Risk of Neurodevelopmental Disorders in Preschool Children Associated with the Longitudinal Trajectory of Phthalates during Pregnancy: Potential Mechanisms Based on Metabonomics of Cord Blood.

This study looked at chemicals called phthalates (found in plastics) that pregnant mothers were exposed to and how this affected their children's development. Researchers followed 3,220 families and found that higher exposure to certain phthalates during pregnancy increased the chances of autism traits in children. Boys seemed more affected than girls. The chemicals may interfere with important fatty acid processes that support brain development.

This longitudinal study examined phthalate exposure during pregnancy and neurodevelopmental outcomes in 3,220 children aged 1.5-6 years. Researchers measured phthalate levels in maternal urine at multiple time points and assessed children for autism spectrum disorder (ASD), ADHD, and emotional/behavioral problems. High exposure to certain phthalates (MMP, LMWP, DEHP) was associated with increased autistic traits, with odds ratios ranging from 2.09 to 4.87. Boys showed stronger associations than girls for some exposures.

High MBP exposure was linked to slightly increased ADHD risk and emotional/behavioral problems. Cord blood metabolomics suggested phthalates interfere with linoleic and arachidonic acid metabolism, potentially explaining neurodevelopmental impacts.

Results suggest prenatal phthalate exposure may contribute to neurodevelopmental risk, particularly autism traits. Healthcare providers should consider discussing phthalate reduction strategies with pregnant patients. Findings support need for environmental assessments in neurodevelopmental evaluations.

Single study design limits generalizability. Unclear methodology for exposure trajectory construction and outcome assessment measures. Metabolomic findings require replication. Causal relationships cannot be definitively established from observational data.

Phthalate exposure during pregnancy may result in neurotoxicity to offspring, but no studies have investigated the effects of longitudinal phthalate trajectories during pregnancy on children. Therefore, exposure trajectories were constructed by using urine concentrations of phthalates at different times. Similarly, 3220 children were screened for symptoms of autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), and emotional and behavioral problems (EBPs) via multiple measures between the ages of 1.5 and 6 years. We also explored potential biological mechanisms through the metabonomics of cord blood.

The results showed that high MMP during pregnancy was positively associated with autistic traits in all children (OR: 2.09, 95%CI: 1.10, 4.00) and boys (OR: 2.47, 95%CI: 1.08, 5.63). High LMWP (OR: 3.43, 95%CI: 1.15, 10.20), DEHP (OR: 3.24, 95%CI: 1.08, 9.69), or all phthalates (OR: 4.87, 95%CI: 1.48, 16.05) increased the probability of the occurrence of autistic traits. High MBP exposure in late pregnancy slightly increased the incidence of ADHD (OR: 1.61, 95%CI: 0.91, 2.85). High MBP (OR: 1.42, 95%CI: 1.02, 1.97) exposure increased the incidence of EBPs.

Sex-specific associations were also observed. Mechanistically, phthalate exposure interfered with linoleic and arachidonic acid (AA) metabolism. In summary, longitudinal exposure to phthalates during pregnancy may increase the risk of neurodevelopmental disorders (NDDs) in children with sex-specificity. These findings may provide new insights into the underlying mechanisms of phthalates affecting neurodevelopment.