Impact of Periconceptional Exposure to Phthalates on Pregnancy, Birth, and Neonatal Outcomes

Abstract

Purpose of Review

The purpose of this review was to evaluate recent available evidence on exposure to phthalates during pregnancy and the immediate periconceptional period and the health effects in the mother and offspring during the peripartum period. Articles were included if they included biospecimen-based exposure assessment and consideration of quantifiable health effects in either the mother or the offspring.

Recent Findings

Outcome assessment variables were indicators of fetal growth and indicators of hormonal effects—including genital endpoints and pregnancy duration. The studies reviewed provided inconsistent and weak evidence of relationships between phthalate exposure during pregnancy and these outcomes. Some trends emerged involving high molecular weight phthalate metabolites and genital endpoints, including anogenital distance and male genital anomalies, particularly with the metabolites of di(2-ethylhexyl) phthalate (DEHP). Some evidence implicated high molecular weight phthalate metabolites and biomarkers of thyroid and immune function. Results surrounding fetal growth were mixed and varied by metabolite, infant gender, time of exposure ascertainment, and parent exposed.

Summary

Difficulties with exposure assessment likely limit the findings. All reviewed studies relied on between one and three exposure measurements, constraining reliability of results and knowledge regarding gestational windows of development. Additionally, the difficulty of applying standardized methodology in the measurement of anogenital distance restricts the weight that can be placed on findings across studies.

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