Prenatal phenol and paraben exposures in relation to child neurodevelopment including autism spectrum disorders in the MARBLES study

Environ Res. 2019 Dec;179(Pt A):108719. doi: 10.1016/j.envres.2019.108719. Epub 2019 Sep 4.


Background: Environmental phenols and parabens are endocrine disrupting chemicals (EDCs) with the potential to affect child neurodevelopment including autism spectrum disorders (ASD). Our aim was to assess whether exposure to environmental phenols and parabens during pregnancy was associated with an increased risk of clinical ASD or other nontypical development (non-TD).

Methods: This study included mother-child pairs (N = 207) from the Markers of Autism Risks in Babies - Learning Early Signs (MARBLES) Cohort Study with urinary phenol and paraben metabolites analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) from repeated pregnancy urine samples. Because family recurrence risks in siblings are about 20%, MARBLES enrolls pregnant women who already had a child with ASD. Children were clinically assessed at 3 years of age and classified into 3 outcome categories: ASD, non-TD, or typically developing (TD). Single analyte analyses were conducted with trinomial logistic regression and weighted quantile sum (WQS) regression was used to test for mixture effects.

Results: Regression models were adjusted for pre-pregnancy body mass index, prenatal vitamin use (yes/no), homeowner status (yes/no), birth year, and child's sex. In single chemical analyses phenol exposures were not significantly associated with child's diagnosis. Mixture analyses using trinomial WQS regression showed a significantly increased risk of non-TD compared to TD (OR = 1.58, 95% CI: 1.04, 2.04) with overall greater prenatal phenol and paraben metabolites mixture. Results for ASD also showed an increased risk, but it was not significant.

Discussion: This is the first study to provide evidence that pregnancy environmental phenol exposures may increase the risk for non-TD in a high-risk population.

Keywords: Autism; Cohort study; Epidemiology; Parabens; Phenols.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autism Spectrum Disorder / epidemiology*
  • Autistic Disorder / epidemiology
  • Biomarkers
  • Calcium Carbonate
  • Child
  • Child, Preschool
  • Chromatography, Liquid
  • Cohort Studies
  • Environmental Exposure / statistics & numerical data*
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Male
  • Parabens / metabolism*
  • Phenol / metabolism*
  • Phenols
  • Pregnancy
  • Tandem Mass Spectrometry
  • Vitamins


  • Biomarkers
  • Parabens
  • Phenols
  • Vitamins
  • Phenol
  • Calcium Carbonate