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Similar names, different results: Consistency of the associations between prenatal exposure to phthalates and parent-ratings of behavior problems in preschool children
https://orcid.org/0000-0001-7031-8952
Highlights Prenatal phthalate exposure was associated with BASC-2 and CBCL behavior problems. Higher phthalates were associated with greater odds of borderline or clinical problems. Higher phthalates were associated with higher composite scale scores on the BASC-2. Many associations were only significant for male children. The analytical approach used to correct for urine dilution influenced associations.
Abstract Background Environmental health research has reported mixed findings on the associations between prenatal exposure to phthalates and parent-ratings of child behavioral problems. Objective We examined the consistency of the associations between prenatal urinary phthalate concentrations and child behavior scores across two standardized instruments – the Behavior Assessment System for Children-Second Edition (BASC-2) and the Child Behavior Checklist (CBCL) – using two analytical approaches used to correct for urine dilution. Method A sample of 351 mother–child pairs were selected from a prospective birth cohort of pregnant women enrolled between 2009 and 2012. Women provided spot urine samples during the second trimester of pregnancy, which were analyzed for levels of nine urinary phthalate metabolites. When their typically developing children were 3–4 years of age, mothers completed the BASC-2 and CBCL on the same day. Adjusted regression analyses examined the associations between maternal prenatal phthalate concentrations and child behavior scores on the BASC-2 and CBCL. To correct for urine dilution, primary regression analyses included urinary creatinine concentration as a separate independent variable (i.e., covariate). In the secondary regression analyses, creatinine-adjusted phthalate concentrations were used. Results Primary logistic regression analyses that included urinary creatinine as a covariate showed that higher prenatal phthalate concentrations were related to increased odds of scores falling into the borderline or clinical range on the Hyperactivity, Aggression, Anxiety, Depression, Withdrawal, Externalizing Problems, Internalizing Problems, and Behavioral Symptoms Index scales on the BASC-2 (ORs from 1.39 to 2.07), but only the Anxious/Depressed and Externalizing Problems scales on the CBCL (ORs from 1.80 to 3.28). Primary linear regression analyses showed that higher prenatal phthalate concentrations were related to higher scores on the Externalizing Problems (β’s = 0.16), Internalizing Problems (β’s from 0.16 to 0.20), and Behavioral Symptoms Index (β’s from 0.18 to 0.21) scales on the BASC-2, but not related to any CBCL scales. Sex-stratified analyses found that many associations were only significant for male children. Secondary analyses using creatinine-adjusted phthalate concentrations revealed that some of the associations from the primary analyses remained significant; however, a number of unique associations were observed. Conclusion Prenatal phthalate exposure was associated with preschool behavioral development; however, findings were not consistent for the BASC-2 and CBCL, especially related to the clinical/syndrome scales and Internalizing Problems scale. Further, many findings differed based on the analytical approach used to correct for urine dilution. Future work is needed to delineate the similarities and differences between similarly named child behavior constructs assessed by different neurodevelopmental assessments. Also, research is needed to better understand why and how different analytical approaches influence the reported associations between maternal prenatal phthalate concentrations and children’s behavior problems.
Similar names, different results: Consistency of the associations between prenatal exposure to phthalates and parent-ratings of behavior problems in preschool children
https://orcid.org/0000-0001-7031-8952
Highlights Prenatal phthalate exposure was associated with BASC-2 and CBCL behavior problems. Higher phthalates were associated with greater odds of borderline or clinical problems. Higher phthalates were associated with higher composite scale scores on the BASC-2. Many associations were only significant for male children. The analytical approach used to correct for urine dilution influenced associations.
Abstract Background Environmental health research has reported mixed findings on the associations between prenatal exposure to phthalates and parent-ratings of child behavioral problems. Objective We examined the consistency of the associations between prenatal urinary phthalate concentrations and child behavior scores across two standardized instruments – the Behavior Assessment System for Children-Second Edition (BASC-2) and the Child Behavior Checklist (CBCL) – using two analytical approaches used to correct for urine dilution. Method A sample of 351 mother–child pairs were selected from a prospective birth cohort of pregnant women enrolled between 2009 and 2012. Women provided spot urine samples during the second trimester of pregnancy, which were analyzed for levels of nine urinary phthalate metabolites. When their typically developing children were 3–4 years of age, mothers completed the BASC-2 and CBCL on the same day. Adjusted regression analyses examined the associations between maternal prenatal phthalate concentrations and child behavior scores on the BASC-2 and CBCL. To correct for urine dilution, primary regression analyses included urinary creatinine concentration as a separate independent variable (i.e., covariate). In the secondary regression analyses, creatinine-adjusted phthalate concentrations were used. Results Primary logistic regression analyses that included urinary creatinine as a covariate showed that higher prenatal phthalate concentrations were related to increased odds of scores falling into the borderline or clinical range on the Hyperactivity, Aggression, Anxiety, Depression, Withdrawal, Externalizing Problems, Internalizing Problems, and Behavioral Symptoms Index scales on the BASC-2 (ORs from 1.39 to 2.07), but only the Anxious/Depressed and Externalizing Problems scales on the CBCL (ORs from 1.80 to 3.28). Primary linear regression analyses showed that higher prenatal phthalate concentrations were related to higher scores on the Externalizing Problems (β’s = 0.16), Internalizing Problems (β’s from 0.16 to 0.20), and Behavioral Symptoms Index (β’s from 0.18 to 0.21) scales on the BASC-2, but not related to any CBCL scales. Sex-stratified analyses found that many associations were only significant for male children. Secondary analyses using creatinine-adjusted phthalate concentrations revealed that some of the associations from the primary analyses remained significant; however, a number of unique associations were observed. Conclusion Prenatal phthalate exposure was associated with preschool behavioral development; however, findings were not consistent for the BASC-2 and CBCL, especially related to the clinical/syndrome scales and Internalizing Problems scale. Further, many findings differed based on the analytical approach used to correct for urine dilution. Future work is needed to delineate the similarities and differences between similarly named child behavior constructs assessed by different neurodevelopmental assessments. Also, research is needed to better understand why and how different analytical approaches influence the reported associations between maternal prenatal phthalate concentrations and children’s behavior problems.
Similar names, different results: Consistency of the associations between prenatal exposure to phthalates and parent-ratings of behavior problems in preschool children
https://orcid.org/0000-0001-7031-8952
Highlights Prenatal phthalate exposure was associated with BASC-2 and CBCL behavior problems. Higher phthalates were associated with greater odds of borderline or clinical problems. Higher phthalates were associated with higher composite scale scores on the BASC-2. Many associations were only significant for male children. The analytical approach used to correct for urine dilution influenced associations.
Abstract Background Environmental health research has reported mixed findings on the associations between prenatal exposure to phthalates and parent-ratings of child behavioral problems. Objective We examined the consistency of the associations between prenatal urinary phthalate concentrations and child behavior scores across two standardized instruments – the Behavior Assessment System for Children-Second Edition (BASC-2) and the Child Behavior Checklist (CBCL) – using two analytical approaches used to correct for urine dilution. Method A sample of 351 mother–child pairs were selected from a prospective birth cohort of pregnant women enrolled between 2009 and 2012. Women provided spot urine samples during the second trimester of pregnancy, which were analyzed for levels of nine urinary phthalate metabolites. When their typically developing children were 3–4 years of age, mothers completed the BASC-2 and CBCL on the same day. Adjusted regression analyses examined the associations between maternal prenatal phthalate concentrations and child behavior scores on the BASC-2 and CBCL. To correct for urine dilution, primary regression analyses included urinary creatinine concentration as a separate independent variable (i.e., covariate). In the secondary regression analyses, creatinine-adjusted phthalate concentrations were used. Results Primary logistic regression analyses that included urinary creatinine as a covariate showed that higher prenatal phthalate concentrations were related to increased odds of scores falling into the borderline or clinical range on the Hyperactivity, Aggression, Anxiety, Depression, Withdrawal, Externalizing Problems, Internalizing Problems, and Behavioral Symptoms Index scales on the BASC-2 (ORs from 1.39 to 2.07), but only the Anxious/Depressed and Externalizing Problems scales on the CBCL (ORs from 1.80 to 3.28). Primary linear regression analyses showed that higher prenatal phthalate concentrations were related to higher scores on the Externalizing Problems (β’s = 0.16), Internalizing Problems (β’s from 0.16 to 0.20), and Behavioral Symptoms Index (β’s from 0.18 to 0.21) scales on the BASC-2, but not related to any CBCL scales. Sex-stratified analyses found that many associations were only significant for male children. Secondary analyses using creatinine-adjusted phthalate concentrations revealed that some of the associations from the primary analyses remained significant; however, a number of unique associations were observed. Conclusion Prenatal phthalate exposure was associated with preschool behavioral development; however, findings were not consistent for the BASC-2 and CBCL, especially related to the clinical/syndrome scales and Internalizing Problems scale. Further, many findings differed based on the analytical approach used to correct for urine dilution. Future work is needed to delineate the similarities and differences between similarly named child behavior constructs assessed by different neurodevelopmental assessments. Also, research is needed to better understand why and how different analytical approaches influence the reported associations between maternal prenatal phthalate concentrations and children’s behavior problems.
Similar names, different results: Consistency of the associations between prenatal exposure to phthalates and parent-ratings of behavior problems in preschool children
England-Mason, Gillian (author) / Martin, Jonathan W. (author) / MacDonald, Amy (author) / Kinniburgh, David (author) / Giesbrecht, Gerald F. (author) / Letourneau, Nicole (author) / Dewey, Deborah (author)
2020-06-11
Article (Journal)
Electronic Resource
English
Phthalates , Behavioral development , Preschool children , Parent-rating scales , APrON Study , EDCs , endocrine-disrupting chemicals , CBCL , Child Behavior Checklist for ages 1½–5 , BASC-2 , Behavior Assessment System for Children-Second Edition Parent Rating Scales- Preschool , FSIQ , Full-Scale Intelligence Quotient , DEHP , di(2-ethyl-hexyl) phthalate , MEHP , mono(2-ethylhexyl) phthalate , MEHHP , mono(2-ethyl-5-hydroxy-hexyl) phthalate , MEOHP , mono(2-ethyl-5-oxohexyl) phthalate , MECPP , mono(2-ethyl-5-carboxypentyl) phthalate , DBP , dibutyl phthalate , MBP , mono-n-butyl phthalate , MiBP , mono-iso-butyl phthalate , MBzP , mono-benzyl phthalate , MEP , mono-ethyl phthalate , MMP , mono-methyl phthalate , ΣHMWP , molar sum of high molecular weight phthalates , ΣLMWP , molar sum of low molecular weight phthalates , LOD , limit of detection , GMs , geometric means , ADH , Attention-Deficit/Hyperactivity , PD , Pervasive Developmental , BSI , Behavioral Symptoms Index , ORs , odds ratios
Phthalates dietary exposure and food sources for Belgian preschool children and adults
| Online Contents | 2012