Background and Objectives:
Phthalates are chemical products widely used as plasticizers, potentially harmful, especially for their antiandrogenic effects in specific populations, such as pregnant women and newborns. Ingestion is an important exposure pathway, however specific exposure sources and drivers are mainly unknown. The aim of this study was to evaluate the association between dietary and cooking habits during pregnancy and phthalates exposure at delivery.

Methods:
197 women were recruited after delivery, in a single-center prospective cohort study at Modena’s University Hospital (Italy), from January 2019 to October 2020. Exposure to 6 phthalates was assessed in urine samples and expressed as µg/g of urinary creatinine. Pregnancy, dietary and cooking habits were recorded by ad hoc questionnaire. Descriptive statistics and bivariate analyzes were performed.

Results:
Overall, exposure resulted widespread in women at delivery. In women usually boiling food, urinary levels of Monobenzylphthalate (MBzP) (3.4±2 vs 4.7±3.3 μg/g) and Mono-2-ethylhexylphthalate (MEHP) (2.3±1.8 vs 5.2±15.2 μg/g) were significantly lower, whereas in women usually frying food, mono-n-butylphthalate (MnBP) appeared significantly higher (23.2±59.6 vs 9.8±11.5 μg/g). Low fruit consumption during pregnancy was associated with higher MnBP concentrations compared to daily consumption (39.3±83.1 vs 10.6±11.5 μg/g). Concentrations of monoethylphthalate (MEP) appeared higher in women who consumed cheese, eggs and fish. Daily consumption of red meat, beef and pork was associated with higher levels of di(2-ethylhexyl)phthalate (DEHP) metabolites.

Conclusion:
No strong association among exposure and dietary habits was observed, even though urinary levels of some phthalates resulted higher in women frequently consuming fat food and lower when consuming fruits or choosing healthier cooking methods. Surprisingly, no correlation appeared with packaged foods and packaging material. Further studies are needed to better elucidate ingestion exposure pathways with a greater focus on alternative sources of contamination such as food production, processing and transportation to better guide evidence-based policy making.