ArticleEnvironment international2021
Phthalate mixtures in pregnancy, autistic traits, and adverse childhood behavioral outcomes.
Article in Environment international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Sex-dependent vulnerability to early-life phthalates exposure and autism spectrum disorders: a systematic review.Frontiers in child and adolescent psychiatry · 2026Pooled it
- Pollutant Burden in Autism Spectrum Disorder: Mechanistic Convergence, Genetic Susceptibility, and Clinical Translation.Current issues in molecular biology · 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
- Mixtures of key components of the external exposome in association with MRI biomarkers of brain structure: Multi-Ethnic Study of Atherosclerosis.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Prenatal phthalate exposure and neurodevelopmental delay in early childhood (1 to 3 years): An Environmental influences on Child Health Outcomes (ECHO) study.Environment international · 2026Article
- Nephrotoxicity of Phthalates: A Review Based on Epidemiological and Toxicological Evidence.Toxics · 2025Review
- Prenatal exposure to endocrine disrupting chemicals and the association with behavioural difficulties in 7-year-old children in the SELMA study.Journal of exposure science & environmental epidemiology · 2025Article
- Prenatal exposure to phthalates and alternative plasticizers and emotional and behavioral outcomes in early childhood in the Environmental influences on Child Health outcomes (ECHO) cohort.Environment international · 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
- Neurobehavioral effects of gestational exposure to mixtures of non-persistent endocrine disruptors in preschool-aged children: The environmental influences on child health outcomes (ECHO) program.Environmental research · 2025Article
- An assessment of organophosphate ester mixtures and the placental transcriptome.Environment international · 2025Article
- Gestational phthalate exposure and behavioral problems in preschool-aged children with increased likelihood of autism spectrum disorder.International journal of hygiene and environmental health · 2025Article
- Associating prenatal phthalate exposure with childhood autistic traits: Investigating potential adverse outcome pathways and the modifying effects of maternal vitamin D.Eco-Environment & Health · 2024Article
- Disrupted Prenatal Metabolism May Explain the Etiology of Suboptimal Neurodevelopment: A Focus on Phthalates and Micronutrients and their Relationship to Autism Spectrum Disorder.Advances in nutrition (Bethesda, Md.) · 2024Review
- Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood.American journal of perinatology · 2024Article
- Subpopulations of children with multiple chronic health outcomes in relation to chemical exposures in the ECHO-PATHWAYS consortium.Environment international · 2024Article
- Impact of Long-Lasting Environmental Factors on Regulation Mediated by the miR-34 Family.Biomedicines · 2024Review
- [Association analysis between mixed exposure to phenols and semen quality].Se pu = Chinese journal of chromatography · 2024Article
- Prenatal exposures to phthalates and life events stressors in relation to child behavior at age 4-6: A combined cohort analysis.Environment international · 2024Article
- Phthalate exposure induces cell death and ferroptosis in neonatal microglial cells.Turkish journal of medical sciences · 2024Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundPrenatal exposure to multiple phthalates is ubiquitous, and yet few studies have evaluated these exposures as a mixture in relation to child autistic traits and behavioral problems.
objectivesTo assess cumulative associations between prenatal phthalate mixtures and child behaviors, including effect modification by exposure timing and child sex.
methodsAnalyses included 501 mother/child pairs from the multicenter pregnancy cohort The Infant Development and Environment Study (TIDES). Nine maternal urinary phthalate metabolites were measured in early and late pregnancy, and behavior was assessed at ages 4-5 years using composite T scores for the Behavioral Assessment System for Children (BASC-2), which measures several dimensions of child behavior, and the Social Responsiveness Scale (SRS-2), which measures social impairment consistent with autistic traits. We utilized weighted quantile sum (WQS) regressions to examine pregnancy period-specific associations between phthalate mixtures and behavioral outcomes. Full-sample 95% WQS confidence intervals are known to be anti-conservative, so we calculated a confirmatory p-value using a permutation test. Effect modification by sex was examined with stratified analyses.
resultsA one-quintile increase in the early pregnancy phthalate mixture was associated with increased SRS-2 total score (coefficient = 1.0, confirmatory p = 0.01) and worse adaptive skills (coefficient = -1.0, confirmatory p = 0.06) in both sexes. In sex-stratified analyses, the early pregnancy phthalate mixture was associated with increased SRS-2 total score in boys (coefficient = 1.2, confirmatory p = 0.04) and girls (coefficient = 1.0, confirmatory p = 0.10) and worse BASC-2 adaptive skills score in girls (coefficient = -1.5, confirmatory p = 0.06), while the late pregnancy phthalate mixture was associated with increased BASC-2 externalizing score in boys (coefficient = 1.3, confirmatory p = 0.03).
conclusionOur results suggest cumulative adverse associations between prenatal phthalate mixtures and multiple facets of childhood behavior.
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