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Updated: Dec 9, 2025

Long-term Behavioral and Reproductive Consequences of Embryonic Exposure to Low-dose Toxicants
Published on: March 6, 2018
Fetal exposure to phthalates and bisphenols and childhood general and organ fat. A population-based prospective
Chalana M Sol1,2, Susana Santos1,2, Liesbeth Duijts1,2
1The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Insights
Maternal phthalate exposure during pregnancy, specifically phthalic acid, is linked to increased pericardial fat in children. Bisphenol exposure did not show significant associations with childhood adiposity. Further research is needed to confirm these findings.
Area of Science:
- Environmental Health
- Pediatric Endocrinology
- Toxicology
Background:
- Fetal exposure to endocrine-disrupting chemicals like phthalates and bisphenols may impact long-term growth and fat development.
- Limited data exists on the specific effects of these exposures on general and organ-specific fat accumulation in childhood.
Purpose of the Study:
- To investigate the association between maternal urinary concentrations of phthalates and bisphenols during pregnancy and measures of general and organ fat in school-aged children.
- To assess potential impacts on body mass index, fat mass index, visceral fat, pericardial fat, and liver fat fraction at 10 years of age.
Main Methods:
- A prospective, population-based cohort study involving 1128 mother-child pairs.
- Maternal urinary phthalate metabolites and bisphenol concentrations were measured across three trimesters.
- Childhood adiposity and organ fat were assessed at age 10 using dual-energy X-ray absorptiometry and magnetic resonance imaging.
Main Results:
- An increase in first-trimester phthalic acid concentration was associated with a higher pericardial fat index in children (SDG increase of 0.14).
- Tendencies for associations between second-trimester low molecular weight phthalates and pericardial fat were observed but not statistically significant after multiple testing adjustments.
- No significant associations were found between high molecular weight phthalates (DEHP, DnOP) or bisphenols and childhood adiposity outcomes.
Conclusions:
- Maternal first-trimester phthalic acid exposure is associated with increased pericardial fat in children at 10 years.
- Maternal bisphenol exposure during pregnancy was not linked to childhood adiposity.
- Findings are hypothesis-generating and require further investigation into mechanisms and replication.
Objectives:
Fetal exposure to phthalates and bisphenols might have long-lasting effects on growth and fat development. Not much is known about the effects on general and organ fat development in childhood. We assessed the associations of fetal exposure to phthalates and bisphenols with general and organ fat measures in school-aged children.
Methods:
In a population-based, prospective cohort study among 1128 mother-child pairs, we measured maternal urinary phthalate metabolites and bisphenol concentrations in first, second, and third trimester. Offspring body mass index, fat mass index by dual-energy X-ray absorptiometry, and visceral and pericardial fat indices and liver fat fraction were measured by magnetic resonance imaging at 10 years.
Results:
After adjustment for confounders and correction for multiple testing, an interquartile range increase in first trimester phthalic acid concentrations remained associated with a 0.14 (95% confidence interval: 0.05, 0.22) standard deviation score increase in pericardial fat index. We also observed tendencies for associations of higher maternal low molecular weight phthalate urinary concentrations in second trimester with childhood pericardial fat index, but these were not significant after adjustment for multiple testing. High molecular weight phthalate, di-2-ethylhexyl phthalate, and di-n-octyl phthalate concentrations were not associated with childhood outcomes. Maternal urinary bisphenol concentrations were not associated with childhood adiposity.
Conclusions:
Maternal first trimester phthalic acid concentrations are associated with increased childhood pericardial fat index at 10 years of age, whereas maternal bisphenol concentrations are not associated with childhood adiposity. We did not find significant sex-specific effects. These findings should be considered as hypothesis generating and need further replication and identification of underlying mechanisms.
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