Table 4 Chemical identification of the metabolic features associated with phthalate exposure and NICU Net Neurobehavioral Scale (NNNS) outcome in the meet-in-the-middle analysis at visit 1 (n = 81) and visit 2 (n = 71) at p < 0.05 using generalized linear models

From: Impact of prenatal phthalate exposure on newborn metabolome and infant neurodevelopment

m/z

rt

Ontology level*

Metabolite

Exposure

Association with exposure (β)

Outcome

Association with outcome (β)

Pathways

Biological function

Visit 1 (8–14 weeks) n = 81

211.0845

2.84

OL2b

2-amino-3-(4-hydroxy-3-methoxyphenyl)propanoic acid

MBP

0.0050

Arousal

0.1241

Pharmaceutical (foodome)

Not enough information

176.095

2.07

OL1, OL2a

Cotinine, Serotonin

MECPP, MEHP, \(\Sigma\)DEHP

0.0201, 0.0503, 2.036

Arousal

−0.3115

Biomarker (environmental)

Tryptophan metabolism (endogenous)

Cotinine is a biomarker for tobacco use which can impact the nervous system33

Serotonin is a neurotransmitter28

235.0878

5.17

OL2b

Acetyl-S-(3-hydroxypropyl-1-methyl)-L-cysteine

MEP

−0.0002

Arousal, Attention

−0.0873, −0.0929

Biomarker (environmental)

Biomarker for tobacco use can impact the nervous system33,34

173.048

2.38

OL2b

Quinaldic acid

MiBP

0.0034

Arousal

−0.0965

Tryptophan metabolism (endogenous)

Not enough information

196.074

8.59

OL2a

3,4,5-trimethoxybenzaldehyde

MiBP

−0.0021

Arousal

0.0655

Pharmaceutical (foodome)

Not enough information

416.329

15.04

OL2b

Calcitriol

MBP

−0.0021

Attention

−0.0484

Steroid biosynthesis (endogenous)

Increases the amount of calcium in the body83

172.146

12.59

OL2a

Decanoic acid

MEP

−0.0037

Attention

−0.7346

Fatty acid (endogenous)

Reduces oxidative stress in neuroblastoma cells84

194.08

5.94

OL1

Caffeine

MEP

0.0001

Attention

0.0460

Caffeine metabolism (drug)

Not enough information

355.1936

15.44

OL2b

JWH-019

MEP

−0.0004

Attention

−0.1770

Biomarker (environmental)

Synthetic cannabinoid85

284.076

3.23

OL1

Xanthosine

MiBP

−0.0030

Attention

0.0736

Purine metabolism (endogenous)

Involved in the synthesis and degradation of nucleic acids during rapid DNA/RNA turnover86

278.1518

14.36

OL2b

Monoethylhexyl phthalic acid, Mono-n-octyl phthalate

MiBP

−0.0050

Attention

−0.1130

Biomarkers (environmental)

Phthalate exposure metabolites MEHP and MnOP87,88

186.1256

10.1

OL2a

10-hydroxy-2-decenoic acid

MiBP

0.0019

Attention

0.0486

Fatty acid (endogenous)

Not enough information

Visit 2 (24–30 weeks) n = 71

105.043

0.57

OL2b

Serine

MEHP, MiBP

−0.0222, −0.0051

Attention

0.0649

Glycine, serine and threonine metabolism (endogenous)

Neurotransmitter precursor23

165.079

3.31

OL2a

Phenylalanine

MEHP

−0.0209

Attention

−0.0228

Phenylalanine metabolism (endogenous)

Found in high levels in breastmilk and is a neurotransmitter precursor30

173.105

6.67

OL2b

Acetylleucine, Hexanoyl Glycine

MEHHP, \(\Sigma\)DEHP

0.0209, 1.9220

Arousal

−0.2026

Valine, leucine and isoleucine metabolism (endogenous)

Decreased neural inflammation in mouse models81

176.095

2.56

OL1, OL2a

Cotinine, Serotonin

MiBP

−0.0188

Arousal

−0.4044

Biomarker (environmental)

Tryptophan metabolism (endogenous)

Cotinine is a biomarker for tobacco use which can impact the nervous system33

Serotonin is a neurotransmitter28

179.0946

10.72

OL2a

Propham

MiBP

0.0022

Attention

−0.0519

Pesticide (environmental)

Not enough information

180.0786

10.35

OL2a

4-hydroxy-3-methoxycinnamic alcohol

MiBP

0.0022

Attention

−0.0519

Metabolite from fruits and vegetables (foodome)

Beneficial to gut microbiota and lipid metabolism89

181.074

1.56

OL2a

Tyrosine

MEP

−0.0002

Attention

−0.0608

Tyrosine metabolism (endogenous)

Thyroid hormone; low level associated with increase illness and neurodevelopmental issues in newborns25

183.0895

0.77

OL2b

Epinephrine

MBP

0.0013

Attention

−0.0427

Tyrosine metabolism (endogenous)

Hormone and neurotransmitter90

186.1256

10.1

OL2a

10-hydroxy-2-decenoic acid

MBP

−0.0021

Attention

0.0629

Fatty acid (endogenous)

Not enough information

 193.0739

7.21

OL2a

3-Methylhippuric acid

MEP

0.0003

Arousal

−0.1245

Urinary metabolite (environmental)

A normal urine metabolite increased by consumption of phenolic compounds91

220.085

2.72

OL2a

5-Hydrotryptophan

MBP

−0.0017

Arousal

−0.0543

Tryptophan metabolism (endogenous)

Serotonin precursor29

229.0463

5.43

OL1

Flonicamid

MBP, MECPP, MEHHP, MEOHP, MEHP, MiBP, \(\Sigma\)DEHP

0.0051, 0.0171, 0. 0210, 0.0277, 0.0343, 0.0077, 2.0323

Arousal

−0.1524

Pesticide (environmental)

Not enough information

233.072

4.58

OL2a

(R)-N-Acetyl-S-(1-(hydroxymethyl)-2-propen-1-yl)-L-cysteine

MECPP, MEHHP, MEOHP, \(\Sigma\)DEHP

−0.0105, −0.0124, −0.0177, −1.1830

Arousal

−0.1781

Acrylamide metabolite (environmental)

Acrylamide is classified as a possible human carcinogen; found in cigarettes or processed foods32

330.2559

16.54

OL2a

Docosapentaenoic acid

MEP

−0.0004

Arousal

0.1572

Fatty acid (endogenous)

Anti-inflammatory; Found in high concentrations in breastmilk74

376.2977

15.66

OL2a

Lithocholic acid

MBP

0.0036

Attention

−0.1203

Bile acid biosynthesis (endogenous)

Displays anti-neoplastic and anti-carcinogenic properties92

400.3341

16.1

OL2b

Calcifediol, 7-Ketocholesterol

MBzP

0.0297

Attention

0.0725

Steroid biosynthesis (endogenous)

Increases the amount of calcium in the body83

Oxidation product of cholesterol93

406.2719

13.08

OL1

7 & 12-Ketochenodeoxycholic acid

MBP, MiBP

−0.0101, −0.0038

Attention

0.4866

Bile acid biosynthesis (endogenous)

Not enough information

408.2876

14.13

OL2b

Cholic acid

MBP, MEHP, MiBP

0.0011, 0.0067, 0.0015

Attention

−0.0228

Bile acid biosynthesis (endogenous)

Not enough information

  1. MEP monoethyl phthalate, MBP mono-n-butyl phthalate, MiBP monoisobutyl phthalate, MBzP monobenzyl phthalate, MEHP mono-2-ethylhexyl phthalate, MEOHP mono-2-ethyl-5-oxohexyl phthalate, MEHHP mono-2-ethyl-5-hydroxyhexyl phthalate, MECPP mono-2-ethly-5-carboxypentyl phthalate, \(\Sigma\)DEHP sum of Di-2-ethylhexyl phthalate metabolites.
  2. *Ontology level indicates the strength of the evidence supporting each metabolite’s identification or annotation, considering retention time, exact mass (MS), MS/MS fragmentation pattern, and isotopic ion pattern. Metabolites that closely matched the IESL by RT (within ±0.5 min), MS (within <5 ppm), and displayed a high degree of similarity in MS/MS fragmentation patterns (similarity score >30) received an OL1 label. For metabolites matching by RT and MS, they were labeled OL2a. An OL2b label was assigned to signals that matched the IESL by MS and MS/MS but fell outside the RT window (±0.5 min).
  3. The chemical identity was conducted by matching peaks by accurate mass and retention time to authentic reference standards in an in-house library run under identical conditions using tandem mass spectrometry. Source data and exact two-sided p-values are provided as a Source Data file. Atlanta African American Maternal-Child cohort, 2016–2018.