# Determination of the half-life of di(2-ethylhexyl) phthalate (DEHP) in a preterm neonate using blood transfusion as the source of intravenous exposure

## TL;DR

This study measured how quickly a harmful chemical called DEHP is eliminated from the body of a preterm infant after a blood transfusion, finding it is processed faster than in adults.

## Contribution

The study provides novel half-life data for DEHP metabolites in a preterm infant, highlighting differences in metabolism compared to adults.

## Key findings

- Urinary DEHP metabolite levels increased sharply after blood transfusion.
- DEHP metabolite half-lives in the preterm infant were shorter than in adults.
- The study highlights the need for population-specific DEHP metabolism data in preterm infants.

## Abstract

•Blood transfusion served as a sentinel DEHP exposure in a preterm infant in the NICU.•Urinary DEHP metabolites rose sharply after transfusion and showed clear elimination patterns.•Calculated DEHP metabolite half-lives in this preterm infant were shorter than reported in adults.

Blood transfusion served as a sentinel DEHP exposure in a preterm infant in the NICU.

Urinary DEHP metabolites rose sharply after transfusion and showed clear elimination patterns.

Calculated DEHP metabolite half-lives in this preterm infant were shorter than reported in adults.

In the neonatal intensive care unit (NICU), infants face treatments that convey high-dose exposure to phthalates, a family of ubiquitous endocrine-disrupting organic chemicals. Past research shows that NICU-based phthalate exposure, particularly exposure to di (2-ethylhexyl) phthalate (DEHP), is associated with increased risk of abnormal multisystem outcomes among preterm infants. Blood product transfusion is a recognized significant source of DEHP exposure in hospitalized patients. In this pilot study we collected serial urine samples from one preterm subject following a clinically indicated blood transfusion as a sentinel DEHP exposure. Each specimen was analyzed for DEHP metabolites via liquid chromatography coupled with triple quadrupole tandem mass spectrometry. The calculated half-lives of DEHP metabolites in this subject were generally shorter than reported for adults. Our pilot data demonstrate the need for future studies to estimate population-level half-lives of DEHP metabolites in preterm infants to allow for more accurate NICU-based DEHP source identification than possible with estimates of DEHP metabolism in adults. Source identification is critical to mitigate exposure in the highly vulnerable NICU population.