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Maternal phthalate exposure and BMI trajectory in children-an 18-year birth cohort follow-up study
Hui-Ju Wen1,2, Pen-Hua Su3, Chien-Wen Sun2
1Institute of Earth Science, Academia Sinica, Taipei, Taiwan.
Insights
Prenatal exposure to certain phthalates like DEHP is linked to long-term obesity in children. Maternal urinary phthalate metabolites were associated with increasing BMI z scores and stable high BMI trajectories up to age 18.
Area of Science:
- Environmental Health
- Pediatrics
- Endocrinology
Background:
- Obesity is a global health crisis, with increasing prevalence in children.
- Phthalate plasticizers are suspected obesogens, but their impact on early-life exposure and long-term obesity is not well understood.
Purpose of the Study:
- To investigate the association between prenatal phthalate exposure and children's body mass index (BMI) patterns.
- To analyze BMI trajectories from age 2 to 18 years in relation to maternal phthalate exposure during pregnancy.
Main Methods:
- Quantified seven phthalate metabolites in maternal urine using LC-MS/MS.
- Calculated BMI z scores for children and used trajectory analysis to identify BMI patterns.
- Employed generalized estimating equations (GEE) and logistic regression to assess phthalate-BMI associations.
Main Results:
- Maternal urinary diethyl phthalate (DEP) metabolites correlated with increased BMI z scores in children (ages 2-18).
- Doubled maternal urinary ∑mDEHP (3 monohexyl phthalate metabolites of DEHP) exposure increased the risk of children maintaining a stable high BMI trajectory until age 18.
- BMI trajectories stabilized after age 5, with significant overweight/obesity rates observed throughout follow-up.
Conclusions:
- Prenatal phthalate exposure is associated with adverse long-term BMI trajectories in children.
- Specific phthalates, such as DEHP, may play a role in the developmental origins of childhood obesity.
- Early-life phthalate exposure represents a potential modifiable risk factor for preventing childhood obesity.
Background:
Obesity is a major health concern worldwide. Previous studies have suggested that phthalate plasticizers are obesogens. However, the relationship between early-life phthalate exposure and long-term obesity development remains unknown.
Objective:
We investigated the association between prenatal phthalate exposure and children's body mass index (BMI) patterns in an 18-year birth cohort follow-up study in Taiwan.
Methods:
Our analytical lab quantified seven phthalate metabolites in maternal urine during pregnancy using quantitative liquid chromatography-tandem mass spectrometry. In addition, we calculated BMI z scores for participated children at each follow-up, utilized trajectory analysis to describe children's BMI z-score patterns at 2-18 years of age, and adopted generalized estimating equations (GEE) and multivariate logistic regression models to assess the association between prenatal phthalate exposure and BMI z scores in children.
Results:
A total of 208 mother-child pairs were included in the analysis. Maternal urinary diethyl phthalate (DEP) metabolites were associated with the increase of BMI z scores in children aged 2-18 years in the GEE model. Doubled maternal urinary ∑mDEHP (3 mono hexyl-metabolites of di-ethyl-hexyl phthalate (DEHP) increased the risk of children being in the stable-high BMI trajectory group until the age of eighteen.
Impact Statement:
We observed that BMI trajectories of children remained stable after the age of 5 years. During each follow-up, a higher frequency of overweight or obese was observed in children, ranging from 15.9% to 35.6% for girls and 15.2-32.0% for boys, respectively. Prenatal phthalate exposure was associated with increasing BMI z scores in children. Prenatal DEHP exposure was associated with a stable-high BMI trajectory in children up to the age of 18 years.
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