SynthesisEnvironment international2019
Phthalate exposure and female reproductive and developmental outcomes: a systematic review of the human epidemiological evidence.
Synthesis in Environment international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 4 syntheses or guidelines pooled it, 150 citations in OpenAlex.
- Phthalate Exposures and Placental Health in Animal Models and Humans: A Systematic Review.Toxicological sciences : an official journal of the Society of Toxicology · 2022Pooled it
- Challenges and recommendations on the conduct of systematic reviews of observational epidemiologic studies in environmental and occupational health.Journal of exposure science & environmental epidemiology · 2021Pooled it
- Hazards of diethyl phthalate (DEP) exposure: A systematic review of animal toxicology studies.Environment international · 2020Pooled it
- Hazards of diisobutyl phthalate (DIBP) exposure: A systematic review of animal toxicology studies.Environment international · 2019Pooled it
- The association between serum iodine concentration in the first trimester and foetal ultrasound biometric parameters and birth size among Chinese pregnant women.Annals of medicine · 2026Article
- Review
- Endocrine Disruptors and Gynecological Malignancies.Diagnostics (Basel, Switzerland) · 2026Review
- Prenatal phthalate exposure and emotional-behavioral problems in children aged 1.5 to 3 years from the PROTECT birth cohort.Journal of exposure science & environmental epidemiology · 2026Article
- Gestational Exposure to 10 Classes of Priority Chemicals and Birth Outcomes in the ECHO Cohort.JAMA network open · 2026Article
- Exploring the relationship between microplastic exposure and bone health.Endocrine connections · 2026Review
- The Impact of Endocrine Disruptor Exposure During Pregnancy on Bacterial Complications and Viral Infections: A Narrative Review.Microorganisms · 2026Review
- Identifying dietary and daily product-use patterns explaining joint variation in multiple urinary phthalate metabolites via sparse reduced-rank regression.Frontiers in nutrition · 2026Article
- Case Report: Recurrent gestation-limited intractable abdominal colic with elevated phthalate and paraben biomarkers: a hypothesis-generating observation.Frontiers in medicine · 2026Article
- FIGO committee opinion: Environmental drivers of obstetric health and early childhood development.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Genetic variants (LhcgrBiology of sex differences · 2025Article
- Prenatal exposure to phthalate mixtures and child neurodevelopment in toddlers aged 1-3 years from the PROTECT birth cohort.International journal of hygiene and environmental health · 2025Article
- Di (2-ethylhexyl) Phthalate decrease pregnancy rate via disrupting the microbe-gut-hypothalamic-pituitary-ovarian axis in mice.NPJ biofilms and microbiomes · 2025Article
- Prenatal and Childhood Phthalate Mixtures and Adolescent Sleep Health in the HOME Study.Environmental health perspectives · 2025Article
- Single-cell RNA-seq reveals that granulosa cells are a target of phthalate toxicity in the ovary.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- IMPACT OF REAL-LIFE ENVIRONMENTAL EXPOSURES ON REPRODUCTION: Phthalates disrupt female reproductive health: a call for enhanced investigation into mixtures.Reproduction (Cambridge, England) · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveWe performed a systematic review of the epidemiology literature to identify the female reproductive and developmental effects associated with phthalate exposure. DATA SOURCES AND STUDY ELIGIBILITY CRITERIA: Six phthalates were included in the review: di(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DINP), dibutyl phthalate (DBP), diisobutyl phthalate (DIBP), butyl benzyl phthalate (BBP), and diethyl phthalate (DEP). The initial literature search (of PubMed, Web of Science, and Toxline) included all studies of female reproductive and developmental effects in humans, and outcomes were selected for full systematic review based on data availability. STUDY EVALUATION AND SYNTHESIS
methodsFor each outcome, studies were evaluated using criteria defined a priori for risk of bias and sensitivity by two reviewers using a domain-based approach. Evidence was synthesized by outcome and phthalate and strength of evidence was summarized using a structured framework.
resultsThe primary outcomes reviewed here are (number of included/excluded studies in parentheses): pubertal development (5/13), time to pregnancy (3/4), preterm birth (8/12), and spontaneous abortion (5/0). Among these outcomes, preterm birth had moderate evidence of a positive association with phthalate exposure (specifically DEHP, DBP, and DEP). Exposure levels for BBP, DIBP, and DINP were generally lower than for the phthalates with an observed effect, which may partially explain the difference due to lower sensitivity. Other phthalate/outcome combinations were considered to have slight or indeterminate evidence of an association. CONCLUSIONS AND IMPLICATIONS OF KEY
findingsOverall, these results support that some phthalates may be associated with higher odds of preterm birth in humans, though there is some remaining inconsistency. More evidence is needed on the mechanism and relevant exposure window for this association. The views expressed are those of the authors and do not necessarily represent the views or policies of the U.S. EPA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.