title: Prenatal Phthalate Exposure and Childhood Growth and Blood Pressure: Evidence from the Spanish INMA-Sabadell Birth Cohort Study.
abstract: BACKGROUND
  Human evidence on the effects of early life phthalate exposure on obesity and cardiovascular disease risks, reported by experimental studies, is limited to a few cross-sectional studies.
  
  
  OBJECTIVE
  We evaluated the associations between prenatal phthalate exposure and childhood growth and blood pressure in a Spanish birth cohort study.
  
  
  METHODS
  We assessed exposure using the average of two phthalate metabolite spot-urine concentrations collected from the mothers in the first and third pregnancy trimesters (creatinine-adjusted, n = 391). Study outcomes were the difference in age- and sex-specific z-scores for weight between birth and 6 months of age; and repeated age- and sex-specific z-scores for body mass index (BMI) at 1, 4, and 7 years; waist-to-height ratio at 4 and 7 years; and age- and height-specific z-scores for systolic and diastolic blood pressure at 4 and 7 years.
  
  
  RESULTS
  The sum of five high-molecular-weight phthalate metabolites (ΣHMWPm) was associated with lower weight z-score difference between birth and 6 months (β per doubling of exposure = -0.41; 95% CI: -0.75, -0.06) and BMI z-scores at later ages in boys (β = -0.28; 95% CI: -0.60, 0.03) and with higher weight z-score difference (β = 0.24; 95% CI: -0.16, 0.65) and BMI z-scores in girls (β = 0.30; 95% CI: -0.04, 0.64) (p for sex interaction = 0.01 and 0.05, respectively). The sum of three low-molecular-weight phthalates (ΣLMWPm) was not significantly associated with any of the growth outcomes. ΣHMWPm and ΣLMWPm were associated with lower systolic blood pressure z-scores in girls but not in boys.
  
  
  CONCLUSIONS
  This study suggests that prenatal phthalate exposure may be associated with postnatal growth and blood pressure in a sex-specific manner. Inconsistencies with previous cross-sectional findings highlight the necessity for evaluating phthalate health effects in prospective studies.
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors: Damaskini
authors: D
authors: Valvi
authors: Maribel
authors: M
authors: Casas
authors: Dora
authors: D
authors: Romaguera
authors: Nuria
authors: N
authors: Monfort
authors: Rosa
authors: R
authors: Ventura
authors: David
authors: D
authors: Martinez
authors: Jordi
authors: J
authors: Sunyer
authors: Martine
authors: M
authors: Vrijheid
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004785:Environmental Pollutants / Q000633:toxicity*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010795:Phthalic Acids / Q000633:toxicity*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D011446:Prospective Studies; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D065927:Waist-Height Ratio; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D004785:Environmental Pollutants; D010795:Phthalic Acids