Distinct Impacts of Prenatal and Postnatal Phthalate Exposure on Behavioral and Emotional Development in Children Aged 1.5 to 3 Years

Development is a continuous process, but few studies have assessed the simultaneous impact of prenatal and postnatal phthalate exposure on children's behavioral and emotional development. A total of 491 mother-child pairs from the general population in southern Taiwan were studied from 2021 to 2022. Urinary concentrations of bisphenol A (BPA) and phthalate metabolites-mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-benzyl phthalate (MBzP), and mono-2-ethylhexyl phthalate (MEHP)-were measured in pregnant mothers during the second trimester and in their corresponding children aged 1.5 to 3 years. Behavioral symptoms in children were evaluated using the Child Behavior Checklist (CBCL). Odds ratios (ORs) represent a 1-unit increase in log10-transformed creatinine-corrected maternal urine concentrations. Prenatal maternal urinary MnBP levels were associated with total problems (OR = 19.32, 95% CI: 1.80-43.13, <i>p</i> = 0.04), anxiety (OR = 33.58, 95% CI: 2.16-521.18, <i>p</i> = 0.01), and sleep problems (OR = 41.34, 95% CI: 1.04-1632.84, <i>p</i> = 0.04) in children. Additionally, urinary MnBP levels in children correlated with total problems (OR = 7.06, 95% CI: 1.01-49.05, <i>p</i> = 0.04) and internalizing problems (OR = 11.04, 95% CI: 1.27-95.72, <i>p</i> = 0.01). These findings suggest that prenatal and postnatal exposure to dibutyl phthalate (DBP), metabolized as MnBP, distinctly affects children's behavioral development.