Prenatal and postnatal exposure to di-(2-ethylhexyl) phthalate and neurodevelopmental outcomes: A systematic review and meta-analysis

BACKGROUND: Di-(2-ethylhexyl) phthalate (DEHP), the most widely used phthalate, has recently been associated with neurodevelopmental disturbances in children. However, the risk is yet to be quantified. Therefore, a systematic review and meta-analysis focusing on the association between exposure to DEHP and neurodevelopmental outcomes is necessary, with particular attention to study design (longitudinal vs. cross-sectional).

METHODS: We performed a comprehensive literature search for associations between exposure to DEHP and neurodevelopmental outcomes. Among 106 published studies found in public databases, eight longitudinal studies and two cross-sectional studies were included in the meta-analysis.

RESULTS: We observed a statistically significant association between the concentrations of DEHP metabolites and the neurodevelopment outcomes of children among cross-sectional results, and found significant association between DEHP exposure measured in prenatal period and the psychomotor development outcomes measured later in childhood.

CONCLUSIONS: To our knowledge, this is the first meta-analysis of studies investigating the association between DEHP exposure and neurodevelopment in children. A need exists for more researches and a precautionary policy for potential health hazard of DEHP, the most commonly used phthalate, to promote healthier neurodevelopment in children.