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

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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.HighlightsThe effects of di-(2-ethylhexyl) phthalate (DEHP) on the neurodevelopmental outcomes in children need to be synthesized.This meta-analysis showed that exposure to DEHP in childhood has an adverse association with the intelligence quotient.Exposure to DEHP in prenatal period was negatively associated with psychomotor development of childhood.Further studies considering an exposure assessment of DEHP and measurement timings of neurodevelopment outcomes are required.

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