环境对儿童健康结果的影响（ECHO）队列研究中，产前暴露于邻苯二甲酸盐和替代增塑剂与儿童早期的情绪和行为结果
Prenatal exposure to phthalates and alternative plasticizers and emotional and behavioral outcomes in early childhood in the Environmental influences on Child Health outcomes (ECHO) cohort.
作者信息
Oh Jiwon, Buckley Jessie P, Upadhyaya Sudhi, Kannan Kurunthachalam, Barrett Emily S, Bastain Theresa M, Breton Carrie V, Eick Stephanie M, Geiger Sarah Dee, Ghassabian Akhgar, Habre Rima, Herbstman Julie B, Hirtz Deborah, Liang Donghai, LeWinn Kaja, Meeker John D, O'Connor Thomas G, Hertz-Picciotto Irva, Ruden Douglas, Sathyanarayana Sheela, Schantz Susan L, Schweitzer Julie B, Sigal Anat, Woodruff Tracey J, Zhao Qi, Schmidt Rebecca J, Bennett Deborah H
机构信息
Department of Public Health Sciences, University of California Davis, Medical Sciences 1C, Davis, CA 95616, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599, USA.
出版信息
Environ Int. 2025 Aug;202:109647. doi: 10.1016/j.envint.2025.109647. Epub 2025 Jun 30.
BACKGROUND
Evidence suggests prenatal phthalate exposure adversely affects children's behavior. However, epidemiological studies on alternative plasticizers remain scarce. This study investigated associations of gestational exposure to phthalates and alternative plasticizers with internalizing and externalizing behaviors in children aged 1.5-5 years.
METHODS
The study included 2617 mother-child dyads from 13 Environmental influences on Child Health Outcomes (ECHO) cohorts. Maternal urine samples, primarily collected mid- to late-pregnancy, were analyzed for 27 phthalate metabolites and 6 alternative plasticizer metabolites. Based on detection frequency, metabolite concentrations were modeled either continuously or categorically (Group 1: non-detectable, 2: lower detectable, 3: higher detectable). Covariate-adjusted associations between individual metabolite concentrations and internalizing and externalizing T-scores on the Child Behavior Checklist for Ages 1½-5 were estimated using linear mixed-effects models. Effect modification by child sex was also examined.
RESULTS
An interquartile range increase in mono-benzyl phthalate (MBzP) and membership in Group 3, versus Group 1, for mono-hexyl phthalate (MHxP) were associated with higher externalizing T-scores (β for continuous MBzP = 0.53, 95% CI: 0.05, 1.00; β for MHxP Group 3 = 1.23, 95% CI: 0.35, 2.12). We observed no robust associations between phthalate metabolites and internalizing T-scores, nor between cyclohexane-1,2-dicarboxylic acid mono carboxyisooctyl ester (DINCH) metabolites and any behavioral outcomes. Child sex modified associations between several metabolites and externalizing T-scores, although the direction of effect varied by metabolite.
CONCLUSION
This large-scale study suggests that prenatal exposure to several phthalates, but not to the alternative plasticizer DINCH, may be associated with a small-to-modest increase in externalizing behaviors in young children.
背景
有证据表明，产前邻苯二甲酸盐暴露会对儿童行为产生不利影响。然而，关于替代增塑剂的流行病学研究仍然很少。本研究调查了孕期邻苯二甲酸盐和替代增塑剂暴露与1.5至5岁儿童内化和外化行为之间的关联。
方法
该研究纳入了来自13个儿童健康结果环境影响（ECHO）队列的2617对母婴。主要在妊娠中期至晚期采集的孕妇尿液样本，分析了27种邻苯二甲酸酯代谢物和6种替代增塑剂代谢物。根据检测频率，代谢物浓度以连续或分类方式建模（第1组：未检测到，第2组：较低可检测到，第3组：较高可检测到）。使用线性混合效应模型估计个体代谢物浓度与1.5 - 5岁儿童行为检查表上的内化和外化T分数之间的协变量调整关联。还检查了儿童性别对效应的修饰作用。
结果
邻苯二甲酸单苄酯（MBzP）四分位数间距增加以及邻苯二甲酸单己酯（MHxP）第3组（相对于第1组）与较高的外化T分数相关（连续MBzP的β = 0.53，95% CI：0.05，1.00；MHxP第3组的β = 1.23，95% CI：0.35，2.12）。我们未观察到邻苯二甲酸酯代谢物与内化T分数之间，以及环己烷 - 1,2 - 二羧酸单羧基异辛酯（DINCH）代谢物与任何行为结果之间有显著关联。儿童性别改变了几种代谢物与外化T分数之间的关联，尽管效应方向因代谢物而异。
结论
这项大规模研究表明，产前暴露于几种邻苯二甲酸盐，但不包括替代增塑剂DINCH，可能与幼儿外化行为的小幅至适度增加有关。
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