Journal article
Exposure to organophosphate ester flame retardants and plasticizers during pregnancy and autism-related outcomes in the ECHO Cohort
Environmental health perspectives
11 Jun 2025
PMID: 40499048
Abstract
Organophosphate ester flame retardants and plasticizers (OPEs) have myriad uses in industry and consumer products. Increasing human exposure to OPEs has raised concerns about their potential effects on child neurodevelopment during pregnancy.
We investigated whether OPE urinary concentrations during pregnancy were associated with child autism-related outcomes.
We included 4159 mother-child pairs from 15 cohorts in the NIH Environmental influences on Child Health Outcomes (ECHO) Consortium, with children born from 2006-2020 (median age [interquartile range]: 6 [4,10] years). Nine OPE biomarkers were measured in urine samples collected mid- to late pregnancy. Dilution-adjusted biomarkers were modeled continuously, categorically (high [> median], moderate [≤ median], non-detect), or as detect/non-detect depending on their detection frequency. We assessed child autism-related traits via a) parent report on the Social Responsiveness Scale (SRS) and b) clinical autism diagnosis. We examined associations of OPEs with child outcomes, including modification by child sex, using generalized estimating equations to account for clustering by ECHO cohort.
Compared with non-detectable concentrations, high exposure to bis(butoxyethyl) phosphate (BBOEP) was associated with higher autistic trait scores (adj-β 0.97, 95% confidence interval [CI]: 0.42, 1.52) and greater odds of autism diagnosis (adjusted odds ratio [adj-OR]: 1.27, 95% CI: 1.07, 1.50). Bis(1-chloro-2-propyl) phosphate (BCPP) showed associations with autistic trait scores (BCPP adj-β for high exposure vs. non-detect: 0.34, 95% CI: -0.46, 1.13; BCPP adj-β for moderate exposure vs. non-detect: 0.72, 95% CI: 0.24, 1.20). High exposure to bis(2-chloroethyl) phosphate (BCETP) was associated with lower odds of autism diagnosis (adj-OR: 0.76, 95% CI: 0.60, 0.95). Other OPEs showed no associations in adjusted models. Associations between BBOEP and higher autistic trait scores were stronger in males than females.
Prenatal exposure to OPEs, specifically BCPP and BBOEP, may be associated with higher risk of autism diagnosis and related traits in childhood. https://doi.org/10.1289/EHP16177.
Metrics
17 Record Views
Details
- Title
- Exposure to organophosphate ester flame retardants and plasticizers during pregnancy and autism-related outcomes in the ECHO Cohort
- Creators
- Jennifer L Ames - Kaiser PermanenteAssiamira Ferrara - Kaiser PermanenteJuanran Feng - Kaiser PermanenteStacey Alexeeff - Kaiser PermanenteLyndsay A Avalos - Kaiser PermanenteEmily S Barrett - Environmental and Occupational Health Sciences InstituteTheresa M Bastain - Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USADeborah H Bennett - University of California, DavisJessie P Buckley - University of North Carolina at Chapel HillCourtney C Carignan - Michigan State UniversityPatricia Cintora - University of Illinois Urbana-ChampaignAkhgar Ghassabian - Departments of Pediatrics and Population Health, New York University Grossman School of Medicine,New York, NY, USAMonique M Hedderson - Kaiser PermanenteIxel Hernandez-Castro - Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USAKurunthachalam Kannan - University at Albany, State University of New YorkMargaret R Karagas - Geisel School of Medicine at Dartmouth, Hanover, NH, USACatherine J Karr - University of WashingtonJordan R Kuiper - George Washington UniversityDonghai Liang - Emory UniversityKristen Lyall - Drexel UniversityCindy T McEvoy - University of PortlandRachel Morello-Frosch - University of California, BerkeleyThomas G O'Connor - University of RochesterJiwon Oh - University of California, DavisAlicia K Peterson - Kaiser PermanenteLesliam Quiros-Alcala - Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USASheela Sathyanarayana - University of WashingtonSusan Schantz - University of Illinois Urbana-ChampaignRebecca J Schmidt - University of California, DavisAnne P Starling - University of North Carolina at Chapel HillTracey J Woodruff - University of California, San FranciscoHeather E Volk - Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USAYeyi Zhu - Kaiser PermanenteLisa A Croen - Kaiser PermanenteECHO Cohort Consortium
- Publication Details
- Environmental health perspectives
- Publisher
- EHP Publishing
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Other Identifier
- 991022056899204721