ArticleThe Lancet. Planetary health2024
Prenatal phthalate exposure and adverse birth outcomes in the USA: a prospective analysis of births and estimates of attributable burden and costs.
Article in The Lancet. Planetary health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 46 citations in OpenAlex.
- Beyond genetics: how environmental stressors drive pediatric hypertension risk.Pediatric nephrology (Berlin, Germany) · 2026Review
- Prenatal exposure to DEHTP replacement metabolites and odds of preeclampsia and gestational hypertension in a diverse nulliparous U.S. cohort.Environmental advances · 2026Article
- Maternal mycoestrogen exposure in relation to timing of birth and placental corticotropin releasing hormone concentrations in a U.S. pregnancy cohort.Reproductive toxicology (Elmsford, N.Y.) · 2026Article
- Advancing child health: forecasting the next great research achievements.Pediatric research · 2026Article
- Article
- Prenatal diisononyl phthalate exposure induces the development of pulmonary dysplasia in offspring.Scientific reports · 2026Article
- Subclinical Diastolic Indices in Children with Type 1 Diabetes: A Cross-Sectional Comparative Study from Northern Iran.International journal of endocrinology and metabolism · 2026Article
- Association of umbilical cord blood phthalate levels with neonatal growth parameters in term pregnancies.BMC pediatrics · 2026Article
- An Innovative Screening Panel for Preventing Miscarriages-Perspectives, Guidance and Guidelines.Antioxidants (Basel, Switzerland) · 2026Article
- Preterm birth attributable to exposure to chemicals used in plastic materials: a global estimate.EClinicalMedicine · 2026Article
- Mediating effect of social determinants of health between race and phthalate biomarkers in pregnancy.Pregnancy (Hoboken, N.J.) · 2026Article
- The placental transcriptome serves as a mechanistic link between prenatal phthalate exposure and placental efficiency.Environment international · 2025Article
- Plastic Pollution and Child Health: A Narrative Review of Micro- and Nanoplastics, Additives, and Developmental Risks.Journal of clinical medicine · 2025Review
- Computer-Aided Molecular Design Meets Network Toxicology and Molecular Docking: A Joint Strategy to Explore Common Molecular Mechanisms of Phthalates on Human Breast Cancer and Structure-Activity Relationship.International journal of molecular sciences · 2025Article
- Environmental Toxicants in the Hispanic Community Epigenetically Contributing to Preeclampsia.Cardiovascular toxicology · 2025Review
- Endocrine-disrupting chemicals exposure: cardiometabolic health risk in humans.Cardiovascular diabetology · 2025Review
- Health impacts of exposure to synthetic chemicals in food.Nature medicine · 2025Review
- Prenatal phthalate exposure and anogenital distance in infants at 12 months.Environment international · 2025Article
- Prenatal and Childhood Phthalate Mixtures and Adolescent Sleep Health in the HOME Study.Environmental health perspectives · 2025Article
- Periods of susceptibility for associations between phthalate exposure and preterm birth: Results from a pooled analysis of 16 US cohorts.Environment international · 2025Article
Corrections and comments
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Authors and funding
19 authors at 16 institutions in 1 country.
Funding
Abstract
backgroundPhthalates are synthetic chemicals widely used in consumer products and have been identified to contribute to preterm birth. Existing studies have methodological limitations and potential effects of di-2-ethylhexyl phthalate (DEHP) replacements are poorly characterised. Attributable fractions and costs have not been quantified, limiting the ability to weigh trade-offs involved in ongoing use. We aimed to leverage a large, diverse US cohort to study associations of phthalate metabolites with birthweight and gestational age, and estimate attributable adverse birth outcomes and associated costs.
methodsIn this prospective analysis we used extant data in the US National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Program from 1998 to 2022 to study associations of 20 phthalate metabolites with gestational age at birth, birthweight, birth length, and birthweight for gestational age z-scores. We also estimated attributable adverse birth outcomes and associated costs. Mother-child dyads were included in the study if there were one or more urinary phthalate measurements during the index pregnancy; data on child's gestational age and birthweight; and singleton delivery.
findingsWe identified 5006 mother-child dyads from 13 cohorts in the ECHO Program. Phthalic acid, diisodecyl phthalate (DiDP), di-n-octyl phthalate (DnOP), and diisononyl phthalate (DiNP) were most strongly associated with gestational age, birth length, and birthweight, especially compared with DEHP or other metabolite groupings. Although DEHP was associated with preterm birth (odds ratio 1·45 [95% CI 1·05-2·01]), the risks per log
interpretationIn a large, diverse sample of US births, exposure to DEHP, DiDP, DiNP, and DnOP were associated with decreased gestational age and increased risk of preterm birth, suggesting substantial opportunities for prevention. This finding suggests the adverse consequences of substitution of DEHP with chemically similar phthalates and need to regulate chemicals with similar properties as a class.
fundingNational Institutes of Health.
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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.