Exact(2)
Thirteen (24%) infants were exposed to DEHP-containing products at low intensiveness, 24 (44%) were exposed at medium intensiveness, and 17 (32%) were exposed at high intensiveness.
Urinary MEHHP and MEOHP concentrations among infants who were exposed to DEHP-containing products at medium intensiveness were more than four times that of those in the low-intensiveness group.
Similar(58)
In turn, urinary creatinine measurements were available for only 62% and 92% of infants in the low- and medium-intensiveness product use group, respectively.
In units of MEHHP, the relative level of exposure to DEHP among infants in the medium-intensiveness product use group was 4.7 times that among infants in the low-intensiveness group (95% CI for multiplication factor, 1.5 15), and among infants in the high-intensiveness group, exposure to DEHP was 14 times as great (95% CI for multiplication factor, 3.9 50; Figure 1).
The medium-intensiveness group included infants receiving enteral feedings by indwelling gavage tubes either continuously or by bolus feedings; intravenous hyperalimentation by indwelling percutaneous intravenous central catheter (PICC) line, broviac, or umbilical vessel catheter (UVC); and/or nasal continuous positive airway pressure by nasal prongs.
Second, the modest association between medium- and high-intensiveness product use and urinary concentrations of MBP was unexpected.
The DEHP estimated dose for the infants in the medium-and low-intensiveness product use groups would be approximately 2- and 20-fold lower.
Median urinary MEHHP concentrations (and 25th and 75th percentiles) among infants in the low-, medium-, and high-intensiveness product use groups were 27 (18, 60), 307 (34, 614), and 555 (32844844) ng/mL, respectively; median urinary MEOHP concentrations among infants in these groups were 29 (11, 42), 286 (25, 611), and 598 (318, 906) ng/mL, respectively.
Concentrations of MBP were somewhat higher in the medium-and high-DEHP-intensiveness group; MBzP did not vary by product use group.
Before data collection, we defined three levels of intensiveness of DEHP-containing product use (low, medium, and high) based on a review of medical products typically used in both NICUs and information provided by their manufacturers with respect to DEHP content.
We observed a suggestive pattern in the distribution of urinary MBP: Compared with infants exposed at low intensiveness, concentrations of MBP were nearly four times as high among infants exposed at medium (p = 0.05) and high intensiveness (p = 0.07).
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