Fetal exposure to bisphenols and phthalates and risk of respiratory conditions in infancy.

Fetal exposure to bisphenols and phthalates and risk of respiratory conditions in infancy. The Generation R Next Study.

Penumathsa Suresh Varma, Tarik Karramass, L Trasande, Kelly K Ferguson, Kurunthachalam Kannan, Amrit K Sakhi, Vincent W V Jaddoe, Liesbeth Duijts

Environ Res

Jun 14, 2026

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Abstract

Fetal exposure to bisphenols and phthalates may lead to alterations in the development of the respiratory and immune systems in children, subsequently increasing their susceptibility to respiratory conditions in infancy. We aimed to study the associations of fetal exposure to bisphenol and phthalate metabolites with the risk of respiratory conditions in infancy. This study, involving 1295 mother-child pairs, was embedded in a population-based prospective cohort in Rotterdam, the Netherlands. We measured maternal concentrations of bisphenols and phthalate metabolites in spot urine samples collected during the first and third trimesters of pregnancy. The ever occurrence and number of episodes of asthma-related symptoms and respiratory tract infections were assessed at ages 6 and 12 months using ISAAC-based questionnaires. The pregnancy-averaged and trimester-specific urinary bisphenol and phthalate metabolite concentrations were not associated with the ever occurrence of wheezing, shortness of breath, or upper or lower respiratory infections in the first year of life. However, a doubling in the pregnancy-averaged urinary concentrations of Bisphenol F (BPF), Bisphenol S (BPS), and certain high molecular weight (HMW) phthalates was associated with 1 to 3 or 4 and more episodes of asthma-related symptoms in the first year of life (range odds ratio (OR) [95% confidence interval]: 1.04 [1.01, 1.06] to 1.35 [1.22, 1.49]). A mixture of pregnancy-averaged bisphenol and phthalate concentrations was not associated with any of the respiratory conditions. To conclude, fetal exposure to bisphenols, phthalates or their mixtures was not associated with ever occurrence of respiratory conditions in infancy. However, higher levels of BPF, BPS and certain HMW phthalates may increase the number of episodes of asthma-related symptoms in infancy.