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Updated: May 21, 2025
Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
Published on: September 20, 2018
Prenatal phthalate exposure and anogenital distance in infants at 12 months
Kim N Cajachagua-Torres1, Nicole B Salvi1, Eunsil Seok2
1Department of Pediatrics, New York University Grossman School of Medicine, NY, USA.
Insights
Gestational exposure to phthalates, such as DiNP and DEHP, was linked to longer anogenital distance (AGD) in female infants. No significant associations were found in males, warranting further investigation into underlying biological mechanisms.
Area of Science:
- Environmental Health
- Reproductive Toxicology
- Endocrinology
Background:
- Anogenital distance (AGD) serves as a postnatal indicator of prenatal exposure to androgens and anti-androgens.
- AGD is recognized as a predictor of reproductive health outcomes in both males and females.
Purpose of the Study:
- To investigate the association between phthalate exposure during pregnancy and anogenital distance (AGD) in male and female infants.
- To explore phthalate exposure as a potential environmental factor influencing reproductive development markers.
Main Methods:
- Urinary phthalate metabolite concentrations were measured in 506 mother-infant pairs during early and mid-gestation.
- Anogenital distance (AGD) was measured in infants at approximately 13 months of age.
- Linear regression and partial-linear single-index (PLSI) models were employed to analyze associations between phthalates and AGD.
Main Results:
- Higher gestational exposure to di-isononyl phthalate (DiNP) was associated with longer anus-fourchette distance (AGDaf) in females.
- Increased exposure to di(2-ethylhexyl) phthalate (DEHP) correlated with longer anus-clitoris distance (AGDac) in females.
- No significant associations between phthalate metabolites and AGD were observed in males after correction for multiple testing. DiNP and DEHP were identified as key contributors to longer AGD in females, with a detected interaction between them.
Conclusions:
- Prenatal exposure to specific phthalates (DiNP and DEHP) during early pregnancy is associated with an increased anogenital distance in female infants.
- The findings suggest a potential impact of phthalates on reproductive development markers in females.
- Further research is recommended to elucidate the biological mechanisms underlying these observed associations.
Objective:
Anogenital distance (AGD) is a postnatal marker of in utero exposure to androgens and anti-androgens, and a predictor of reproductive health. We examined the association between gestational exposure to phthalates and AGD in male and female infants.
Methods:
In 506 mother-infant pairs (276 males, 230 females), we measured urinary concentrations of phthalate metabolites at < 18 and 18-25 weeks of gestation and AGD at child age 12.9 months (95 % range 11.4-21.1). Phthalate metabolite concentrations were adjusted for urinary dilution, averaged, and natural log-transformed. We measured anus-clitoris distance (AGDac) and anus-fourchette distance (AGDaf) in females, and anus-scrotum distance, anus-penis distance, and penile width in males. We used linear regression and partial-linear single-index (PLSI) models to examine associations between phthalates and AGD as single pollutants and in mixture.
Results:
Fifty-eight percent of mothers were Hispanic, followed by 27 % non-Hispanic White. Higher exposures to ∑di-isononyl(phthalate) (∑DiNP) was associated with longer AGDaf [1.28 mm (95 % confidence interval [CI]: 0.52, 2.03) and 0.97 mm (95 %CI: 0.25, 1.69), respectively]. Higher exposures to ∑di(2-ethylhexyl)phthalate (∑DEHP) was associated with longer AGDac [2.80 mm (95 %CI: 1.17, 4.44), and 1.90 mm (95 %CI: 0.76, 3.04), respectively]. No association was observed between phthalate metabolites and AGD in males after multiple testing correction. In mixture analyses, ∑DiNP and ∑DEHP were the main contributors to longer AGD in females. We also detected an interaction between ∑DiNP and ∑DEHP in association with AGD in females.
Conclusion:
Early pregnancy phthalate exposure was associated with longer AGD in female infants. Biological mechanisms underlying these associations should be further investigated.
