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Peer-reviewedCC BY 4.0Environmental Science & Technology

Parenteral Nutrition as a Source of Xenobiotic Exposure in Preterm Infants in a Single-Center Case Study

  • Michael Eigenschink1,2
  • Nika Wattaul1,2
  • Sabrina Berger3
  • Jesse Peach3
  • Ernst W. Müllner4
  • Angelika Berger1,2
  • Benedikt Warth3,5
  • Harald H. Sitte6,7,8
  • Lukas Wisgrill1,2,5
8 affiliations
  1. 1Department of Pediatrics, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
  2. 2Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
  3. 3Department of Food Chemistry and Toxicology, University of Vienna, Waehringer Strasse 38, Vienna 1090, Austria
  4. 4Center for Medical Biochemistry, Max Perutz Laboratories, Medical University of Vienna, Dr.-Bohr-Gasse 9, Vienna 1030, Austria
  5. 5Exposome Austria, National Research Infrastructure and EIRENE-AT Node, Vienna 1090, Austria
  6. 6Center for Physiology and Pharmacology, Institute of Pharmacology, Medical University of Vienna, Waehringer Strasse 13a, Vienna 1090, Austria
  7. 7Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman 19328, Jordan
  8. 8AddRess Center for Addiction Research and Science, Medical University of Vienna, Waehringer Strasse 13a, Vienna 1090, Austria
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Abstract

In premature infants, successful ex utero maturation depends on endogenous and exogenous stimuli. Chemical insults during this period may impact long-term development. Given immature hepatic biotransformation, parenteral xenobiotic exposure may be of particular toxicological relevance. We conducted a single-center case study to characterize the xenobiotic burden of neonatal parenteral nutrition (PN). A standardized PN regimen for a 28-week, 1000 g reference infant was passed through infusion lines and the flow-through analyzed via a multianalyte exposome LC-MS/MS assay. Eighteen of 221 targeted xenobiotics were detected. Diisononyl phthalate (DINP, 780 ng/mL), bisphenol A (BPA, 250 ng/mL), methylparaben (MP, 74 ng/mL), and 5-hydroxymethyl-2-furanoic acid (HMFA, 43 ng/mL) showed the highest mean concentrations. The estimated daily intake of BPA (9.5 μg/kg bw/d) exceeded calculated and official Health-Based Guidance Values. Consistent with immature detoxification, pharmacokinetic modeling suggested accumulation of DINP, MINP, and free BPA in premature infants. The higher predicted exposure of premature infants to free BPA warrants investigation into 4-methyl-2,4-bis­(4-hydroxyphenyl)­pent-1-ene (MBP) formation under potentially saturated Phase II metabolism. An exploratory analysis of plasma data from extremely premature infants indicated PN as a contributory rather than predominant source of intervention-related exposure. These findings represent a relevant clinical reference scenario rather than a population-wide exposure estimate.

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Cite

BibTeXRIS
BibTeX
@article{eigenschink2026parenteral,
  title = {{Parenteral Nutrition as a Source of Xenobiotic Exposure in Preterm Infants in a Single-Center Case Study}},
  author = {Michael Eigenschink and Nika Wattaul and Sabrina Berger and Jesse Peach and Ernst W. Müllner and Angelika Berger and Benedikt Warth and Harald H. Sitte and Lukas Wisgrill},
  journal = {Environmental Science \& Technology},
  year = {2026},
  month = oct,
  doi = {10.1021/acs.est.6c12407},
  url = {https://doi.org/10.1021/acs.est.6c12407},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Parenteral Nutrition as a Source of Xenobiotic Exposure in Preterm Infants in a Single-Center Case Study
AU  - Michael Eigenschink
AU  - Nika Wattaul
AU  - Sabrina Berger
AU  - Jesse Peach
AU  - Ernst W. Müllner
AU  - Angelika Berger
AU  - Benedikt Warth
AU  - Harald H. Sitte
AU  - Lukas Wisgrill
PY  - 2026
DA  - 2026/10/19
JO  - Environmental Science & Technology
DO  - 10.1021/acs.est.6c12407
UR  - https://doi.org/10.1021/acs.est.6c12407
AB  - In premature infants, successful ex utero maturation depends on endogenous and exogenous stimuli. Chemical insults during this period may impact long-term development. Given immature hepatic biotransformation, parenteral xenobiotic exposure may be of particular toxicological relevance. We conducted a single-center case study to characterize the xenobiotic burden of neonatal parenteral nutrition (PN). A standardized PN regimen for a 28-week, 1000 g reference infant was passed through infusion lines and the flow-through analyzed via a multianalyte exposome LC-MS/MS assay. Eighteen of 221 targeted xenobiotics were detected. Diisononyl phthalate (DINP, 780 ng/mL), bisphenol A (BPA, 250 ng/mL), methylparaben (MP, 74 ng/mL), and 5-hydroxymethyl-2-furanoic acid (HMFA, 43 ng/mL) showed the highest mean concentrations. The estimated daily intake of BPA (9.5 μg/kg bw/d) exceeded calculated and official Health-Based Guidance Values. Consistent with immature detoxification, pharmacokinetic modeling suggested accumulation of DINP, MINP, and free BPA in premature infants. The higher predicted exposure of premature infants to free BPA warrants investigation into 4-methyl-2,4-bis­(4-hydroxyphenyl)­pent-1-ene (MBP) formation under potentially saturated Phase II metabolism. An exploratory analysis of plasma data from extremely premature infants indicated PN as a contributory rather than predominant source of intervention-related exposure. These findings represent a relevant clinical reference scenario rather than a population-wide exposure estimate.
SN  - 0013-936X
SN  - 1520-5851
ER  -