Predictors, sources, and health risks of environmental antibiotic exposure in Chinese pregnant women.

Environmental antibiotic exposure poses potential hazards on human health, but data remain limited in pregnant women. A total of 732 pregnant women without recent clinical use of antibiotics were selected from the Wenzhou Mother and Child Cohort (WMCC) established in the Yangtze River Delta of East China and parent compounds and metabolites of 32 antibiotics from six common categories were determined in urine. Antibiotics and their metabolites were detected in 86.5% of urine samples. Several general characteristics of pregnant women, including age, household income, screen time, and education level, were associated with urinary concentrations of quinolone, tetracyclines, or phenicols. Higher consumption frequencies of animal-derived food categories, including freshwater fishes, marine fishes, livestock meat other than pork (i.e. beef, mutton, and others), poultry meat, eggs, a category consisting of shrimp, crab, and shellfish, and a category consisting of milk powder and cheese products, were associated with elevated urinary concentrations of tetracyclines, quinolones, sulfonamides, lincosamides, or macrolides, but only tetracyclines were positively associated with consumption frequencies of plant-derived food categories, including wheat flour and its products and fresh vegetables, and tetracyclines, lincosamides, or macrolides showed a marginal association with intake of tap water. A hazard index exceeding one was observed in 4.2% and 0.4% of pregnant women based on microbiological and toxicological thresholds, respectively. These results indicated an extensive environmental antibiotic exposure among Chinese pregnant women with general characteristics as predictors, animal-derived foods as a more significant source than plant-derived foods and drinking water, and a small fraction at health risk.