Kim Ha Kim 2011

Methods:

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Prenatal phthalate exposure was determined by measuring phthalate metabolites in the spot urine of the mother during the third trimester of pregnancy (range of gestational age at urine collection: 35.7-41.7 weeks). The spot urine samples were collected at the obstetric clinics between 0900 and 1800 hours. We measured the secondary metabolites at DEHP [mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP); mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) and DBP [mono-n-butyl phthalate (MBP)]. Samples were refrigerated at -20°C.

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To find out how much phthalate exposure babies had before birth, researchers collected one urine sample from each mother during the third trimester of pregnancy (35.7-41.7 weeks). They tested the urine for chemicals that are left behind after the body breaks down common phthalates, which are chemicals found in many everyday plastic and personal care products. The urine samples were kept frozen until they were tested.

Introduction:

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Prenatal exposure to phthalates has been associated with poor birth outcomes (Wolff et al. 2008), neurological outcomes in the neonate (Engel et al. 2009), behavioural problems (Engel et al. 2010), reduced masculine play in boys (Swan et al. 2010), and social impairment (Miodovnik et al. 2011) in childhood. However, the effects of prenatal phthalate exposure on neurodevelopment at infants at 6 months have not been investigated.

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Exposure to phthalates before birth may be linked to health and developmental problems in children. These include complications at birth, differences in brain developments, behavioural challenges, less typically masculine play in boys, and difficulties with social skills. However, researchers have not yet studied whether exposure to phthalates before birth affects babies’ brain developments at 6 months of age.

Results:

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Inverse associations between phthalate biomarkers and developmental indices at 6 months were also observed in females, but the association was weaker and did not reach statistical significance (Table 3). The differences between males and females were significant (/>< 0.10) for PDI in associations with MEHHP and HHP + OHP only (Table 3).

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Higher phthalate levels were linked to lower developmental scores in girls at 6 months of age. However, this relationship was weaker than it was in boys and was not strong enough to show that it was not due to chance. The differences between boys and girls were only considered meaningful for some of the phthalates that were measured.

Discussion:

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In this study, we hypothesized that prenatal exposure to DEHP and DBP would be inversely associated with MDI and PDI as measured by the BSID-II. This study observed a strong inverse association between prenatal exposure to MEHHP, MEOHP, and MBP in the third trimester of pregnancy and the MDI and PDI of the male infants at 6 months. These findings add further support to the possibility that prenatal phthalate exposure may be detrimental to neurodevelopment and suggest possible sex differences in the sensitivity to phthalates.

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In this study, the researchers expected that babies exposed to higher levels of certain phthalates before birth would have lower mental and physical development scores at 6 months of age. They found that boys whose mothers had higher levels of these phthalates during their third trimester of pregnancy typically had lower developmental scores. These results suggest that exposure to phthalates before birth may negatively affect early brain development and that boys may be more sensitive to these chemicals than girls.

Future Directions:

• What future research should follow up on this work?

I believe that this study could be followed up with future research on the long-term effects of phthalate exposure by following children for many years to determine whether the developmental differences persist or worsen. Multiple collections of urine samples throughout pregnancy could also make these results more reliable, rather than relying on a single urine sample. Lastly, conducting similar studies on a larger and more diverse population would strengthen the results and help determine whether the findings apply across various populations and lifestyles.

Difficult Material:

• What did you not understand about this paper that someone else may be able to help you with? Or, if you understood everything, what did you find most challenging to understand?

I found interpreting the results section to be the most challenging part of the paper, as it uses units and terminology that I am unfamiliar with. When looking at it more closely, I was able to understand the general findings, but interpreting the specific statistical results and what they represented took the most time.