ArticleEnvironmental research2023
Early pregnancy phthalates and replacements in relation to fetal growth: The human placenta and phthalates study.
Article in Environmental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Systematic evidence map on the association between exposure to personal care products and fetal growth.Environment international · 2026Pooled it
- Evaluating the mediating role of gestational phthalate and replacement biomarkers in the associations between race/ethnicity and birthweight.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- Review
- Longitudinal patterns of urinary biomarkers of placental and renal function in pregnancy and associations with early pregnancy exposure to phthalates and replacements.Reproductive toxicology (Elmsford, N.Y.) · 2026Article
- Considerations for the Analysis of Urinary Environmental Chemical Concentrations During Pregnancy.Epidemiology (Cambridge, Mass.) · 2026Article
- Association of umbilical cord blood phthalate levels with neonatal growth parameters in term pregnancies.BMC pediatrics · 2026Article
- Prenatal Exposure to Mixtures of Nonpersistent Endocrine-Disrupting Chemicals and Angiogenic Biomarkers, Placental Function, and Fetal Growth.Environmental science & technology · 2026Article
- Microplastic exposure and human health risks across the life cycle: a focus on reproduction, development, and aging.Frontiers in cell and developmental biology · 2026Review
- Analysis of Human Placental Tissues Using Gas Chromatography High Resolution Accurate Mass Spectrometry to Characterize Exposure to a Range of Semivolatile Organic Compounds.Exposure and health · 2026Article
- Mediating effect of social determinants of health between race and phthalate biomarkers in pregnancy.Pregnancy (Hoboken, N.J.) · 2026Article
- Early-life phthalate mixture exposure and reproductive hormone levels during minipuberty.Frontiers in endocrinology · 2026Article
- Exposure to phthalates and replacements during pregnancy in association with gestational blood pressure and hypertensive disorders of pregnancy.Environmental research · 2025Article
- Prenatal exposure to phthalates and phthalate replacements in relation to chorionic plate surface vasculature at delivery.The Science of the total environment · 2025Article
- Longitudinal associations between urinary biomarkers of phthalates and replacements with novel in vivo measures of placental health.Human reproduction (Oxford, England) · 2024Article
- Personal care product use patterns in association with phthalate and replacement biomarkers across pregnancy.Journal of exposure science & environmental epidemiology · 2024Article
- Variability and Longitudinal Trajectories of Phthalate and Replacement Biomarkers across Pregnancy in the Human Placenta and Phthalates Study.Environmental science & technology · 2023Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundPregnant persons are exposed ubiquitously to phthalates and increasingly to chemicals introduced to replace phthalates. In early pregnancy, exposure to these chemicals may disrupt fetal formation and development, manifesting adverse fetal growth. Previous studies examining the consequences of early pregnancy exposure relied on single spot urine measures and did not investigate replacement chemicals.
objectiveCharacterize associations between urinary phthalate and replacement biomarkers in early pregnancy and fetal growth outcomes.
methodsAnalyses were conducted among 254 pregnancies in the Human Placenta and Phthalates Study, a prospective cohort with recruitment 2017-2020. Exposures were geometric mean concentrations of phthalate and replacement biomarkers quantified in two spot urine samples collected around 12- and 14-weeks of gestation. Outcomes were fetal ultrasound biometry (head and abdominal circumferences, femur length, estimated fetal weight) collected in each trimester and converted to z-scores. Adjusted linear mixed effects (single-pollutant) and quantile g-computation (mixture) models with participant-specific random effects estimated the difference, on average, in longitudinal fetal growth for a one-interquartile range (IQR) increase in individual (single-pollutant) or all (mixture) early pregnancy phthalate and replacement biomarkers.
resultsMono carboxyisononyl phthalate and the sums of metabolites of di-n-butyl, di-iso-butyl, and di-2-ethylhexyl phthalate were inversely associated with fetal head and abdominal circumference z-scores. A one-IQR increase in the phthalate and replacement biomarker mixture was inversely associated with fetal head circumference (β: -0.36 [95% confidence interval: -0.56, -0.15]) and abdominal circumference (-0.31 [-0.49, -0.12]) z-scores. This association was mainly driven by phthalate biomarkers.
conclusionsUrine concentrations of phthalate biomarkers, but not replacement biomarkers, in early pregnancy were associated with reductions in fetal growth. Though the clinical implications of these differences are unclear, reduced fetal growth contributes to excess morbidity and mortality across the lifecourse. Given widespread global exposure to phthalates, findings suggest a substantial population health burden resulting from early pregnancy phthalate exposure.
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Registered trials
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