Evidence map›Paper›PMID 42839036›Full record

ArticlePediatric research2026

Prenatal exposure to nonpersistent endocrine disruptors and early childhood BMI: single pollutant and mixture analyses from the ECHO Program.

Dorothy Nakiwala, Wei Perng, Emily S Barrett, Zhongzheng Niu, Akram N Alshawabkeh, John D Meeker, Dana Dabelea, Anne P Starling, ECHO Cohort Consortium

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Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Dorothy NakiwalaLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center and the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. dorothy.nakiwala@cuanschutz.edu.
Wei PerngLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center and the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Emily S BarrettDepartment of Biostatistics and Epidemiology, Rutgers School of Public Health; Environmental and Occupational Health Sciences Institute, Rutgers, the State University of New Jersey, Piscataway, NJ, USA.
Zhongzheng NiuDivision of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Akram N AlshawabkehCollege of Engineering, Northeastern University, Boston, MA, USA.
John D MeekerDepartment of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Dana DabeleaLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center and the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Anne P StarlingLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center and the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
ECHO Cohort Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExposure to non-persistent endocrine-disrupting chemicals (EDCs), including phenols and phthalates, has been linked to obesity risk. While many studies focus on single-chemical exposures, mixture effects on child adiposity remain unclear.

objectivesTo assess associations of prenatal phenol and phthalate exposures, singly and as mixtures, with early childhood BMI in the U.S. Environmental influences on Child Health Outcomes (ECHO) Program.

methodsWe included 586 mother-child pairs from three ECHO sites with 23 phenols and phthalate metabolites measured in maternal urine during pregnancy, and child BMI z-scores (BMIZ) at 2-5 years. Associations were estimated using covariate-adjusted single-pollutant linear regression and two mixture methods: Bayesian Weighted Quantile Sum (BWQS) and Bayesian Kernel Machine Regression (BKMR). Sex-specific effects were examined in stratified models.

resultsNo associations were observed between the overall prenatal EDC mixture and BMIZ. In single-pollutant models, MBzP (highest tertile) was inversely associated with BMIZ (β = -0.36, 95% CI: -0.63, -0.08), while MEP (second tertile) was positively associated (β = 0.27, 95% CI: 0.01, 0.53). Among boys, MBP (second tertile) was positively associated (β = 0.45, 95% CI: 0.11, 0.79).

conclusionsWe found no strong evidence for mixture effects, though some individual compounds showed non-linear and sex-specific associations. IMPACT: Using a 23-analyte panel of phenols and phthalate metabolites, and complementary (BKMR, BWQS) alongside single-pollutant and sex-stratified models, this study strengthens inference and addresses limitations of prior research. Prenatal exposure to ubiquitous, short-lived endocrine-disrupting phthalates showed non-monotonic, sex-specific associations with early childhood BMI in single-pollutant models. These findings contribute to the limited evidence base on mixture effects of endocrine-disrupting chemicals in early-life obesity risk.

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PMID42839036

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