The article “Gestational Exposures to Phthalates and Folic Acid, and Autistic Traits in Canadian Children” attempts to show a possible dose-response of elevated exposures to phthalates during pregnancy to severity of autism in children [2]. The study is prospective, enrolling over 2000 women in the first trimester of pregnancy and checking their urine for metabolites of phthalates. Of some fourteen metabolites, six to seven are ubiquitous within the population. Measuring these metabolites is the strength of this paper. From these pregnancies, 610 children undergo neuropsychological testing between the ages of 3-4 years; however, the neuropsychological testing is by parent questionnaire, the SRS-2, which does not diagnose autism. The questionnaire results had an overall mean of 45.3 and standard deviation of 6.1. A two-fold increase in two urinary metabolites resulted in a 0.5 and 0.6 elevation in the questionnaire results. With an SRS-2 score of >75 being 80% sensitive for autism, an elevation of a half a point is of perhaps questionable importance. The article also questions the mothers regarding folate intake and relates this to a possible attenuation of affects caused by the phthalates [2].
Whether, phthalates contribute to autism has yet to be determined. Reviewing similar articles gives varying results [2]. If nothing else, this article shows that women excrete many phthalate metabolites in their urine early in pregnancy. Evaluating phthalates in pregnancy with regards to other outcomes, one study demonstrated antiandrogenic properties in male infants [1]. It would appear prudent for pregnant women to try to avoid phthalates, but if you look up phthalates, they appear to be in everything and somewhat impossible to avoid. In good news, many large retailers such as Wal-Mart, Target, CVS, and Best Buy are working to limit chemicals, such as phthalates, in the products they sell.
1. Bornehag CG, Carlstedt F, Jönsson BA, et al. Prenatal phthalate exposures and anogenital distance in Swedish boys. Environ Health Perspect. 2015;123(1):101–107. doi:10.1289/ehp.1408163
2. Oulhote Y, Lanphear B, Braun JM, et al. Gestational Exposures to Phthalates and Folic Acid, and Autistic Traits in Canadian Children. Environ Health Perspect. 2020;128(2):27004. doi:10.1289/EHP5621
3. Strucken, E. Call It The Walmart Effect: Large Retailers Step In As EPA Tries To Roll Back Chemical Safety. Forbes. Oct. 5 2017. https://www.forbes.com/sites/edfenergyexchange/2017/10/05/call-it-the-walmart-effect-large-retailers-step-in-as-epa-tries-to-roll-back-chemical-safety/#71fff0437ac1
