Prenatal and postnatal exposure to phthalate esters and asthma: a 9-year follow-up study of a taiwanese birth cohort

PLoS One. 2015 Apr 13;10(4):e0123309. doi: 10.1371/journal.pone.0123309. eCollection 2015.


Previous studies have shown that phthalate exposure in childhood is associated with the development of respiratory problems. However, few studies have assessed the relative impact of prenatal and postnatal exposure to phthalates on the development of asthma later in childhood. Therefore, we assessed the impact of prenatal and postnatal phthalate exposure on the development of asthma and wheezing using a Taiwanese birth cohort. A total of 430 pregnant women were recruited, and 171 (39.8%) of them had their children followed when they were aged 2, 5, and 8 years. The International Study of Asthma and Allergies in Childhood questionnaire was used to assess asthma and wheezing symptoms and serum total immunoglobulin E levels were measured at 8 years of age. Urine samples were obtained from 136 women during their third trimester of pregnancy, 99 children at 2 years of age, and 110 children at 5 years. Four common phthalate monoester metabolites in maternal and children's urine were measured using liquid chromatography-electrospray ionization-tandem mass spectrometry. Maternal urinary mono-benzyl phthalate [MBzP] concentrations were associated with an increased occurrence of wheezing in boys at 8 years of age (odds ratio [OR] = 4.95 (95% CI 1.08-22.63)), for upper quintile compared to the others) after controlling for parental allergies and family members' smoking status. Urinary mono-2-ethylhexyl phthalate [MEHP] levels over the quintile at 2-year-old were associated with increased asthma occurrence (adjusted OR = 6.14 (1.17-32.13)) in boys. Similarly, the sum of di-2-ethyl-hexyl phthalate [DEHP] metabolites at 5 years was associated with asthma in boys (adjusted OR = 4.36 (1.01-18.86)). Urinary MEHP in maternal and 5-year-old children urine were significantly associated with increased IgE in allergic children at 8 years. Prenatal and postnatal exposure to phthalate was associated with the occurrence of asthma in children, particularly for boys.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asthma / blood
  • Asthma / diagnosis
  • Asthma / epidemiology*
  • Asthma / etiology*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Environmental Exposure*
  • Esters
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / immunology
  • Infant
  • Infant, Newborn
  • Male
  • Metabolome
  • Middle Aged
  • Odds Ratio
  • Phthalic Acids / adverse effects*
  • Phthalic Acids / metabolism
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Respiratory Sounds / diagnosis
  • Respiratory Sounds / etiology
  • Risk
  • Risk Factors
  • Taiwan / epidemiology
  • Young Adult


  • Esters
  • Phthalic Acids
  • Immunoglobulin E
  • phthalic acid

Grant support

Financial support received from the Department of National Health Research Institutes, Taiwan, is gratefully acknowledged: EH-102-SP-02, EO-103-PP-05, EH-103-SP-02, EO-104-PP-05, EO-090-PP-03 and also Ministry of Science and Technology (MOST 103-2314-B-400006). The funding agents had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.