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Review
. 2017 Mar:68:105-118.
doi: 10.1016/j.reprotox.2016.08.015. Epub 2016 Sep 3.

Effects of early exposure to phthalates and bisphenols on cardiometabolic outcomes in pregnancy and childhood

Elise M Philips  1 , Vincent W V Jaddoe  2 , Leonardo Trasande  3
Affiliations
Review

Effects of early exposure to phthalates and bisphenols on cardiometabolic outcomes in pregnancy and childhood

Elise M Philips et al. Reprod Toxicol. 2017 Mar.

Abstract

Pregnant women are exposed to various chemicals, including endocrine-disrupting chemicals (EDCs) such as phthalates and bisphenols. Increasing evidence suggests that early life exposures to phthalates and bisphenols may contribute to cardiometabolic risks. The aim of this narrative review was to summarize current knowledge of the effects of fetal and childhood exposure to phthalates and bisphenols on child growth and child cardiometabolic outcomes and the effects on maternal outcomes. In total, 54 studies were identified and included. The majority of studies found effects of phthalates and bisphenols on maternal, child growth, and cardiometabolic outcomes. Currently results suggest that early life exposure to phthalates and bisphenols may have a substantial influence on perinatal and postnatal cardiometabolic programming. In a large part of the investigated outcomes studies show contradictory results. However, the majority of the existing evidence is based on non-cohort studies with single samples neglecting time-variant effects and complicating conclusions regarding causal inference. More studies are needed investigating the mechanisms and its potential interactions.

Keywords: Bisphenols; Cardiometabolic effects; Growth; Phthalates; Prenatal and childhood exposure; Review.

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Figures

Figure 1
Figure 1. Potential mechanisms of effect
ERα: estrogen receptor alpha ; ERβ: estrogen receptor beta ; E2: estradiol ; AR : androgen receptor ; T/DHT: testosterone / dihydrotestosterone ; PPAR: peroxisome proliferator-activated receptors ; RXR: retinoid X receptors ; FFA: free fatty acids.
Figure 2
Figure 2
Exposure to phthalates and bisphenols is believed to induce pathways towards several adverse health effects, including epigenetic changes, hormonal disruption, oxidative and nitrosative stress. Effects could be affected by the time of exposure, both during fetal life and childhood. Fetal exposure has been linked with prematurity and low birth weight. Childhood exposure has been associated with early signs of cardiovascular and metabolic dysfunction. Both prematurity and low birth weight have also been associated with cardiometabolic dysfunction. Therefore, both fetal and childhood exposure may give rise to an increased risk of cardiovascular and metabolic disease in adulthood.
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