The role of phthalate esters in autism development: A systematic review
Abstract
Background Available evidence implicates environmental factors in the pathogenesis of autism spectrum disorders (ASD). However, the role of specific environmental chemicals such as phthalate esters that influence ASD risk remains elusive. This paper systematically reviews published evidences on association between prenatal and/or childhood exposure to phthalate and ASD.Methods Studies pertaining to systematic literature search from Scopus, PubMed, PsycInfo and Web of Science prior to December 2015 were identified. The authors included studies which assessed the effect of exposure to phthalates on occurrence of ASD. This comprehensive bibliographic search identified five independent studies. Each eligible paper was summarized with respect to its methods and results with particular attention to study design and exposure assessment. Because of the heterogeneity in the type of included studies, different methods of assessing exposure to phthalates and the use of different statistics for summarizing the results, meta-analysis could not be used to combine the results of included studies.Results The results of this systematic review have revealed the limited number of studies conducted and assessed phthalate exposure. Seven studies were regarded as relevant to the objectives of this review. Two of them did not measure phthalate exposure directly and did not result in quantitative results. Out of the five studies in which phthalate exposure was mainly measured by the examining biomarkers in biological samples, two were cohort studies (one with positive results and another one with not clear association). Among the three case control studies, two of them showed a significant relation between exposure to phthalate and ASD and the last case control study had negative results. Indeed, this case control studies showed a compromised phthalate metabolite glucuronidation pathway, as a probable explanation of mechanism of the relation between phthalate exposure and ASD.Conclusions This review reveals evidence showing a connection between exposure to phthalates and ASD. Nevertheless, further research is needed with appropriate attention to exposure assessment and relevant pre and post-natal cofounders.
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A review of seven studies (five human, three case-control and two cohort) found that one cohort and two case-control studies reported an association between phthalate and autism.
“The role of phthalates in ASD was recently reviewed and summarized across seven studies, inclusive of five human studies, three case–control in design and two cohort studies [202]. One cohort and two case–control studies reported an association between phthalate and autism.”
From The contribution of environmental exposure to the etiology of autism spectrum disorder (2019) · cites this paper as [202]
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- Authors
- Jeddi, M. Z., Janani, L., Memari, A. H., Akhondzadeh, S., & yunesian, M.
- Affiliations
- Center for Air Pollution Research (IR)
- Iran University of Medical Sciences (IR)
- Tehran University of Medical Sciences (IR)
- Roozbeh Hospital (IR)
- Corresponding author
- yunesian, Masud
- Venue
- Environmental Research
- Publisher
- Elsevier BV
- Published
- 2016-11
- Volume
- 151
- Pages
- 493-504
- ISSN
- 0013-9351 (ISSN-L)
- OpenAlex
- W2518182346
- Cited by
- 76
- References
- 69
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 11 · 2023: 5 · 2022: 5 · 2021: 15 · 2020: 6 · 2019: 6 · 2018: 9 · 2017: 3 · 2016: 1
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Environmental Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institute for Environmental Research (IER), Tehran University of Medical Sciences (TUMS) and Health Services (92-02-46-22909)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
- Keywords
- phthalates, autism spectrum disorder, prenatal exposure, children's exposure, environmental chemicals, autism risk factors, phthalate metabolites, biomarkers of exposure, exposure assessment
- MeSH terms
- Autistic Disorder, Esters, Humans, Phthalic Acids
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