Maternal phthalate exposure during pregnancy and male reproductive disorders: a systematic review and metaanalysis.
Level 3 - non-randomized controlled study
Systematic review of observational studies.
PubMed 35611408 · doi:10.24953/turkjped.2020.2060
What was done
The authors systematically searched PubMed, Cochrane Library, and Web of Science without regional or date restrictions for English-language studies evaluating maternal phthalate exposure and male reproductive disorders. When multiple papers evaluated overlapping cohorts, only the most recent was retained. Due to limited homogeneous statistical data across the literature, the authors performed a synthesis of observed trends rather than a uniform quantitative meta-analysis.
What was found
A total of 19 manuscripts were included. The abstract reports no numerical effect sizes, odds ratios, or confidence intervals. Directionally, maternal exposure to di-(2-ethylhexyl) phthalate (DEHP), di-n-butyl phthalate (DBP), diethyl phthalate (DEP), and benzyl butyl phthalate (BBP) was associated with shorter anogenital distance (AGD) in male offspring. In addition, exposure to DEHP and di-isodecyl phthalate (DIDP) was associated with elevated risks for cryptorchidism and hypospadias, with early pregnancy identified as a sensitive exposure window.
Why it matters
This review synthesizes human observational evidence linking ubiquitous gestational phthalate exposure to congenital male reproductive tract anomalies and anti-androgenic anatomical markers.
Limits
The abstract provides no numerical effect sizes, confidence intervals, or total participant sample sizes. High heterogeneity across the included studies prevented comprehensive statistical pooling, leading the authors to note a lack of statistical power and caution that findings represent approximate trends requiring further validation.
Cited by
- supports Higher maternal phthalate levels during pregnancy correlate with reduced anogenital distance in male infants.