Associations of Exposure to 24 Endocrine-Disrupting Chemicals with Perinatal Depression and Lifestyle Factors: A Prospective Cohort Study in Korea

During pregnancy, reproductive hormonal changes could affect the mental health of women, such as depression and anxiety. Previous studies have shown that exposure to endocrine disrupting chemicals (EDCs) is significantly associated with mental health symptoms; however, the results were inconsistent. We aimed to examine the association between 24 endocrine-disrupting chemicals (EDCs) in maternal urine and perinatal depression and their association with dietary and lifestyle factors. Participants were recruited from the “No Environmental Hazards for Mother–Child” cohort in Korea. Structured questionnaires asking dietary and lifestyle factors and evaluation of depressive symptoms were administered during antepartum (14 weeks of gestation) and postpartum (within four weeks after birth) periods. Urine samples were collected from 242 and 119 women during antepartum and postpartum periods, respectively. To assess perinatal depression, we used the Center for Epidemiological Studies-Depression Scale and the Edinburgh Postnatal Depression Scale. Antepartum depression and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) (1.50, 1.01–2.23) and 1-hydroxypyrene (1-OHP) (0.05, 0–0.89) showed significant positive association. Additionally, postpartum depression showed significant associations with mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) (2.78, 1.00–7.70), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) (2.79, 1.04–7.46), 2-hydroxynaphthalene (2-NAP) (7.22, 1.43–36.59), and 2-hydroxyfluorene (2-FLU) (<0.01, 0–0.004). Some dietary factors (consumption of fish, fermented foods, cup noodles, and popcorn) and consumer product factors (use of skin care, makeup, perfume, antibiotics, sunscreen, nail polish, new furniture, plastic tableware, detergent, polish, paint, and pesticide) were associated with the concentration level of chemicals. We found that exposure to several EDCs during pregnancy and the postpartum period was associated with perinatal depression and dietary–lifestyle factors. Women in childbirth need to actively seek out information about exposure to EDCs and make efforts to avoid them for their own and fetal health.