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Environ Res. 2019 Feb;169:26-32. doi: 10.1016/j.envres.2018.10.014. Epub 2018 Oct 19.

Phthalate exposure during pregnancy and long-term weight gain in women.

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Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.
CONACYT, National Institute of Public Health, Center for Nutrition and Health Research, Av Universidad 655 Col. Sta. Ma. Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico. Electronic address:
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA.
Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, USA.
Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, USA.
Division of Research in Community Interventions, National Institute of Perinatology, Mexico City, Mexico.



Phthalates are known endocrine disruptors and peroxisome proliferator-activated receptor (PPAR) activators, potentially capable of promoting an obesogenic effect. Pregnant women are especially vulnerable to phthalate exposure due to physiological and metabolic changes during pregnancy, including those related to the metabolism of xenobiotics. Phthalate exposure during pregnancy has been associated with early gestational weight gain, however, its effect on long-term weight gain remains unclear. The aim of the present study was to evaluate the association between phthalate exposure during pregnancy and long-term changes in weight among women.


Urinary phthalate concentrations, socioeconomic, anthropometry and information on diet and socioeconomic status were collected during pregnancy from 178 women from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort. Maternal body weight and diet information was also collected up to 5 times in the first year postpartum and twice during follow-up visits 5.2-10.7 years later. A path analysis was performed to assess associations between urinary phthalate metabolite levels during pregnancy and change in weight (kg) per year after delivery, including age, education, living with/without partner, parity, daily energy intake and breastfeeding duration.


The mean age at pregnancy was 27.3 ± 5.9 years and mean body mass index during the first postpartum year was 27.07 ± 4.22 kg/m2. On average, women gained 3.48 kg (0.52 ± 0.84 kg/year). A unit increase in log-transformed mono-3-carboxypropyl phthalate (MCPP) was associated with 0.33 kg (95% CI: 0.09, 0.56) higher weight gain per year, and mono-benzyl phthalate (MBzP) with 0.21 kg (95% CI: -0.38, -0.03) lower weight gain per year.


Exposure to certain phthalates during pregnancy may be associated with long-term weight change in women. More studies on the effects of phthalate exposure during pregnancy on women's long-term health are required.


MBZP; MCPP; Phthalates; Pregnancy; Weight

[Available on 2020-02-01]

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