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Published on: August 7, 2017
Maternal phthalate exposure and asthma, rhinitis and eczema in 552 children aged 5 years; a prospective cohort study
Camilla Jøhnk1, Arne Høst2, Steffen Husby2
1Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000, Odense, Denmark.
Insights
Prenatal exposure to certain phthalates showed a potential link to increased childhood rhinitis and eczema risk. However, no significant association was found with asthma in this prospective cohort study.
Area of Science:
- Environmental Health
- Pediatric Allergy
- Toxicology
Background:
- Prenatal exposure to phthalates is suspected to influence immune development, potentially increasing risks for asthma, eczema, and rhinitis.
- Limited prospective cohort studies exist, with only one investigating rhinitis, highlighting a gap in understanding long-term effects.
Purpose of the Study:
- To investigate the association between maternal urinary phthalate metabolite concentrations during pregnancy and the development of asthma, eczema, and rhinitis in offspring at age 5.
- To contribute data from a prospective cohort to the limited existing research on phthalate exposure and allergic diseases in children.
Main Methods:
- Quantified 12 phthalate metabolites in maternal urine during the third trimester from 552 pregnant women in the Odense Child Cohort.
- Assessed asthma, rhinitis, and eczema in offspring at age 5 using an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.
- Employed logistic regression analysis, adjusting for relevant confounding factors.
Main Results:
- No significant associations were observed between prenatal phthalate exposure and childhood asthma.
- Increased odds of rhinitis were noted with higher concentrations of diisononyl phthalate (DiNP) and di-2-ethylhexyl phthalate (DEHP) metabolites.
- A significant association was found between higher diisononyl phthalate (DiNP) metabolite levels and an increased odds of eczema, while a di-ethyl phthalate (DEP) metabolite showed a reduced odds of eczema medication use.
Conclusions:
- The lack of association with asthma may be attributed to low exposure levels and diagnostic challenges in young children.
- Elevated odds of rhinitis warrant further investigation in larger cohorts and older children.
- Findings suggest potential links between specific phthalates and allergic conditions, necessitating continued research.
Background:
Prenatal phthalate exposure has been suggested to alter immune responses and increase the risk of asthma, eczema and rhinitis. However, few studies have examined the effects in prospective cohorts and only one examined rhinitis. We therefore studied associations between maternal urinary concentrations of phthalate metabolites and asthma, eczema and rhinitis in offspring aged 5 years.
Methods:
From 552 pregnant women in the Odense Child Cohort, we quantified urinary concentrations of 12 phthalate metabolites in third trimester. We assessed asthma, rhinitis and eczema in their offspring at age 5 years with a questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC), and conducted logistic regression adjusting for relevant confounders.
Results:
7.4% of the children had asthma, 11.7% eczema and 9.2% rhinitis. Phthalate exposure was low compared to previous cohorts. No significant associations between prenatal phthalate exposure and asthma were found. Odds ratios (ORs) of child rhinitis with a doubling in ΣDiNPm and di-2-ethylhexyl phthalate metabolite (ΣDEHPm) concentrations were, respectively, 1.15 (95% confidence interval (CI) 0.97,1.36) and 1.21 (CI 0.93,1.58). The OR of eczema when doubling ΣDiNPm was 1.24 (CI 1.00,1.55), whereas the OR of using medicine against eczema when doubling a di-ethyl phthalate (DEP) metabolite was 0.81 (CI 0.68,0.96).
Conclusion:
The lack of association between maternal phthalate exposure and asthma in the offspring may be due to low exposure and difficulties in determining asthma in 5-year-olds. The higher odds of rhinitis may raise public concern but further research in larger cohorts of older children is warranted.
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