Joint trajectories of ADHD and autistic traits in preschoolers linked to prenatal phthalate exposure: insights from the cord blood metabolome

作者：Zi-Xiang Yu, Haifeng Chen, Hua-Yan Mo, Meng-long Geng, Y S Zhang, Juan Tong, Yi Wang, Kun Huang, Ji-xing Zhou, Bei-bei Zhu, Fang-biao Tao, Cheng Zhang, Hui Gao · 发表于：Environment International · 年份：2026 · DOI：10.1016/j.envint.2026.110402 · 研究领域：Effects and risks of endocrine disrupting chemicals、Anesthesia and Neurotoxicity Research、Pharmacological Effects and Toxicity Studies

This study explored the association between prenatal phthalate exposure and the joint trajectories of ADHD and autism traits, as well as potential mechanisms. We measured seven phthalate metabolites in urine samples from 3,083 mother-child pairs and assessed the joint neurodevelopmental trajectories of preschool. The results demonstrated time-, sex-, and metabolite-specific associations between prenatal phthalate exposure and the joint trajectories of ADHD and autistic traits. Higher concentrations of DEHP (OR: 1.922, 95 %CI: 0.928, 3.979, per log10 unit increase) and high-molecular-weight phthalates (HMWP) (OR: 1.897, 95 %CI: 0.917, 3.921) were linked to an elevated risk of the high-coexistence trajectory, particularly in girls. Trimester-specific positive associations were observed: first-trimester MBP (OR: 1.292, 95 %CI: 0.998, 1.672) and low-molecular-weight phthalates (LMWP) (OR: 1.360, 95 %CI: 0.996, 1.855) increased the risk of low-coexistence trajectory in girls, while MBzP (OR: 0.817, 95 %CI: 0.682, 0.977) exposure unexpectedly showed protective effects in boys; third-trimester MBzP (OR: 1.232, 95 %CI: 0.970, 1.565) increased low-coexistence risks in boys. Notably, MEHP (OR: 0.677, 95 %CI: 0.510, 0.897), MEHHP (OR: 0.701, 95 %CI: 0.501, 0.981), DEHP (OR: 0.647, 95 %CI: 0.440, 0.950) and HMWP (OR: 0.656, 95 %CI: 0.447, 0.964) appeared to have protective effects in girls. Sex-specific dose-response relationships were evident. Mechanistically, in boys, DEHP and its meta...