In an article published on October 29, 2021, in the peer-reviewed journal Science of the Total Environment Chia-Huang Chang from the Taipei Medical University, Taiwan, and co-authors evaluated the effect of prenatal exposure to phthalic acid esters (PAEs) on child health based on the Taiwan Maternal and Infant Cohort Study (TMICS). In this Taiwan-wide survey, one-spot urine samples and answers to questions, including plastic consumption, were collected from 1102 pregnant women with a gestational age of 29 – 40 weeks from 2012 – 2015. Due to a plasticizer incident in the country in 2011 where phthalate plasticizer(s) replaced palm oil in food and drinks as a clouding agent, participating women were exposed to relatively high PAE levels before pregnancy.

The targeted analysis of nine PAE metabolites and their normalization to urinary creatinine levels showed a detection rate of six of the metabolites in more than 90 % with geometric means between 7.16 (mono-methyl phthalate (MMP), CAS 4376-18-5) and 22.46 µg/g creatinine (mono-n-butyl phthalate (MnBP), CAS 131-70-4). The authors further reported maternal MnBP exposure to be associated with an increased risk of a low birth weight (LBW) and being small for gestational age (SGA) in male neonates, “whereas female neonates presented negative association between maternal MnBP levels and LBW/SGA.” Employing generalized additive model (GAM)-penalized regression splines, Chang and co-authors detected not only a sex-specific association but also a non-monotonic dose-response of PAE exposure. This supports previous findings on the non-monotonic dose-response effects of endocrine-disrupting chemicals (FPF reported and here). Exposure to certain phthalate metabolites during pregnancy may not only affect the offspring but also the mother, for instance by potentially disrupting maternal thyroid functioning (FPF reported).

An earlier US-based cohort study reported that diet is one factor explaining urinary phthalate metabolite levels in adolescents (FPF reported). Previous Taiwanese studies showed that prenatal phthalate exposure may delay pubertal development in girls (FPF reported) and that education and voluntary restraint may help to decrease phthalate exposure in children (FPF reported). On November 19, 2021, the Food Packaging Forum hosted a webinar on the latest science of phthalates’ human health impacts.



Chang C-H. (2021). “The sex-specific association of prenatal phthalate exposure with low birth weight and small for gestational age: A nationwide survey by the Taiwan Maternal and Infant Cohort Study (TMICS).Science of the Total Environment. DOI: 10.1016/j.scitotenv.2021.151261