Maternal serum polybrominated diphenyl ether concentrations during pregnancy and adolescent bone mineral density at age 12 years

Katherine M. Marquess, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Jordan R. Kuiper, Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, D.C., USA.
Bruce P. Lanphear, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.
Antonia M. Calafat, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Andreas Sjodin, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Maria Ospina, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Lesliam Quirós-Alcalá, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Kim M. Cecil, Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Halley Wasserman, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Yingying Xu, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Kimberly Yolton, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Heidi J. Kalkwarf, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Joseph M. Braun, Department of Epidemiology, Brown University, Providence, RI, USA.
Aimin Chen, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Jessie P. Buckley, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: Jessie.Buckley@unc.edu.

Document Type

Journal Article

Publication Date

1-13-2026

Journal

International journal of hygiene and environmental health

Volume

272

DOI

10.1016/j.ijheh.2026.114742

Keywords

Adolescent health; Bone mineral density; Environmental epidemiology; Mixture analysis; Organophosphate esters; Polybrominated diphenyl ethers

Abstract

Polybrominated diphenyl ethers (PBDEs), used as chemical flame retardants, are developmental osteotoxicants in mechanistic studies, but the effects of in utero exposure on adolescent bone health are unknown. We examined associations of gestational serum PBDE concentrations and BMD Z-scores in adolescence. Among 184 mother-adolescent pairs enrolled in the Health Outcomes and Measures of the Environment Study (Cincinnati, OH: 2003-2006), we quantified five PBDEs in maternal serum and four organophosphate ester (OPE) metabolites in maternal urine collected at 16- or 26-weeks gestation. At age 12 years, we conducted dual energy x-ray absorptiometry scans and calculated bone mineral density (BMD) Z-scores for six skeletal sites. We estimated covariate-adjusted associations per log increase in maternal serum PBDE concentrations using linear regression and assessed effect measure modification (EMM) by adolescent's sex using interaction terms. We also examined PBDE and OPE mixtures using quantile-based g-computation. In adjusted models, BDE-153 concentrations were associated with lower femoral neck BMD (β: -0.42; 95 % CI: -0.79, -0.05). Results were similar but weaker for other individual PBDEs and their mixture. The associations of BDEs-28, -47, and -100 with hip and femoral neck BMD Z-score were modified by adolescent's sex. For example, log BDE-28 was associated with total hip BMD Z-score differences of -0.75 (95 % CI: -1.50, 0.01) for males and 0.21 (95 % CI: -0.31, 0.74) for females (EMM p = 0.04). Higher quartiles of the PBDE + OPE mixture showed weak, site-specific associations with BMD, though all CIs crossed the null. In utero PBDE exposure may negatively affect adolescent bone health.

Department

Environmental and Occupational Health

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