Early prenatal phthalate exposure, sex steroid hormones, and birth outcomes

Sheela Sathyanarayana, Samantha Butts, Christina Wang, Emily Barrett, Ruby Nguyen, Stephen M. Schwartz, Wren Haaland, Shanna H. Swan

Research output: Contribution to journalArticlepeer-review

92 Scopus citations


Context: Adequate sex steroidhormoneconcentrations are essential fornormal fetal genital development in early pregnancy. Our previous study demonstrated an inverse relationship between third-trimester di-2-ethyl hexyl phthalate exposure and total testosterone (TT) concentrations. Here, we examine earlypregnancy phthalates, sex steroid hormone concentrations, and newborn reproductive outcomes. Design: We examined associations between urinary phthalate metabolite concentrations in early pregnancy and serum free testosterone (FT), TT, estrone (E1), and estradiol (E2) in 591 woman/infant dyads in The Infant Development and Environment Study; we also examined relationships between hormones and newborngenital outcomes using multiple regression models with covariate adjustment. Results: E1 and E2 concentrations were 15% to 30% higher in relation to 1-unit increases in log monoisobutyl phthalate (MiBP), mono-2-ethyl hexyl phthalate, and mono-2-ethyl-5-oxy-hexyl phthalate concentrations, and E2 was 15% higher in relation to increased log monobenzyl phthalate (MBzP). FT concentrations were 12% lower in relation to 1-unit increases in log mono(carboxynonyl) phthalate (MCNP) and mono-2-ethyl-5-carboxypentyl phthalate concentrations. Higher maternal FT was associated with a 25% lower prevalence of having a male genital abnormality at birth. Conclusions: The positive relationships between MiBP, MBzP, and DEHP metabolites and E1/E2 are unique and suggest a positive estrogenic effect in early pregnancy. The inverse relationship between MCNP and DEHP metabolites and serum FT supports previous work examining phthalate/testosterone relationships later in pregnancy. Higher FT in relation to a 25% lower prevalence of male genital abnormalities confirms the importance of testosterone in early fetal development.

Original languageEnglish (US)
Pages (from-to)1870-1878
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number6
StatePublished - Jun 1 2017

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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