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Perioperative Exposure to Suspect Neurotoxicants from Medical Devices in Newborns with Congenital Heart Defects.

Gaynor, J William; Ittenbach, Richard F; Calafat, Antonia M; Burnham, Nancy B; Bradman, Asa; Bellinger, David C; Henretig, Frederick M; Wehrung, Erin E; Ward, J Laurenson; Russell, William W; Spray, Thomas L.
Ann Thorac Surg; 2018 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-30071236


Industrial chemicals are increasingly recognized as potential developmental neurotoxicants. Di(2-ethylhexyl) phthalate (DEHP), used to impart flexibility and temperature tolerance to polyvinylchloride, and bisphenol A (BPA), used to manufacture polycarbonate, are commonly present in medical devices. The magnitude of exposure during hospitalization for cardiac surgery in neonates is unknown.


We quantified urinary concentrations of DEHP metabolites and BPA preoperatively and post-operatively in neonates undergoing cardiac surgery and their mothers. Urinary concentrations of these biomarkers reflect recent exposures (half-lives are approximately 6-24 hours). Biomarker concentrations in mothers and infant preoperative and post-operative samples were compared.


Eighteen infants, age 5 (Mean) ± 4 (SD) days, underwent surgery. The maternal sample was obtained on postpartum day 4 ± 4. The preoperative urine sample was obtained on day-of-life (DOL) 4 ± 2 and the post-operative sample on DOL 6 ± 4. Mean maternal concentrations for DEHP metabolites and BPA were at the 50th percentile for females in the U.S. general population. Infant preoperative concentrations of one DEHP metabolite and BPA were significantly higher than maternal concentrations. For all DEHP metabolites, postoperative concentrations were significantly greater than preoperative concentrations.


There is considerable perioperative exposure to DEHP and BPA for neonates undergoing cardiac surgery. For both BPA and DEHP metabolites, infant concentrations were significantly higher than maternal concentrations, consistent with infant's exposure to medical devices. Further study is needed to determine the potential role of these suspect neurotoxicants in the etiology of neurodevelopmental disability after cardiac surgery.
Selo DaSilva