preterm birth and the risk of endometrial cancer in women with polycystic ovarian syndrome. METHODS: We analyzed data from the National Health Information Database established by the Korean National Health Insurance Service between January 2002 and December 2019. We included women with gestational diabetes mellitus, pregnancy induced hypertension, preterm birth, and endometrial cancer from among the polycystic ovarian syndrome population. All conditions were diagnosed according to the Korean Informative Classification of Diseases, 10th revision codes. Age, area of residence, income, body mass index, waist circumference, total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides, fasting blood sugar, and creatinine levels were included as covariates in the multiple logistic regression analysis. RESULTS: Of 467 221 women with polycystic ovarian syndrome included, 5099 had endometrial cancer. Age, residence, income, body mass index, waist circumference, total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides, fasting blood sugar, and creatinine levels differed significantly between the endometrial cancer and non-endometrial cancer groups (p≤0.001-0.032). Among the polycystic ovarian syndrome population, the odds ratios (ORs) of endometrial cancer were 1.50, 1.43, and 1.23 in women with a history of gestational diabetes mellitus, pregnancy induced hypertension, and preterm birth, respectively, compared with those without a history of these conditions (OR 1.50, 95% confidence interval (CI) 1.32 to 1.69, p<0.001; 1.43, 1.04 to 1.97, p=0.027; and 1.23, 1.05 to 1.45, p=0.011, respectively). CONCLUSION: Our results suggest that a history of pregnancy complications (gestational diabetes mellitus, pregnancy induced hypertension, and preterm birth) increases the risk of endometrial cancer in women with polycystic ovarian syndrome.

Factors affecting the safe sexual behaviors of Korean young adults by gender: a structural equation model.

PURPOSE: The aim of this study was to determine the factors that influence safe sexual behaviors of Korean young adults and identify differences by gender. METHODS: This study aimed to determine which factors affected safe sexual behaviors based on the Theory of Planned Behavior. Data from 437 Korean young adults (in their 20s and 30s) were collected via online survey between January 3 and January 28, 2022. The questionnaire included items on sexual body image, sexual role perception, sexual attitudes, sexual socialization, sexual communication, and safe sexual behaviors. Structural equation modeling was performed. RESULTS: According to the overall model fit of the hypothetical model, the final model was acceptable and explained 49% of safe sexual behaviors. Sexual attitudes (ß=-.70, p<.001) and sexual communication (ß=.53, p<.001) directly affected safe sexual behaviors, and sexual role perception (ß=.42, p<.001) indirectly affected safe sexual behaviors in a combined model. There were gender differences in the path from sexual attitudes (ß=-.94, p<.001) and sexual communication (ß=.66, p<.001) to safe sexual behaviors and from sexual body image (ß=.27, p<.001) to sexual communication. CONCLUSION: Sexual attitudes and sexual communication were predictors of safe sexual behaviors, which differed by gender. Strategies that consider sexual attitudes, sexual communication, sexual role perception, and differences between men and women should be developed to improve the safe sexual behaviors of young adults.

Time-course trend and influencing factors for per- and polyfluoroalkyl substances in the breast milk of Korean mothers.

Many studies have reported that neonates and infants are exposed to several per- and polyfluoroalkyl substances (PFASs) via breastfeeding; however, these studies have had small sample sizes. This study aimed to determine the concentrations and time-course trend of PFASs in breast milk and identify influencing factors governing PFAS concentrations. Between July and September (2018), 207 low-risk primiparous women were recruited from a lactation counseling clinic in Korea and their breast milk samples were tested for 14 PFASs, including four perfluoroalkyl sulfonic acids. A questionnaire survey, comprising 84 questions covering the women's demographic, obstetrical, dietary, lifestyle, behavioral, and neonatal information, was conducted to investigate associations. Twelve of the 14 PFASs were detectable in breast milk samples. Perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorodecanoic acid were detected in 100% of the samples, followed by perfluorohexanesulfonic acid (detection rate: 87%), perfluorononanoic acid (87%), and perfluorohexanoic acid (73%); the median concentrations were 0.05, 0.10, 0.031, 0.007, and 0.033 ng/mL, respectively. The PFAS concentrations in breast milk measured in our study were higher than those reported in other studies or countries. In 12 years, from 2007 to 18, the mean concentration of PFOA in breast milk increased by approximately three times (278%). The major factors associated with PFAS concentrations in the bivariate association analysis were body mass index; living area (non-metropolitan); neonatal age; and frequency of fish, ice cream, and canned food consumption. In the multiple regression model, fish consumption significantly influenced the PFOS concentrations in breast milk (ß = 0.88, p = 0.033). Frequently, fish consumption has been analyzed as the main dietary factor related to PFOS concentration. Our findings suggest the need for a comprehensive cohort study on PFAS exposure and its association with infant health.

Effects of Exposure Duration and Exposure Levels of Ambient Air Pollutants on the Risk of Polycystic Ovarian Syndrome: A 2015-2019 Korean Population-Based Cohort Study.

Exposure to ambient air pollution is associated with an increased risk of menstrual disorders and infertility. This study examined the relationships between the levels and duration of air pollution exposure and the risk of polycystic ovarian syndrome (PCOS) using Korean population-based cohort data (2015-2019). Real-time data on PM10, PM2.5, O3, CO, SO2, and NO2 were provided by the Korean Ministry of Environment. The average monthly air pollutant concentration from 1 January 2014 to 31 December 2018 was analyzed. To assess individual-level exposure to air pollutants, a spatial prediction model and an area-averaging approach were used. In total, 237,582 PCOS cases were analyzed. The annual age-adjusted PCOS incidence was 6.70, 8.28, 9.73, 11.58, and 11.97% from 2015-2019, respectively. The PCOS risk increased 1.29-1.32, 1.43-1.52, and 1.32-fold following exposure to the 2-year and 3-year average levels of PM2.5, O3, and NO2, respectively, compared to their 1-year average levels. The PCOS risk increased 1.75-fold (95% confidence interval: 1.66-1.85) in the fourth-quartile for the NO2 level. Increased SO2 and CO levels in the second- and third-quartiles were also associated with an increased PCOS risk. Exposure to air pollutants thus increased the risk for PCOS in the Korean population.

Age-Adjusted Prevalence and Characteristics of Women with Polycystic Ovarian Syndrome in Korea: A Nationwide Population-Based Study (2010-2019).

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder in women of reproductive age and is associated with an increased risk of obesity, compensatory hyperinsulinemia, dyslipidemia, metabolic syndrome, and endometrial cancer. This study analyzed 544619 women using the Korean Informative Classification of Disease, version 10, codes E28.0-E28.9 in the population-based National Health Information Databases from 2010 to 2019. The age-adjusted incidence and prevalence rates of PCOS over 10 years among Korean women were 2.8% and 4.3%, respectively; and they increased in the late teens, peaked in the 20s, and began to decrease at the age of 30. We also found that the body mass index, levels of fasting blood glucose, and high-density lipoprotein values in the recent two years (2018-2019) were higher in women with PCOS compared to the general population. This is the first study to investigate the prevalence of PCOS in a nationwide population of reproductive-aged Korean women. Further research is needed to examine the short- and long-term health risks and psychological problems associated with PCOS.