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1334049 
Journal Article 
Abstract 
Follow-up study of adolescents exposed to di-2-ethylhexyl phthalate (DEHP) as neonates on extracorporeal membrane oxygenation (ECMO) support 
Rais-Bahrami, K; Nunez, S; Revenis, ME; Short, BL; Luban, NL 
2003 
1 
Pediatric Research
ISSN: 0031-3998
EISSN: 1530-0447 
DART/TER/3001008 
53 
4 Pt. 2 
422A-423A 
English 
WOS:000181897902388 
BACKGROUND: Exposure to DEHP occurs throughout life. Of particular concern is the exposure of fetuses, preterm infants and babies, because the developing human reproductive system may be affected when the metabolic pathways of detoxification are immature. DEHP has been shown to damage the reproductive systems in newborn animals. Adverse effects include reduced fertility, and sperm production in males and ovarian dysfunction in females. DEHP is used to make polyvinyl chloride (PVC) plastic tubing flexible. DEHP can leach out of PVC medical devices into the solution it contains. Most blood products are stored in DEHP plasticized bags. Treatments that involve high DEHP exposures are blood exchange transfusions and ECMO. Although potential exposure to DEHP in ECMO patients is significant, it has not been associated with a short-term toxicity.

OBJECTIVE: To evaluate long-term toxicity, we undertook a study of neonatal ECMO survivors to assess their onset of puberty and sexual maturity.

DESIGN/METHODS: A study of 12 male and 6 female, at age 14-16 years who had undergone ECMO in the neonatal period. All subjects had a complete physical examination including height, weight, head circumference and Tanner staging. The testicular volume and phallic length were measured in male participants. Laboratory tests included thyroid, liver and renal function as well as measurements for LH, FSH, testosterone for males and estradiol for females.

RESULTS: With the exception of one patient with Marfan syndrome, the rest had normal growth percentile for age and sex. All had normal values for thyroid, liver and renal functions. Sexual hormones were appropriate for the pubertal maturity. The results for male patients are shown in table as mean (normal ranges) (Table: see text).

CONCLUSIONS: Our study of adolescents exposed to significant quantities of DEHP as neonates showed no significant adverse effects of DEHP on their physical growth and pubertal maturity. Thyroid, liver, renal, and male and female gonadal functions were within normal range for age and sex distribution when compared with known reference data. 
Adolescent; Infant, Newborn; Support, U.S. Gov't, P.H.S.; Extracorporeal Membrane Oxygenation/ ADVERSE EFFECTS; Diethylhexyl Phthalate/ ADVERSE EFFECTS 
Annual Meeting of the Pediatric Academic Society 
Seattle, WA 
May 3-6, 2003