Fetal phthalate exposure and asthma outcomes from infancy to adolescence: Individual participant data meta-analysis
Tarik Karramass1, Liesbeth Duijts2, Demetris Avraam3
1Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Insights
Fetal exposure to phthalates may alter lung function in children. However, this study found no consistent links between phthalate exposure and childhood wheezing or asthma. Further research is needed to confirm these findings.
Area of Science:
- Environmental Health
- Pediatric Respiratory Medicine
- Toxicology
Background:
- Phthalates are common in consumer products and early-life exposure may affect lung development.
- Childhood respiratory conditions like asthma and wheezing are significant public health concerns.
- Understanding prenatal exposure impacts is crucial for preventing long-term respiratory morbidity.
Purpose of the Study:
- To investigate the association between fetal phthalate exposure and respiratory outcomes in children.
- To examine links with wheezing, asthma, and lung function from infancy through adolescence.
- To assess the impact of specific phthalate metabolites and groups on respiratory health.
Main Methods:
- Individual participant data meta-analysis of six European birth cohorts (3,745 mother-child pairs).
- Assessed maternal urinary phthalate metabolite concentrations during pregnancy.
- Examined associations with wheezing (0-5 years), asthma (5-12 years), and lung function (5-12 years).
Main Results:
- Higher phthalate concentrations were not linked to wheezing in infancy or preschool years.
- Mono-benzyl phthalate showed a borderline association with increased asthma risk, which attenuated after correction.
- Certain low-molecular-weight phthalates were associated with improved lung function (FEV1, FEV1/FVC, FEF75) after multiple testing correction.
Conclusions:
- Fetal exposure to higher phthalate concentrations is associated with lung function adaptations.
- No consistent associations were found between phthalate exposure and childhood wheezing or asthma.
- Further research is required to establish causality, elucidate mechanisms, and evaluate long-term respiratory effects.
Objective:
Early-life exposure to phthalates, widely used in consumer products, may induce developmental lung adaptations and predispose to respiratory morbidity throughout childhood. We assessed the associations of fetal phthalate exposure with wheezing, asthma, and lung function from birth to adolescence.
Methods:
We performed 1-stage individual participant data meta-analyses with data from six European birth cohorts (3,745 mother-child pairs) to assess associations of pregnancy-averaged maternal urinary concentrations of 7 phthalate metabolites and 3 phthalate groups (high- and low-molecular-weight phthalate metabolites and sum of di-2-ethylhexyl phthalate metabolites) with wheezing in infancy (0-1 years) and at preschool age (1-5 years), and asthma and lung function at school age (5-12 years).
Results:
Higher maternal pregnancy urine phthalate concentrations were not associated with wheezing in infancy or preschool age. Higher maternal pregnancy urine mono-benzyl phthalate concentrations were associated with an increased risk of asthma at school age (odds ratio (95% confidence interval): 1.13 (1.01-1.26) per natural log interquartile range unit increase in concentration), but not with wheezing or lung function and attenuated into non-significance after multiple testing correction. Higher maternal pregnancy concentrations of mono-2-ethyl-5-hydroxyhexyl phthalate, mono-iso-butyl phthalate, mono-n-butyl phthalate and low-molecular-weight phthalate metabolites were associated with higher FEV1, FEV1/FVC and FEF75 z-scores after multiple testing correction.
Conclusion:
Fetal exposure to higher phthalate concentrations is associated with lung function adaptations, while overall no consistent associations were observed with childhood wheezing or asthma. Future studies are needed to assess the causality of the observed associations, to identify the underlying mechanisms, and to assess potential respiratory consequences in adult life.
Related Concept Videos
01:30Socioemotional Development during Infancy
Primary Temperament Types
01:29Asthma-I: Introduction
02:26Protein Networks
These interactions can be represented through maps depicting protein-protein interaction networks, represented as nodes and edges. Nodes are circles that are representative of a protein,...
01:18Cognitive Development During Adolescence
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.