Prenatal phthalate exposure and gender role behavior in preschool children from central Taiwan

[[abstract]]Background: Phthalates exposure was found to be associated with decreased anogenital index in newborns across the US. It is hypothesized that male sex hormone might be altered and gender role behavior changed in relation to phthalates exposure. Methods: We investigated the relations of testosterone and the Pre-School Activities Inventory (PSAI) to 11 phthalate monoester metabolites, by fully automated LC-LC/MS-MS-system, in a birth cohort of 300 newborns established in 2001 and followed till 2006 in central Taiwan. Phthalate exposure was associated with decreased testosterone (TT) concentrations at the years of 0 (cord carboxyl-mono-isononyl phthalate (cx-MiNP) and cord TT: spearman correlation r 5 2 0.49, P , 0.05), 2–3 (urinary mono-benzyl phthalate (MBzP) and serum TT: r 5 2 0.44, P , 0.05), and 5– 6 (MBzP and TT: r 5 2 0.27, P , 0.05) years, with more significant r in boys at 0 year (cx-MiNP and PSAI: r 5 2 0.61, P , 0.05) and with more significant r in girls at 2 and 5 years (MBzP: r 5 2 0.91, P , 0.001, and r 5 2 0.46, P , 0.05, respectively). Results: Prenatal exposure to phthalates was associated with decreased PSAI scores at the age of 5 years, indicating stereotyped feminine toys and activities: Pearson correlation r between maternal urinary MBzP and PSAI score was 2 0.32 (P 5 0.06, n 5 55) adjusted for gender and education of the major caretaker, and was 2 0.66 (P 5 0.01) when maternal TT was further adjusted. Urinary MBzP was associated with decreased PSAI score (r 5 2 0.54, P 5 0.01) in 5– 6 year old girls, adjusted for the education and their TT. Children with PSAI less than the median experienced significantly higher prenatal exposure to MBzP, MnBP, (both being BBP metabolites), and OH-MiNP and oxo-MiNP (DiNP metabolites). Conclusion: It is firstly reported that testosterone levels decreased with increasing phthalates exposure consistently in the young children at the ages of 0, 2 and 5 years. The feminine role was found associated with prenatal exposure to BBP and DiNP metabolites. The decreased PSAI scores might associate partly with decreased TT and some other substantial factors that await further investigations