Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Neurotoxicology. 2019 Jul;73:199-212. doi: 10.1016/j.neuro.2019.04.007. Epub 2019 Apr 17.
Phthalate have been detected widely in the environment; while several studies have indicated that prenatal phthalate exposure has adverse effects on neurodevelopment, the results were inconsistent.
We aimed to determine the current research status of the relationship between prenatal exposure to different types of phthalate and cognition and behavioral development in children. We conducted a systematic review to evaluate the current state of knowledge.
We systematically searched PubMed, Web of Science, and EMBASE electronic databases up to May 2018 with manual searches of the references of retrieved publications and relevant reviews. Only birth cohort studies that reported on the association between phthalate exposure and cognitive or behavioral development were included in this review. We evaluated the risk of bias for each of the included studies using a modified instrument based on the Cochrane Collaboration's "Risk of Bias" tool.
Twenty-six birth cohort studies met our inclusion criteria, nine of which investigated the impact of phthalate exposure during pregnancy on cognition, 13 on neurobehavior, and 4 on both cognition and neurobehavior. However, ten articles reported that the effect of prenatal exposure to phthalates on cognitive development was statistically significant, 15 articles reported that the effect of prenatal exposure to phthalates on neurobehavior was statistically significant. The effect of prenatal phthalate exposure on neurodevelopment differed according to sex, but the results are inconsistent, for instance, among the five studies investigating the association between mental development index (MDI) and Mono-n-butyl phthalate (MnBP), two of them showed a significantly decreasing MDI scores with increasing concentrations of MnBP among girls, but among boys one study showed the inverse association, another showed the positive association.
Di(2-ethylhexyl) phthalate, dibutyl phthalate, butyl-benzyl phthalate and di-ethyl phthalate exposure during pregnancy was associated with lower cognitive scores and worse behavior in offspring, and sex-specific effects on cognitive, psychomotor, and behavioral development were identified, especially the impact of phthalate exposure on neurobehavior in boys.
邻苯二甲酸酯在环境中广泛存在，虽然有几项研究表明产前邻苯二甲酸酯暴露对神经发育有不良影响，但结果并不一致。
我们旨在确定目前关于产前暴露于不同类型邻苯二甲酸酯与儿童认知和行为发育之间关系的研究现状。我们进行了系统评价，以评估当前的知识状况。
我们系统地检索了 PubMed、Web of Science 和 EMBASE 电子数据库，检索截止日期为 2018 年 5 月，并对检索到的文献和相关综述的参考文献进行了手工检索。本综述仅纳入了报告邻苯二甲酸酯暴露与认知或行为发育之间关联的出生队列研究。我们使用基于 Cochrane 协作“偏倚风险”工具的改良工具，对纳入研究的每个研究进行了偏倚风险评估。
共有 26 项出生队列研究符合纳入标准，其中 9 项研究探讨了孕期邻苯二甲酸酯暴露对认知的影响，13 项研究探讨了对神经行为的影响，4 项研究同时探讨了对认知和神经行为的影响。然而，有 10 篇文章报道了产前暴露于邻苯二甲酸酯对认知发育的影响具有统计学意义，15 篇文章报道了产前暴露于邻苯二甲酸酯对神经行为的影响具有统计学意义。产前邻苯二甲酸酯暴露对神经发育的影响因性别而异，但结果不一致，例如，在五项研究中单-正丁基邻苯二甲酸酯（MnBP）与精神发育指数（MDI）之间的关联中，有两项研究表明，随着 MnBP 浓度的增加，女孩的 MDI 评分显著降低，但在男孩中，一项研究表明存在相反的关联，另一项研究表明存在正相关。
孕期二（2-乙基己基）邻苯二甲酸酯、邻苯二甲酸二丁酯、丁基苄基邻苯二甲酸酯和邻苯二甲酸二乙酯的暴露与后代较低的认知评分和较差的行为有关，并且确定了性别特异性对认知、精神运动和行为发育的影响，特别是邻苯二甲酸酯暴露对男孩神经行为的影响。
