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The association between phthalate exposure ad newborn anogenital distance: a Review

Lai, LiAn (2018) The association between phthalate exposure ad newborn anogenital distance: a Review. Master Essay, University of Pittsburgh.

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AGD is an androgen-sensitive biomarker affected by both maternal phthalate exposure and hormone concentrations. Based on current studies, some phthalates (class of endocrine disrupting chemicals, many used in plastic production) and their metabolites concentration are associated with shorter AGD for the male infant. Moreover, the length of AGD relates to several adverse health outcomes that might originate during the fetal period such as infertility, hypogonadism and prostate cancer. The public health significance for the study is to the pathway from phthalate exposure, maternal hormone level to newborn AGD. The result can be the foundation of further research in public health.
In general, testosterone concentration is positively associated with AGD for both male and females. Longer AGD is an indicator of greater masculinization and shorter AGD is an indicator of hormonal disruption in males and reduced masculinization. Studies focusing on other types of reproductive hormones are rare, and their conclusions are inconsistent. As an example, one study in Spain did not observe a significant association between AGD and follicle-stimulating hormone (FSH), estradiol, and sex hormone-binding globulin (SHBG). In contrast, another study in China reported a negative correlation between AGD and estradiol or SHBG. One study in the US reported the positive relationship between AGD and the hCG in female neonates. Thus, to clarify the inconsistent conclusion, further research to explore the real relationship between AGD and hormone is needed.
While there is a need to further explore how all reproductive hormones affect the length of AGD, there also is a need to address several additional questions. These include research on epigenetic or gene polymorphism to AGD, and the epigenetic studies would be an essential issue. For example, the different association between hCG and AGD among male and female newborns. The sex difference is an important factor for both AGD and phthalate exposure. Besides, there is only one study has identified a SNP on the endocrine receptor related to phthalate exposure and AGD. More studies should be done to investigate how epigenetic or gene affect AGD. Another gap in the literature is the lack of mediation analysis. Through mediation analysis, we can further clarify the pathway from phthalate exposure to hormone levels and then to the anogenital distance, rather than adjusting for hormone concentration in the regression model.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Lai, LiAnlil96@pitt.edulil960000-0002-3912-4671
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairSonger, Thomas J.tjs@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberAdibi, Jennifer J.ADIBU@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberBarchowsky, Aaronaab20@pitt.eduUNSPECIFIEDUNSPECIFIED
Centers: Other Centers, Institutes, Offices, or Units > Alzheimer's Disease Research Center
Date: 27 April 2018
Date Type: Submission
Defense Date: April 2018
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 54
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Child Health
Date Deposited: 31 May 2019 20:31
Last Modified: 01 May 2021 05:15


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