title: Phthalate exposure and childrens neurodevelopment: A systematic review.
abstract: BACKGROUND
  Emerging evidence from observational studies suggests that prenatal exposure to phthalates affects neurodevelopment in children.
  
  
  OBJECTIVE
  To conduct a systematic review of the existing literature on the association between urinary phthalate concentrations and children's neurodevelopment.
  
  
  METHODS
  We searched electronic bibliographic databases (MEDLINE, PubMed, EMBASE, PsycINFO, CINAHL, Global Health, CAB abstracts, and ERIC) (1910 to February 21st, 2014); reference lists of included articles, and conference abstracts (American Psychiatric Association, American Academy of Neurology, and Pediatric Academic Societies). Two independent reviewers screened abstracts and extracted data. We included original studies reporting on the association between prenatal or childhood urinary phthalate metabolites, and cognitive and behavioral outcomes (e.g., IQ scores, BASC-2 scores or equivalent) in children 0-12 years of age.
  
  
  RESULTS
  Of 2804 abstracts screened, 11 original articles met our criteria for inclusion.
  
  
  CONCLUSIONS
  A systematic review of the literature supports the contention that prenatal exposure phthalates is associated with adverse cognitive and behavioral outcomes in children, including lower IQ, and problems with attention, hyperactivity, and poorer social communication. Further research characterizing the associations between specific phthalate metabolites and children's neurodevelopmental outcomes is needed to support the development of mitigation strategies and enhance the development of appropriate health policy.
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: mejareda@ucalgary.ca.
authors.forename: Maede
authors.initials: M
authors.lastname: Ejaredar
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Elias C
authors.initials: EC
authors.lastname: Nyanza
authors.affiliation: Behavioral Research Unit, Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Kayla
authors.initials: K
authors.lastname: Ten Eycke
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Behavioral Research Unit, Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Dewey
mesh_terms: D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D002657:Child Development / Q000187:drug effects*; D052244:Endocrine Disruptors / Q000737:chemistry / Q000633:toxicity* / Q000652:urine; D005260:Female; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects; D008970:Molecular Weight; D009420:Nervous System / Q000187:drug effects* / Q000254:growth & development; D009483:Neuropsychological Tests; D010795:Phthalic Acids / Q000737:chemistry / Q000633:toxicity* / Q000652:urine; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000523:psychology
chemical_list: D052244:Endocrine Disruptors; D010795:Phthalic Acids
keywords: Behavior outcomes; Child exposure; Cognitive outcomes; Phthalates; Prenatal exposure