Prenatal Exposure to Phthalates, a Potential Cause of Adverse Fetal Outcomes: A Systematic Review

Background: Phthalates are highly used chemical additives, plasticizers, and solvents found in a wide range of consumer products from auto parts and toys to personal care products and foods. Being so ubiquitous in our daily environments, phthalates have been studied to evaluate their potential for adverse affects on animals, and were found to cause anti-androgenic affects in rats, low birth weight, shortened gestational period as well as birth defects. Newer studies are beginning to look at these factors as they relate to humans. This systematic review used GRADE to evaluate the quality of evidence in the most recent studies on newborn birth outcomes that were exposed prenatally to phthalates. Methods: A systematic review of studies written between 2000 and 2010, using published literature in the English-language, was conducted using MEDLINE, Evidence-Based Medicine Reviews Multifile, and Web of Science using keywords phthalate, phthalates, prenatal, anogenital distance, AGD, birth, low birth weight and birth outcomes. Articles that examined the birth outcomes of birth weight, birth length, head circumference and gestational age after in utero exposure to phthalates were selected. Four studies were analyzed for result outcomes. Results: Three of the four studies have demonstrated that in utero exposure to environmental phthalates is associated with either newborn birth weight, birth length, head circumference or gestational age. The forth study reported no significant relationships between prenatal exposure to phthalates and any of the birth outcomes. Conclusion: The findings deduced in this study using the GRADE process, suggest that, at the current level of exposure, phthalates may have subtle affects on the fetus in relation to certain birth outcomes. However, the evidence is of low quality and further investigation is needed to truly report that these findings are not due to other limitations such as other environmental chemicals not evaluated or confounding factors such as selfreported values. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/243 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/243 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author of this work has made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student author attests that this work is completely his/her original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed. Prenatal Exposure to