Effect of Prenatal Phthalate Exposure on Childhood Atopic Dermatitis: a Systematic Review and a Meta-analysis of Birth Cohort Studies
Abstract
Background: The association between prenatal exposure to phthalate and childhood atopic dermatitis (AD) has been previously investigated; however, the results are inconsistent. We aimed to perform a systematic review and meta-analysis of birth cohort studies to investigate whether prenatal exposure to phthalate increases the risk of developing AD in children.Methods: We performed an electronic search of the MEDLINE, Embase, and Cochrane library databases. Studies were critically appraised, and meta-analyses were performed.Results: Among 129 articles identified, 11 studies met the eligibility criteria. Included studies originated from Europe (n = 5), USA (n = 4), and Asia (n = 2). The study sample size ranged from 147 to 1024 mother-child pairs. Quality assessment using the Newcastle–Ottawa scale of all studies had scores of six or greater. A meta-analysis of data from eight selected studies suggested that monobenzyl phthalate (MBzP) exposure was significantly associated with the risk of AD development (odds ratio 1.16, 95% confidence interval 1.04-1.31, I2 = 17.36%). However, AD development was not associated with other phthalate metabolites such as mono-(2-ethylhexyl) phthalate, monoethyl phthalate, mono-isobutyl phthalate, mono-n-butyl phthalate, and the sum of di-[2-ethylhexyl] phthalate on the development of AD (all P-values > 0.05).Conclusions: Our study suggests a positive association between prenatal exposure to MBzP and the development of childhood AD.
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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