Background

Phthalates are synthetic chemicals with endocrine-disrupting properties. They are reportedly associated with various neurotoxic outcomes. Studies on exposure to phthalates and children’s autistic traits have shown inconsistent results with respect to sex and susceptible time periods. We investigated the association of phthalate exposure during the prenatal period and childhood with autistic traits over time using a birth cohort in South Korea.

Methods

Five phthalate metabolites were measured during mid-term pregnancy and children's follow-up at ages of 4, 6, and 8 years among a total of 547 mother–child pairs. The social communication questionnaire (SCQ) was used to assess autistic traits of children at each time point. The relationship between phthalate metabolites and SCQ scores were analyzed by exposure windows and sex.

Results

A 2.7 fold increase in di-(2-ethylhexyl) phthalate metabolite levels, mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) during pregnancy was associated with increased SCQ scores at 4 years by 8.5% (95% confidence intervals [CI]: 1.9%, 15.5%) and 7.4% (95% CI: 0.3%, 15.0%), respectively, but not at the age of 6 or 8 years. Moreover, MEHHP levels at ages of 4 and 8 years were associated with increased SCQ scores at 8 years by 9.9% (95% CI: 1.8%, 18.6%) and 9.6% (95% CI: 1.3%, 18.6%), respectively. Boys showed stronger associations between phthalate exposure and SCQ scores than girls.

Conclusion

The study suggested different susceptible time windows of phthalate exposure: exposure during pregnancy is associated with autistic traits in young children, whereas exposure during early childhood years leads to autistic traits in school-aged children, particularly boys.

中文翻译：

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邻苯二甲酸盐暴露与儿童自闭症特征的关联

背景

邻苯二甲酸盐是具有内分泌干扰特性的合成化学品。据报道，它们与各种神经毒性结果有关。对邻苯二甲酸盐暴露和儿童自闭症特征的研究表明，性别和易感时间段的结果不一致。我们使用韩国的出生队列调查了随着时间的推移，产前和儿童期邻苯二甲酸盐暴露与自闭症特征的关联。

方法

在 547 对母婴中，在中期妊娠和 4、6 和 8 岁儿童的随访期间测量了五种邻苯二甲酸酯代谢物。社会交流问卷（SCQ）用于评估每个时间点儿童的自闭症特征。通过暴露窗口和性别分析邻苯二甲酸酯代谢物与 SCQ 评分之间的关​​系。

结果

怀孕期间邻苯二甲酸二（2-乙基己基）酯代谢物水平增加 2.7 倍，邻苯二甲酸单（2-乙基-5-羟基己基）酯（MEHHP）和邻苯二甲酸单（2-乙基-5-氧己基）酯（MEOHP）是与 4 年时 SCQ 评分分别增加 8.5%（95% 置信区间 [CI]：1.9%、15.5%）和 7.4%（95% CI：0.3%、15.0%）相关，但在 6 岁时则不然或 8 年。此外，4 岁和 8 岁的 MEHHP 水平与 8 岁的 SCQ 评分分别增加 9.9%（95% CI：1.8%、18.6%）和 9.6%（95% CI：1.3%、18.6%） . 与女孩相比，男孩在邻苯二甲酸盐暴露和 SCQ 分数之间表现出更强的关联。

结论

该研究表明邻苯二甲酸酯暴露的不同易感时间窗口：怀孕期间的暴露与幼儿的自闭症特征有关，而幼儿时期的暴露导致学龄儿童，尤其是男孩的自闭症特征。