Prenatal maternal phthalate exposures and trajectories of childhood adiposity from four to twelve years

Allison Kupsco, Haotian Wu, Antonia M. Calafat, Marianthi Anna Kioumourtzoglou, Alejandra Cantoral, Marcela Tamayo-Ortiz, Ivan Pantic, Maria Luisa Pizano-Zárate, Emily Oken, Joseph M. Braun, Andrea L. Deierlein, Robert O. Wright, Martha M. Téllez-Rojo, Andrea A. Baccarelli, Allan C. Just

Research output: Contribution to journalArticlepeer-review


Background/Aim: Adiposity trajectories reflect dynamic process of growth and may predict later life health better than individual measures. Prenatal phthalate exposures may program later childhood adiposity, but findings from studies examining these associations are conflicting. We investigated associations between phthalate biomarker concentrations during pregnancy with child adiposity trajectories. Methods: We followed 514 mother-child pairs from the Mexico City PROGRESS cohort from pregnancy through twelve years. We measured concentrations of nine phthalate biomarkers in 2nd and 3rd trimester maternal urine samples to create a pregnancy average using the geometric mean. We measured child BMI z-score, fat mass index (FMI), and waist-to-height ratio (WHtR) at three study visits between four and 12 years of age. We identified adiposity trajectories using multivariate latent class growth modeling, considering BMI z-score, FMI, and WHtR as joint indicators of latent adiposity. We estimated associations of phthalates biomarkers with class membership using multinomial logistic regression. We used quantile g-computation to estimate the potential effect of the total phthalate mixture and assessed effect modification by sex. Results: We identified three trajectories of child adiposity, a “low-stable”, a “low-high”, and a “high-high” group. A doubling of the sum of di (2-ethylhexyl) phthalate metabolites (ΣDEHP), was associated with 1.53 (1.08, 2.19) greater odds of being in the “high-high” trajectory in comparison to the “low-stable” group, whereas a doubling in di-isononyl phthalate metabolites (ΣDiNP) was associated with 1.43 (1.02, 2.02) greater odds of being in the “low-high” trajectory and mono (carboxy-isononyl) phthalate (MCNP) was associated with 0.66 (0.45, 97) lower odds of being in the “low-high” trajectory. No sex-specific associations or mixture associations were observed. Conclusions: Prenatal concentrations of urinary DEHP metabolites, DiNP metabolites, and MCNP, a di-isodecyl phthalate metabolite, were associated with trajectories of child adiposity. The total phthalate mixture was not associated with early life child adiposity.

Original languageEnglish (US)
Article number112111
JournalEnvironmental Research
StatePublished - Mar 2022


  • Children's environmental health
  • Environmental epidemiology
  • Mixtures analysis
  • Phthalates
  • Pregnancy
  • Prenatal Exposure Delayed Effects/chemically induced
  • Adiposity
  • Environmental Pollutants/toxicity
  • Humans
  • Female
  • Environmental Exposure
  • Phthalic Acids/toxicity

ASJC Scopus subject areas

  • General Environmental Science
  • Biochemistry


Dive into the research topics of 'Prenatal maternal phthalate exposures and trajectories of childhood adiposity from four to twelve years'. Together they form a unique fingerprint.

Cite this