title: Maternal exposure to di-2-ethylhexylphthalate and adverse delivery outcomes: A systematic review.
abstract: Adverse pregnancy outcomes, including preterm delivery, short gestational age, and abnormal birth weight, remain a public health concern. The evidence on the association of the most common phthalate, di-2-ethylhexyl phthalate (DEHP) with adverse pregnancy outcomes remains equivocal. This systematic review summarizes published studies that investigated the association of DEHP with preterm delivery, gestational age, and birthweight. A comprehensive literature search found 15 relevant studies, most of which evaluated more than one outcome (four studies for preterm delivery, nine studies for gestational age, and ten studies for birthweight). Studies varied greatly with respect to study design, exposure assessment, analytical methods, and direction of the associations. We identified important methodological concerns which could have resulted in selection bias and exposure misclassification and contributed to null findings and biased associations. Given limitations of the previous studies discussed in this review, more thorough investigation of these associations is warranted to advance our scientific knowledge.
authors.affiliation: Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA. Electronic address: lyaghjyan@ufl.edu.
authors.forename: Lusine
authors.initials: L
authors.lastname: Yaghjyan
authors.affiliation: Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd., Gainesville, FL 32610, USA. Electronic address: glghita0429@ufl.edu.
authors.forename: Gabriela L
authors.initials: GL
authors.lastname: Ghita
authors.affiliation: Department of Pediatrics, University of Florida, College of Medicine, 1699 SW 16th Avenue, Gainesville, FL 32608, USA. Electronic address: dumonmd@peds.ufl.edu.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Dumont-Driscoll
authors.affiliation: Department of Chemistry, College of Liberal Arts and Sciences, 125 Buckman Dr., Gainesville FL 32611, USA. Electronic address: ryost@chem.ufl.edu.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Yost
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, USA. Electronic address: changsh@wudosis.wustl.edu.
authors.forename: Su-Hsin
authors.initials: SH
authors.lastname: Chang
mesh_terms: D001724:Birth Weight; D004051:Diethylhexyl Phthalate; D004785:Environmental Pollutants; D005260:Female; D005865:Gestational Age; D006801:Humans; D018811:Maternal Exposure; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth
chemical_list: D004785:Environmental Pollutants; D004051:Diethylhexyl Phthalate
keywords: Birthweight; Gestational age; Phthalate exposure; Preterm delivery