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Updated: Jun 16, 2026

Long-term Behavioral and Reproductive Consequences of Embryonic Exposure to Low-dose Toxicants
Published on: March 6, 2018
Prenatal phthalate exposure is associated with childhood behavior and executive functioning
Stephanie M Engel1, Amir Miodovnik, Richard L Canfield
1Department of Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. stephanie.engel@mssm.edu
Insights
Prenatal exposure to low molecular weight (LMW) phthalates is linked to increased behavioral issues and executive function deficits in children. These findings highlight potential neurodevelopmental impacts of environmental chemical exposure.
Area of Science:
- Environmental Health
- Neurodevelopmental Toxicology
- Pediatric Health
Background:
- Emerging evidence suggests phthalate exposure can impact neurodevelopment.
- Understanding these effects is crucial for public health and child development.
Purpose of the Study:
- To investigate the association between prenatal phthalate exposure and child behavior and executive functioning.
- Focus on children aged 4-9 years.
Main Methods:
- The Mount Sinai Children's Environmental Health Study enrolled 404 pregnant women in NYC.
- Maternal urine samples from the third trimester were analyzed for phthalate metabolites.
- Children (n=188) underwent cognitive and behavioral assessments between ages 4 and 9.
Main Results:
- Higher concentrations of low molecular weight (LMW) phthalate metabolites correlated with increased aggression, conduct problems, attention problems, and depression.
- Adverse associations were also observed for externalizing problems and behavioral symptom index.
- Poorer executive functioning, including global executive composite index and emotional control, was linked to LMW phthalate exposure.
Conclusions:
- Prenatal exposure to LMW phthalates is associated with behavioral problems and executive dysfunction in children.
- These findings align with behavioral issues seen in children diagnosed with conduct or attention deficit hyperactivity disorders.
Background:
Experimental and observational studies have reported biological consequences of phthalate exposure relevant to neurodevelopment.
Objective:
Our goal was to examine the association of prenatal phthalate exposure with behavior and executive functioning at 4-9 years of age.
Methods:
The Mount Sinai Children's Environmental Health Study enrolled a multiethnic prenatal population in New York City between 1998 and 2002 (n = 404). Third-trimester maternal urines were collected and analyzed for phthalate metabolites. Children (n = 188, n = 365 visits) were assessed for cognitive and behavioral development between the ages of 4 and 9 years.
Results:
In multivariate adjusted models, increased loge concentrations of low molecular weight (LMW) phthalate metabolites were associated with poorer scores on the aggression [beta = 1.24; 95% confidence interval (CI), 0.15- 2.34], conduct problems (beta = 2.40; 95% CI, 1.34-3.46), attention problems (beta = 1.29; 95% CI, 0.16- 2.41), and depression (beta = 1.18; 95% CI, 0.11-2.24) clinical scales; and externalizing problems (beta = 1.75; 95% CI, 0.61-2.88) and behavioral symptom index (beta = 1.55; 95% CI, 0.39-2.71) composite scales. Increased loge concentrations of LMW phthalates were also associated with poorer scores on the global executive composite index (beta = 1.23; 95% CI, 0.09-2.36) and the emotional control scale (beta = 1.33; 95% CI, 0.18- 2.49).
Conclusion:
Behavioral domains adversely associated with prenatal exposure to LMW phthalates in our study are commonly found to be affected in children clinically diagnosed with conduct or attention deficit hyperactivity disorders.
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