title: Prenatal phthalate exposure is associated with childhood behavior and executive functioning.
abstract: BACKGROUND
  Experimental and observational studies have reported biological consequences of phthalate exposure relevant to neurodevelopment.
  
  
  OBJECTIVE
  Our goal was to examine the association of prenatal phthalate exposure with behavior and executive functioning at 4-9 years of age.
  
  
  METHODS
  The Mount Sinai Children's Environmental Health Study enrolled a multiethnic prenatal population in New York City between 1998 and 2002 (n = 404). Third-trimester maternal urines were collected and analyzed for phthalate metabolites. Children (n = 188, n = 365 visits) were assessed for cognitive and behavioral development between the ages of 4 and 9 years.
  
  
  RESULTS
  In multivariate adjusted models, increased loge concentrations of low molecular weight (LMW) phthalate metabolites were associated with poorer scores on the aggression [beta = 1.24; 95% confidence interval (CI), 0.15- 2.34], conduct problems (beta = 2.40; 95% CI, 1.34-3.46), attention problems (beta = 1.29; 95% CI, 0.16- 2.41), and depression (beta = 1.18; 95% CI, 0.11-2.24) clinical scales; and externalizing problems (beta = 1.75; 95% CI, 0.61-2.88) and behavioral symptom index (beta = 1.55; 95% CI, 0.39-2.71) composite scales. Increased loge concentrations of LMW phthalates were also associated with poorer scores on the global executive composite index (beta = 1.23; 95% CI, 0.09-2.36) and the emotional control scale (beta = 1.33; 95% CI, 0.18- 2.49).
  
  
  CONCLUSIONS
  Behavioral domains adversely associated with prenatal exposure to LMW phthalates in our study are commonly found to be affected in children clinically diagnosed with conduct or attention deficit hyperactivity disorders.
authors.affiliation: Department of Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. stephanie.engel@mssm.edu
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Engel
authors.forename: Amir
authors.initials: A
authors.lastname: Miodovnik
authors.forename: Richard L
authors.initials: RL
authors.lastname: Canfield
authors.forename: Chenbo
authors.initials: C
authors.lastname: Zhu
authors.forename: Manori J
authors.initials: MJ
authors.lastname: Silva
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Calafat
authors.forename: Mary S
authors.initials: MS
authors.lastname: Wolff
mesh_terms: D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010795:Phthalic Acids / Q000633:toxicity*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis*; D011446:Prospective Studies
chemical_list: D010795:Phthalic Acids