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Maternal phthalate exposure and BMI trajectory in children—an 18-year birth cohort follow-up study

Journal of Exposure Science & Environmental Epidemiology volume 34, pages 601–609 (2024)Cite this article

Abstract

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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Fig. 1
Fig. 2: Association between maternal urinary phthalate metabolite levels and BMI z scores trajectory in children aged 0–18 years.

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Data availability

The data analyzed during the current study are not publicly available due to sensitivity reasons. However, the data are available from the corresponding author on reasonable request. The data are securely stored at the National Health Research Institute, Taiwan.

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Acknowledgements

We thank all the children and their mothers who participated in our 18-year follow-up study and the research team who supported the data collection, specimen collection, and data measurement.

Funding

This study was supported by the National Health Research Institutes (EM-109-PP-05, EM-111-PP-05, EM-113-PP-05) and the Ministry of Science and Technology (MOST 106-3114-B-400-002, MOST 108-2321-B-400-007), and National Science and Technology Council (NSC 112-2314-B-400-009), Taiwan.

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Authors and Affiliations

  1. Institute of Earth Science, Academia Sinica, Taipei, Taiwan

    Hui-Ju Wen

  2. National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan

    Hui-Ju Wen, Chien-Wen Sun, Shin-Fen Tsai & Shu-Li Wang

  3. Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan

    Pen-Hua Su

  4. Department of Public Health, National Defence Medical Centre, Taipei, Taiwan

    Shu-Li Wang

  5. Department of Safety, Health, and Environmental Engineering, National United University, Miaoli, Taiwan

    Shu-Li Wang

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  1. Hui-Ju Wen
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  2. Pen-Hua Su
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Contributions

Wen carried out all statistical analyses, drafted the initial manuscript, interpreted the results, and critically reviewed and revised the manuscript; Su performed the clinical follow-up of children and collected the data; Sun and Tsai collected the data and performed experimental analyses; Wang conceptualized the study, coordinated and supervised data collection, interpreted the data, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

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Correspondence to Shu-Li Wang.

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Wen, HJ., Su, PH., Sun, CW. et al. Maternal phthalate exposure and BMI trajectory in children—an 18-year birth cohort follow-up study. J Expo Sci Environ Epidemiol 34, 601–609 (2024). https://doi.org/10.1038/s41370-024-00696-5

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