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We sought to quantify Black\u2013White differences in repeated urinary concentrations of phthalate biomarkers during pregnancy and to estimate the extent to which neighborhood\u2010level social determinants of health (SDoH) mediate these disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This secondary analysis used data from the Human Placenta Project Study, a prospective observational cohort study conducted at two academic institutions between 2016 and 2018. Eligible participants had singleton pregnancies, were recruited before 14 gestational weeks, and self\u2010identified as Black or White; individuals identifying as Hispanic were excluded. Urine specimens were collected at up to eight visits (12\u201338 weeks\u2019 gestation). Statistical analyses were performed from January to April 2025. Our exposures included self\u2010identified race (Black vs. White) and neighborhood SDoH, principally the 2018 Social Vulnerability Index (SVI) and the National Walkability Index, linked by geocoded residential address. Specific\u2010gravity\u2010adjusted concentrations of 14 phthalate metabolites and four replacement metabolites were quantified by high\u2010performance liquid chromatography\u2010tandem mass spectrometry. We used Bayesian multivariate mediation models to estimate adjusted geometric mean ratios (GMRs) with 95% credible intervals (95% CrIs) for the total effect of race and the joint indirect effects via SVI and Walkability, and we reported the proportion mediated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 249 participants (mean age, 26.5 years; 131 [52.6%] Black), 1562 urine samples were analyzed. Black participants had higher pregnancy\u2010average geometric means of monoethyl phthalate (MEP; total GMR, 3.87; 95% CrI, 3.03\u20134.93), \u03a3di\u2010\n                      <jats:italic>n<\/jats:italic>\n                      \u2010butyl phthalate (\u03a3DnBP; 1.86; 1.52\u20132.27), and monobenzyl phthalate (MBzP; total GMR, 1.41; 95% CrI, 1.04\u20131.90). The proportion mediated for SVI and Walkability jointly was 10% for MEP, 18% for \u03a3DnBP, and 44% for MBzP. No significant racial differences were observed for other phthalate biomarkers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Black pregnant individuals had higher phthalate biomarker concentrations for several phthalates, and up to nearly half of the disparity for MBzP was explained by neighborhood\u2010level SDoH. Interventions aimed at improving community social and built environments may help reduce racially patterned chemical exposures during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70226","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T06:36:03Z","timestamp":1768026963000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mediating effect of social determinants of health between race and phthalate biomarkers in pregnancy"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-1699","authenticated-orcid":false,"given":"Tetsuya","family":"Kawakita","sequence":"first","affiliation":[{"name":"EVMS Department of Obstetrics and Gynecology Macon &amp; Joan Brock Virginia Health Sciences at Old Dominion University (ODU)  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misa","family":"Hayasaka","sequence":"additional","affiliation":[{"name":"EVMS Department of Obstetrics and Gynecology Macon &amp; Joan Brock Virginia Health Sciences at Old Dominion University (ODU)  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Barake","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trinity","family":"Soto","sequence":"additional","affiliation":[{"name":"EVMS Department of Obstetrics and Gynecology Macon &amp; Joan Brock Virginia Health Sciences at Old Dominion University (ODU)  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian","family":"Fleming","sequence":"additional","affiliation":[{"name":"EVMS Department of Obstetrics and Gynecology Macon &amp; Joan Brock Virginia Health Sciences at Old Dominion University (ODU)  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Lueth","sequence":"additional","affiliation":[{"name":"Epidemiology Branch National Institute of Environmental Health Sciences, National Institutes of Health  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stevens","family":"Danielle","sequence":"additional","affiliation":[{"name":"Epidemiology Branch National Institute of Environmental Health Sciences, National Institutes of Health  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Abuhamad","sequence":"additional","affiliation":[{"name":"EVMS Department of Obstetrics and Gynecology Macon &amp; Joan Brock Virginia Health Sciences at Old Dominion University (ODU)  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Pryzybylska","sequence":"additional","affiliation":[{"name":"EVMS Department of Obstetrics and Gynecology Macon &amp; Joan Brock Virginia Health Sciences at Old Dominion University (ODU)  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Sinkovskaya","sequence":"additional","affiliation":[{"name":"EVMS Department of Obstetrics and Gynecology Macon &amp; Joan Brock Virginia Health Sciences at Old Dominion University (ODU)  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly K.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Epidemiology Branch National Institute of Environmental Health Sciences, National Institutes of Health  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Saade","sequence":"additional","affiliation":[{"name":"EVMS Department of Obstetrics and Gynecology Macon &amp; Joan Brock Virginia Health Sciences at Old Dominion University (ODU)  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.01.034"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010publhealth\u2010031912\u2010114413"},{"key":"e_1_2_8_4_1","unstructured":"US EPA O.2022.Chemical Production Data. 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