Prenatal phthalate exposure and performance on the Neonatal Behavioral Assessment Scale in a multiethnic birth cohort

Abstract

We investigated the relationship between prenatal maternal urinary concentrations of phthalate metabolites and neonatal behavior in their 295 children enrolled in a multiethnic birth cohort between 1998 and 2002 at the Mount Sinai School of Medicine in New York City. Trained examiners administered the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) to children within 5 days of delivery. We measured metabolites of 7 phthalate esters in maternal urine that was collected between 25 and 40 weeks’ gestation. All but two phthalate metabolites were over 95% detectable. We summed metabolites on a molar basis into low and high molecular weight phthalates. We hypothesized the existence of sex-specific effects from phthalate exposure a priori given the hormonal activity of these chemicals. Overall we found few associations between individual phthalate metabolites or their molar sums and most of the BNBAS domains. However, we observed significant sex-phthalate metabolite interactions (p < 0.10) for the Orientation and Motor domains and the overall Quality of Alertness score. Among girls, there was a significant linear decline in adjusted mean Orientation score with increasing urinary concentrations of high molecular weight phthalate metabolites (B = -0.37, p = 0.02). Likewise, there was a strong linear decline in their adjusted mean Quality of Alertness score (B = -0.48, p < 0.01). In addition, boys and girls demonstrated opposite patterns of association between low and high molecular weight phthalate metabolite concentrations and Motor performance, with some indication of improved Motor performance with increasing concentration of low molecular weight phthalate metabolites among boys. This is the first study to report an association between prenatal phthalate exposure and neurological effects in humans or animals, and as such requires replication.

May BPA and phthalates have a role in etiopathogenesis of ADHD?

“…35 Also, there are studies which suggest that exposure to phthalates is associated with ADHD and ADHD behaviours, specifically conduct problems and concentration or orientation. [36][37][38] In our study, we found serum BPA and MEHP levels were higher in the ADHD group when compared to healthy controls. The high level of BPA and MEHP in the ADHD group may be related to those dopamine hypotheses.…”

Exposure to phthalates: Reproductive outcome and children health. A review of epidemiological studies

“…Based on results presented above, there seems to be possible association between exposure to phthalates (DEHP, and BBzP ) and the occurrence of asthma symptoms and allergy. The PCV flooring at home and the plastic wall urine [8,14,15,18,43,[49][50][51][52][53][54][57][58][59][60][61]64,73]. As phthalates are metabolized to their monoesters within a few hours or days [79,80], urinary phthalate monoesters are considered good biomarkers for assessing phthalate exposure in humans [8,62,[80][81][82].…”

“…It may be possible to overcome some of the major limitations of studies by choosing a longitudinal design with a follow-up of intraindividual changes. Such prospective design was used in some of the presented studies [8,18,38,43,57,[60][61][62]64,78]. Three studies used also casecontrol design [23,70,72].…”

“…Animal studies have also revealed that the phthalate might cause hyperactivity similar to the clinical syndrome of attention-deficit/hyperactivity disorder (ADHD) found in children [56]. Exposures to phthalates have been examined in relation to neurodevelopment among neonates 5 days after birth in United States [57], in Korea in children from elementary schools [58,59] and in United States both among children 4-9 years [60] and 3.6-6.4 years of age [61] (Table 4). …”

“…The observed risks are generally presumed to be related to the endocrine altering properties of these chemicals [57,61]. In all those studies, exposure to phthalates was associated with neurodevelopmental disorders reflected by significantly poorer scores on conduct problems [60], quality of alertness among girls [57], decreased (less masculine) composite score in boys [61] and lower concentrations and vocabulary score among boys [59] as well as attention deficit hyperactivity disorder (ADHD) [58].…”