Evidence map›Paper›PMID 40132438›Full record

ArticleEnvironment international2025

Periods of susceptibility for associations between phthalate exposure and preterm birth: Results from a pooled analysis of 16 US cohorts.

Alexa Friedman, Barrett M Welch, Alexander P Keil, Michael S Bloom, Joseph M Braun, Jessie P Buckley, Dana Dabelea, Pam Factor-Litvak, John D Meeker, Karin B Michels and 44 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Environment international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Impact of SGA, AGA, and LGA birthweight subclassification on NICU mortality risk identification: a cohort study.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

54 authors.

Alexa FriedmanNational Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Barrett M WelchNational Institute of Environmental Health Sciences, Research Triangle Park, NC, USA; University of Nevada, Reno, NV, USA.
Alexander P KeilNational Cancer Institute, Bethesda, MD, USA.
Michael S BloomGeorge Mason University, Fairfax, VA, USA.
Joseph M BraunBrown University, Providence, Rhode Island, USA.
Jessie P BuckleyUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Dana DabeleaUniversity of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Pam Factor-LitvakColumbia University, NY, USA.
John D MeekerUniversity of Michigan School of Public Health, Ann Arbor, MI, USA.
Karin B MichelsInstitute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Vasantha PadmanabhanUniversity of Michigan Medical School, Ann Arbor, MI, USA.
Anne P StarlingUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Clarice R WeinbergNational Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Jenny AalborgUniversity of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Akram N AlshawabkehNortheastern University, Boston, MA, USA.
Emily S BarrettRutgers School of Public Health, Piscataway, NJ, USA.
Alexandra M BinderUniversity of Hawaii Cancer Center, Honolulu, HI, USA.
Asa BradmanUniversity of California, Merced, CA, USA.
Nicole R BushUniversity of California, San Francisco, San Francisco, CA, USA.
Antonia M CalafatNational Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
David E CantonwineBrigham and Women's Hospital, Boston, MA, USA.
Kate E ChristenburyDLH, LLC, Bethesda, MD, USA.
José F CorderoUniversity of Georgia, Athens, GA, USA.
Stephanie M EngelUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Brenda EskenaziUniversity of California, Berkeley, CA, USA.
Kim G HarleyUniversity of California, Berkeley, CA, USA.
Russ HauserHarvard TH Chan School of Public Health, Boston, MA, USA.
Julie B HerbstmanColumbia University, NY, USA.
Nina HollandUniversity of California, Berkeley, CA, USA.
Tamarra James-ToddHarvard TH Chan School of Public Health, Boston, MA, USA.
Anne Marie Z JukicNational Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Bruce P LanphearSimon Fraser University, Burnaby, British Columbia, Canada.
Thomas F McElrathBrigham and Women's Hospital, Boston, MA, USA.
Carmen MesserlianHarvard TH Chan School of Public Health, Boston, MA, USA.
Roger B NewmanMedical University of South Carolina, Charleston, SC, USA.
Ruby H N NguyenUniversity of Minnesota School of Public Health, Minneapolis, MN, USA.
Katie M O'BrienNational Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Virginia A RauhColumbia University, NY, USA.
J Bruce RedmonUniversity of Minnesota Medical School, Minneapolis, MN, USA.
David Q RichUniversity of Rochester Medical Center, Rochester, NY, USA.
Emma M RosenUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Sheela SathyanarayanaUniversity of Washington and Seattle Children's Research Institute, Seattle, WA, USA.
Rebecca J SchmidtUniversity of California, Davis, CA, USA.
Amy E SparksUniversity of Iowa, Iowa City, IA, USA.
Shanna H SwanIcahn School of Medicine at Mount Sinai, NY, USA.
Christina WangThe Lundquist Institute at Harbor, UCLA Medical Center, West Carson, CA, USA.
Deborah J WatkinsUniversity of Michigan School of Public Health, Ann Arbor, MI, USA.
Barry WeinbergerCohen Children's Medical Center of New York, Northwell Health, Queens, NY, USA.
Abby G WenzelUniversity of Minnesota Medical School, Minneapolis, MN, USA.
Allen J WilcoxNational Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Kimberly YoltonCincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Yu ZhangHarvard TH Chan School of Public Health, Boston, MA, USA.
Ami R ZotaColumbia University, NY, USA.
Kelly K FergusonNational Institute of Environmental Health Sciences, Research Triangle Park, NC, USA. Electronic address: kelly.ferguson2@nih.gov.

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Translational Research Support CoreP30ES005022 · NIEHS · UNIV OF MED/DENT NJ-R W JOHNSON MED SCH · PI BRIAN T BUCKLEY · 1988 to 2026
$47.4M
Research Experiences and Training Coordination CoreP42ES017198 · NIEHS · NORTHEASTERN UNIVERSITY · PI HARRIS, SEAN M · 2010 to 2024
$38.6M
UNC-CH CENTER FOR ENVIRONMENTAL HEALTH &SUSCEPTIBILITYP30ES010126 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Hazel B Nichols · 2001 to 2026
$36.3M
Biostatstics for Research in Environmental HealthT32ES007018 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Stephanie Engel, Rebecca Fry · 1985 to 2026
$31.3M
Environmental Influences on Child Health Outcomes in Puerto Rico (ECHO-PRO)UH3OD023251 · OD · NORTHEASTERN UNIVERSITY · PI Akram N Alshawabkeh · 2018 to 2026
$24.0M
Strategic Vision & Impact on Environmental HealthP30ES017885 · NIEHS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Dana Dolinoy · 2011 to 2026
$21.3M
HEALTH EFFECTS OF PAH &ETS IN MINORITY WOMEN &NEWBORNSR01ES008977 · NIEHS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI PERERA, FREDERICA P · 1997 to 2011
$12.9M
Trajectories and Environments in Autism: a Multi-cohort Study (TEAMS) following autism families in ECHO Phase 2UH3OD023342 · OD · DREXEL UNIVERSITY · PI KRISTEN Lyall, HEATHER E VOLK · 2018 to 2026
$12.8M
PCBs, Phthalates and Male Reproductive HealthR01ES009718 · NIEHS · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HAUSER, RUSS B · 1999 to 2018
$11.6M
Project C: Epigenetic Effects of DDT/E and PBDEs on PubertyP01ES009605 · NIEHS · UNIVERSITY OF CALIFORNIA BERKELEY · PI ESKENAZI, BRENDA · 1999 to 2015
$11.2M
PRENATAL PCB EXPOSURE &NEURODEVELOPMENTAL OUTCOMES IN ADOLESCENCE &ADULTHOODP01ES009584 · NIEHS · MOUNT SINAI SCHOOL OF MEDICINE OF NYU · PI WOLFF, MARY S · 1999 to 2009
$7.3M
Intramural NIH HHS ZIA ES103321NCATS NIH HHS UL1 TR001881NCI NIH HHS R21 CA128382NICHD NIH HHS R21 HD058019NIDDK NIH HHS R01 DK076648NIEHS NIH HHS P01 ES009584NIEHS NIH HHS P01 ES009605NIEHS NIH HHS P01 ES011261NIEHS NIH HHS P01 ES022844NIEHS NIH HHS P30 ES005022NIEHS NIH HHS P30 ES010126NIEHS NIH HHS P30 ES017885NIEHS NIH HHS P42 ES017198NIEHS NIH HHS R01 ES008977NIEHS NIH HHS R01 ES009718NIEHS NIH HHS R01 ES013543NIEHS NIH HHS R01 ES014393NIEHS NIH HHS R01 ES016863NIEHS NIH HHS R01 ES021369NIEHS NIH HHS R01 ES022934NIEHS NIH HHS R01 ES024381NIEHS NIH HHS R01 ES030078NIEHS NIH HHS R01 ES031591NIEHS NIH HHS R01 ES031657NIEHS NIH HHS R21 ES025551NIEHS NIH HHS R21 ES031231NIEHS NIH HHS R24 ES028533NIEHS NIH HHS T32 ES007018NIEHS NIH HHS U24 ES028529NIH HHS UH3 OD023251NIH HHS UH3 OD023342
6 · The paper itself

Abstract

backgroundPhthalate exposure during pregnancy has been associated with preterm birth, but mechanisms of action may depend on the timing of exposure.

objectiveInvestigate critical periods of susceptibility during pregnancy for associations between urinary phthalate metabolite concentrations and preterm birth.

methodsIndividual-level data were pooled from 16 US cohorts (N = 6045, n = 539 preterm births). We examined trimester-averaged urinary phthalate metabolite concentrations. Most phthalate metabolites had 2248, 3703, and 3172 observations in the first, second, and third trimesters, respectively. Our primary analysis used logistic regression models with generalized estimating equations (GEE) under a multiple informant approach to estimate trimester-specific odds ratios (ORs) of preterm birth and significant (p < 0.20) heterogeneity in effect estimates by trimester. Adjusted models included interactions between each covariate and trimester.

resultsDifferences in trimester-specific associations between phthalate metabolites and preterm birth were most evident for di-2-ethylhexyl phthalate (DEHP) metabolites. For example, an interquartile range increase in mono (2-ethylhexyl) phthalate (MEHP) during the first and second trimesters was associated with ORs of 1.15 (95 % confidence interval [CI]: 0.99, 1.33) and 1.11 (95 % CI: 0.97, 1.28) for preterm birth, respectively, but this association was null in the third trimester (OR = 0.91 [95 % CI: 0.76, 1.09]) (p-heterogeneity = 0.03).

conclusionThe association of preterm birth with gestational biomarkers of DEHP exposure, but not other phthalate metabolites, differed by the timing of exposure. First and second trimester exposures demonstrated the greatest associations. Our study also highlights methodological considerations for critical periods of susceptibility analyses in pooled studies.

Indexed as

Environmental PollutantsMaternal ExposurePhthalic AcidsPremature BirthAdultCohort StudiesFemaleHumansPregnancyPregnancy TrimestersUnited StatesYoung AdultEnvironmental Pollutantsphthalic acidPhthalic Acids

Identifiers

PMID40132438
PMCPMC12021553

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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.