Associations between maternal phthalate exposure and neonatal neurobehaviors: The Taiwan maternal and infant cohort study (TMICS)

Hsing-Kang Chen; Shu-Li Wang; Yu-Hsun Chang; Chien-Wen Sun; Ming-Tsang Wu; Mei-Lien Chen; Yu-Jie Lin; Chia-Jung Hsieh; TMICS study group

doi:10.1016/j.envpol.2022.120956

Associations between maternal phthalate exposure and neonatal neurobehaviors: The Taiwan maternal and infant cohort study (TMICS)

Environ Pollut. 2023 Feb 15:319:120956. doi: 10.1016/j.envpol.2022.120956. Epub 2022 Dec 26.

Authors

Hsing-Kang Chen¹, Shu-Li Wang², Yu-Hsun Chang³, Chien-Wen Sun⁴, Ming-Tsang Wu⁵, Mei-Lien Chen⁶, Yu-Jie Lin⁷, Chia-Jung Hsieh⁸; TMICS study group

Affiliations

¹ Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan.
² National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Public Health, National Defense Medical Center, Taipei, Taiwan; Department of Safety, Health, and Environmental Engineering, National United University, Miaoli, Taiwan.
³ Department of Pediatrics, Hualien Tzu Chi General Hospital, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
⁴ National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
⁵ Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁷ Department of Public Health, Tzu Chi University, Hualien, Taiwan.
⁸ Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Department of Public Health, Tzu Chi University, Hualien, Taiwan. Electronic address: cjhsieh@mail.tcu.edu.tw.

PMID: 36581241
DOI: 10.1016/j.envpol.2022.120956

Abstract

Previous studies have shown associations between prenatal phthalate exposure and neurobehavioral changes in children. However, few studies have focused on neonatal neurobehavioral development. This study aimed to examine the associations between prenatal phthalate exposure and neonatal neurobehavioral development in the early days of life after birth. This cohort study included 283 mother-infant pairs who participated in the Taiwan Mother Infant Cohort Study during 2012-2015. Each mother was interviewed, and urine samples were collected during the third trimester of pregnancy (weeks 29-40). Eleven common phthalate metabolites in maternal urine were analyzed. The Chinese version of the Neonatal Neurobehavioral Examination was used to evaluate early infant neurobehavioral development within five days of birth. We performed multiple linear regressions to explore the associations between phthalate exposure and neonatal neurobehavioral development. Sex differences in the association between phthalate metabolites and neonatal neurobehaviors were noted. Among girls, tertiles of phthalate metabolite concentrations were associated with worse behavioral responses and tone and motor patterns in the high-molecular-weight phthalate (HMW) and low-molecular-weight phthalate (LMW) groups. Girls in the highest tertile of di-2-ethylhexyl phthalate (DEHP) and mono-isobutyl phthalate (MiBP) had a negative association with tone and motor patterns. Girls in the highest tertile of mono-n-butyl phthalate (MnBP) and MiBP showed a negative association with behavioral responses. In contrast, tertiles of phthalate metabolite exposure were associated with improved neurobehaviors in mono-methyl phthalate (MMP) among boys. The highest tertile of MMP was positively associated with behavioral responses, primitive reflexes, and tone and motor patterns. Our findings suggest that maternal phthalate exposure affects neonatal neurobehavioral development in a sex-specific manner. Despite the relatively small sample size, our findings add to the existing research linking maternal phthalate exposure to neonatal neurobehavioral development. Additional research is needed to determine the potential long-term effects of prenatal phthalate exposure on children.

Keywords: Maternal exposure; Neonate; Neurodevelopment; Phthalate; Sex difference.

MeSH terms

Child
Cohort Studies
Environmental Exposure
Environmental Pollutants* / toxicity
Environmental Pollutants* / urine
Female
Humans
Infant
Infant, Newborn
Male
Maternal Exposure / adverse effects
Overweight
Phthalic Acids* / metabolism
Pregnancy
Prenatal Exposure Delayed Effects*
Taiwan

Substances

phthalic acid
mono-isobutyl phthalate
Phthalic Acids
Environmental Pollutants