Phthalates are hormonally active pollutants. In-utero exposure to phthalates has been reported to be associated with birth size parameters and pregnancy outcomes. However, previous reports were inconsistent. We examined the associations between meconium exposure to phthalates and the effects on birth size parameters, pregnancy outcomes and sex and thyroid hormones in 251 mother–infant pairs from a Shanghai hospital. We measured 10 metabolites of phthalates in meconium samples collected during the first 24h after delivery. Information on seven birth size parameters (birth weight, birth length, abdominal circumference, head circumference, femur length, biparietal diameter and anogenital distance) and three pregnancy outcomes (gestational diabetes, premature rupture of membrane, and premature birth) was available from the birth record. Concentrations of free testosterone, estradiol (E2), thyroid stimulating hormone, concentrations of total and free thyroxine and triiodothyronine were measured from cord blood. Multivariate linear regression and logistic regression were used to estimate associations between phthalate exposure and health outcomes. mono-iso-butylphthalate (MiBP), mono-n-butylphthalate (MnBP) and mono-2-ethyl-5-oxohexyl phthalate (MEOHP) were positively associated with birth length and femur length which seemed more obvious in female newborn; MiBP, MnBP and mono-2-ethylhexylphthalate (MEHP) were positively associated with gestational diabetes mellitus (GDM) only in mothers with male newborns; monomethyl phthalate (MMP), MiBP and MEOHP were positively associated with E2 in male newborns. This study indicates that meconium exposure to phthalates may adversely affect some fetal growth parameters and GDM with a potential gender effect.

Thyroid nodules (TNs) are becoming increasingly prevalent. However, few studies have reported the effects of phthalates and lead (Pb) on TNs. In this study, we aimed to explore the associations of phthalates and Pb with the risks of TN. We sex-age-matched 220 TNs patients and 220 healthy controls from Zhejiang Shangyu, China. We measured 13 phthalate metabolites in spot urine samples. Blood lead levels (BLLs) were determined by atomic absorption spectrometry. The multivariable logistic regression models were used to assess the associations between urinary phthalate metabolites and BLLs and the risks of TNs. We found BLLs were associated with increased risk of TNs in total population. Female-specific positive associations of mono-2-ethyl-5-carboxypentylphthalate (MECPP), mono-2-ethyl-5-hydroxyhexylphthalate (MEHHP), mono-2-ethyl-5-oxohexylphthalate (MEOHP), mono-2-carboxymethyl-hexyl phthalate (MCMHP), and mono-isononyl phthalate (MiNP) with increased risk of TNs were also observed. Moreover, the positive association between phthalates and TNs was modified by BLLs. At the highest tertile of BLLs, monoethylphthalate (MEP), MECPP, MEHHP, MEOHP, and MiNP were significantly associated with increased risk of TNs. Our results indicated that certain phthalate metabolites and BLLs may contribute to increased risks of TNs.