The prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) has been increasing. Research suggests that exposure to endocrine disrupting chemicals such as phthalates may play a role, but studies of in utero phthalate exposure and ADHD-related symptoms beyond early childhood are limited. We investigated associations between measures of in utero phthalate exposure and ADHD symptoms, such as inattention and impulsivity, in childhood (age 6–11 years, n = 221) and in adolescence (age 9–18 years, n = 200), as well as cross-sectional relationships between phthalate exposure and ADHD symptoms in adolescence (n = 491) among participants in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohort. Women provided urine samples up to three times during pregnancy and adolescents provided a urine sample at 9–18 years of age for phthalate metabolite measurement. We administered the Conners’ Continuous Performance Test (CPT) when children were age 6–11 years and again at 9–18 years of age. We used multivariable linear regression to examine associations between the geometric mean of phthalate metabolite levels across pregnancy and CPT scores in childhood or adolescence separately, adjusting for age, years schooling (at 9–18 only), maternal education, and specific gravity. Although average in utero phthalate concentrations were not associated with CPT scores in childhood, interquartile range (IQR) increases of in utero MBzP, MCPP, and MBP were associated with 4.2%, 4.7%, and 4.5% (p < 0.05) higher Omissions scores in adolescence, respectively, indicating higher inattention. In utero MiBP levels were also associated with higher Inter-Stimulus Interval (ISI) and Variability scores (5.4% and 5.5% per IQR, p < 0.05) in adolescence. In addition, urinary DEHP metabolite levels during adolescence were cross-sectionally associated with poorer scores on several CPT indices indicating greater inattention. These findings suggest that in utero phthalate exposure may have adverse effects on attention, but these effects may not appear until adolescence, a period of extensive neurodevelopment. Future research investigating the long-term effects of in utero phthalate exposure on attention and ADHD in adolescence, as well as identification of potential mechanisms involved, is needed.

注意缺陷/多动障碍（ADHD）的患病率一直在增加。研究表明，邻苯二甲酸盐等内分泌干扰化学物质的暴露可能发挥作用，但对子宫内邻苯二甲酸盐暴露和儿童早期以外的 ADHD 相关症状的研究是有限的。我们还调查了儿童期（6-11 岁，n = 221）和青春期（9-18 岁，n = 200）子宫内邻苯二甲酸酯暴露与 ADHD 症状（例如注意力不集中和冲动）之间的关联。作为墨西哥早期接触环境毒物 (ELEMENT) 队列参与者中邻苯二甲酸酯暴露与青春期 ADHD 症状之间的横截面关系 (n = 491)。妇女在怀孕期间提供了多达 3 次尿样，而青少年在 9-18 岁时提供了尿样用于邻苯二甲酸盐代谢物测量。我们在儿童 6-11 岁和 9-18 岁时进行了康纳斯持续表现测试 (CPT)。我们使用多变量线性回归来分别检查怀孕期间邻苯二甲酸酯代谢物水平的几何平均值与儿童或青春期 CPT 分数之间的关联，并调整年龄、受教育年限（仅限 9-18 岁）、母亲教育和比重。尽管子宫内平均邻苯二甲酸酯浓度与儿童期的 CPT 分数无关，但子宫内 MBzP、MCPP 和 MBP 的四分位距 (IQR) 增加与 4.2%、4.7% 和 4.5% (p < 0.05) 较高的遗漏分数相关分别在青春期，表示注意力不集中。子宫内 MiBP 水平还与青春期较高的刺激间期 (ISI) 和变异性评分（每 IQR 5.4% 和 5.5%，p < 0.05）相关。此外，青春期尿 DEHP 代谢物水平与几个 CPT 指数的较差分数相关，表明注意力不集中。这些发现表明，在子宫内接触邻苯二甲酸酯可能会对注意力产生不利影响，但这些影响可能直到青春期才会出现，这是一个广泛的神经发育时期。未来的研究需要调查子宫内邻苯二甲酸酯暴露对青春期注意力和多动症的长期影响，以及确定所涉及的潜在机制。子宫内 MiBP 水平还与青春期较高的刺激间期 (ISI) 和变异性评分（每 IQR 5.4% 和 5.5%，p < 0.05）相关。此外，青春期尿 DEHP 代谢物水平与几个 CPT 指数的较差分数相关，表明注意力不集中。这些发现表明，在子宫内接触邻苯二甲酸酯可能会对注意力产生不利影响，但这些影响可能直到青春期才会出现，这是一个广泛的神经发育时期。未来的研究需要调查子宫内邻苯二甲酸酯暴露对青春期注意力和多动症的长期影响，以及确定所涉及的潜在机制。子宫内 MiBP 水平还与青春期较高的刺激间期 (ISI) 和变异性评分（每 IQR 5.4% 和 5.5%，p < 0.05）相关。此外，青春期尿 DEHP 代谢物水平与几个 CPT 指数的较差分数相关，表明注意力不集中。这些发现表明，在子宫内接触邻苯二甲酸酯可能会对注意力产生不利影响，但这些影响可能直到青春期才会出现，这是一个广泛的神经发育时期。未来的研究需要调查子宫内邻苯二甲酸酯暴露对青春期注意力和多动症的长期影响，以及确定所涉及的潜在机制。青春期尿 DEHP 代谢物水平与几个 CPT 指数的得分较差有关，表明注意力不集中。这些发现表明，在子宫内接触邻苯二甲酸酯可能会对注意力产生不利影响，但这些影响可能直到青春期才会出现，这是一个广泛的神经发育时期。未来的研究需要调查子宫内邻苯二甲酸酯暴露对青春期注意力和多动症的长期影响，以及确定所涉及的潜在机制。青春期尿 DEHP 代谢物水平与几个 CPT 指数的得分较差有关，表明注意力不集中。这些发现表明，在子宫内接触邻苯二甲酸酯可能会对注意力产生不利影响，但这些影响可能直到青春期才会出现，这是一个广泛的神经发育时期。未来的研究需要调查子宫内邻苯二甲酸酯暴露对青春期注意力和多动症的长期影响，以及确定所涉及的潜在机制。