Prenatal Phthalate Exposure Is Associated with Childhood Behavior and Executive Functioning

• Published in: Environmental health perspectives Vol. 118; no. 4; pp. 565 - 571
• Main Authors: Engel, Stephanie M., Miodovnik, Amir, Canfield, Richard L., Zhu, Chenbo, Silva, Manori J., Calafat, Antonia M., Wolff, Mary S.
• Format: Journal Article
• Language: English
• Published: Research Triangle Park, NC National Institute of Environmental Health Sciences 01.04.2010; US Department of Health and Human Services
• Subjects: Attention-deficit hyperactivity disorder; Biological and medical sciences; Chemical hazards; Child; Child Behavior - drug effects; Child, Preschool; Childhood; Children; Children's Health; Depressive disorders; Diagnosis; Environment. Living conditions; Environmental health; Female; Health aspects; Humans; Medical sciences; Metabolic diseases; Metabolites; Parents; Phthalates; Phthalic Acids - toxicity; Pregnancy; Prenatal Exposure Delayed Effects - diagnosis; Preventive medicine; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk factors; United States; North America; America; Human; Executive function; attention deficit hyperactivity disorder; phthalate; Toxicity; Exposure; Prenatal; BASC; BRIEF; Association; Health and environment; environmental exposure; Environment; Attention disorder with hyperactivity; Behavior; Child; Public health
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.0901470

Background: Experimental and observational studies have reported biological consequences of phthalate exposure relevant to neurodevelopment. Objective: Our goal was to examine the association of prenatal phthalate exposure with behavior and executive functioning at 4–9 years of age. Methods: The Mount Sinai Children's Environmental Health Study enrolled a multiethnic prenatal population in New York City between 1998 and 2002 (n = 404). Third-trimester maternal urines were collected and analyzed for phthalate metabolites. Children (n = 188, n = 365 visits) were assessed for cognitive and behavioral development between the ages of 4 and 9 years. Results: In multivariate adjusted models, increased loge concentrations of low molecular weight (LMW) phthalate metabolites were associated with poorer scores on the aggression [β = 1.24; 95% confidence interval (CI), 0.15–2.34], conduct problems (β = 2.40; 95% CI, 1.34–3.46), attention problems (β = 1.29; 95% CI, 0.16–2.41), and depression (β = 1.18; 95% CI, 0.11–2.24) clinical scales; and externalizing problems (β = 1.75; 95% CI, 0.61–2.88) and behavioral symptom index (β = 1.55; 95% CI, 0.39–2.71) composite scales. Increased loge concentrations of LMW phthalates were also associated with poorer scores on the global executive composite index (β = 1.23; 95% CI, 0.09–2.36) and the emotional control scale (β = 1.33; 95% CI, 0.18–2.49). Conclusion: Behavioral domains adversely associated with prenatal exposure to LMW phthalates in our study are commonly found to be affected in children clinically diagnosed with conduct or attention deficit hyperactivity disorders.