Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark.
Environ Int. 2023 Oct;180:108244. doi: 10.1016/j.envint.2023.108244. Epub 2023 Sep 29.
Phthalates are endocrine disrupting chemicals used in everyday consumer products. Several epidemiological studies have examined the association between prenatal phthalate concentration and Attention-Deficit Hyperactivity Disorder (ADHD) in offspring, but the findings have been inconclusive.
To investigate the association between maternal urinary concentrations of phthalate metabolites during pregnancy and ADHD related symptoms in children at 2 to 4 years in a large prospective cohort.
In the Odense Child Cohort from Denmark were women recruited in early pregnancy from 2010 to 2012. Phthalate concentrations were measured in urine samples collected in 3rd trimester and separated into low and high weight phthalates. Parents filled in the Child Behavior Checklist for ages 1.5 to 5 years (CBCL/1½-5), including a 6-item ADHD symptom scale at children aged 2 to 4 years. Data were analysed by use of adjusted negative binomial regression.
A total of 658 mother-child pairs were included. Urinary phthalate metabolite concentrations were generally low compared to previous cohorts. A doubling in maternal concentration of the low-weighted phthalate metabolite MCPP was significantly associated with lower ADHD symptoms score in children (IRR: 0.95 (95 % CI 0.91-0.98)), strongest in girls (IRR: 0.92 (0.87-0.98)). Sex differences were observed. High maternal phthalate metabolite concentrations were associated with lower ADHD symptom score in girls, significant trends across tertile of MCPP and MnBP (p = 0.018, p = 0.038, respectively). In boys, maternal concentrations of high-molecular-weight phthalates (MBzP, ∑DiNP and ∑DEHP) were associated with an almost significantly higher ADHD symptom score (IRR for a doubling in concentration: 1.04 (95 % CI: 0.99-1.10), IRR: 1.05 (95 % CI: 0.97-1.13), IRR: 1.04 (95 % CI: 0.99-1.10), respectively).
Maternal concentration of the low-weighted phthalate metabolite MCPP was significantly associated with a lower ADHD symptom score in children, strongest in girls. Maternal concentrations of high-molecular-weight phthalates were associated with non-significant increase in ADHD symptom score in boys.
邻苯二甲酸酯是一种用于日常消费产品的内分泌干扰化学物质。几项流行病学研究已经检查了产前邻苯二甲酸酯浓度与后代注意缺陷多动障碍（ADHD）之间的关系，但结果尚无定论。
在丹麦的奥登塞儿童队列中，我们调查了在大型前瞻性队列中，妊娠期间母体尿液中邻苯二甲酸酯代谢物浓度与 2 至 4 岁儿童 ADHD 相关症状之间的关系。
在 2010 年至 2012 年期间，从丹麦奥登塞招募了处于妊娠早期的妇女参加该队列。在妊娠晚期收集尿液样本并测量邻苯二甲酸酯浓度，并将其分为低分子量和高分子量邻苯二甲酸酯。父母在儿童 1.5 至 5 岁时填写儿童行为检查表（CBCL/1½-5），在儿童 2 至 4 岁时填写包括 6 项 ADHD 症状量表的内容。通过使用调整后的负二项式回归来分析数据。
共有 658 对母婴对纳入研究。与以前的队列相比，母体尿液中邻苯二甲酸酯代谢物浓度普遍较低。低分子量邻苯二甲酸酯代谢物 MCPP 浓度加倍与儿童 ADHD 症状评分较低显著相关（IRR：0.95（95%CI 0.91-0.98）），在女孩中最强（IRR：0.92（0.87-0.98））。观察到性别差异。高母体邻苯二甲酸酯代谢物浓度与女孩的 ADHD 症状评分较低相关，MCPP 和 MnBP 的浓度三分位数呈显著趋势（p=0.018，p=0.038）。在男孩中，高分子量邻苯二甲酸酯（MBzP、∑DiNP 和 ∑DEHP）的浓度与 ADHD 症状评分几乎显著升高相关（浓度加倍的 IRR：1.04（95%CI：0.99-1.10），IRR：1.05（95%CI：0.97-1.13），IRR：1.04（95%CI：0.99-1.10））。
低分子量邻苯二甲酸酯代谢物 MCPP 的母体浓度与儿童的 ADHD 症状评分较低显著相关，在女孩中最强。高分子量邻苯二甲酸酯的母体浓度与男孩的 ADHD 症状评分非显著增加相关。
