BACKGROUND: Early-life exposure to endocrine-disrupting chemicals, such as phenols and phthalates, is suspected to impact various dimensions of child health. Using a multi-outcome approach, this study aimed to estimate their cumulative effect on the child cardiometabolic, respiratory and neurodevelopmental health. METHODS: In 373 children of 3 years old from the SEPAGES cohort, a multi-domain health score was built from twenty-three health parameters. Fourteen metabolites of parabens, phenols, and phthalate/DINCH were measured several times during pregnancy (trimester 2 and 3) and infancy (2 and 12 months of age). Two mixture models, quantile g computation (q-gcomp) and Bayesian Kernel Machine Regression (BKMR), estimated associations between increased concentration of parabens, phenols, and phthalates/DINCH and the child health score. RESULTS: Q-gcomp showed that the paraben mixture and the phthalate mixture were associated with a poorer health score (β = -0.11, 95% Confidence Interval (CI): -0.22, 0.00
β = -0.14, 95% CI: -0.27, -0.01, respectively), while no significant association was found for the mixture of phenols (β = -0.06, 95% CI: -0.18, 0.06). A trend for an association was observed between the whole mixture (parabens, phenols and phthalates combined) with a poorer health score (β = -0.14, 95% CI: -0.32, 0.04). Similar patterns of association, while subject to large uncertainty, have been observed with BKMR. DISCUSSION: This study provides further evidence for the adverse health effects of early-life exposure to parabens and phthalates. Based on their potential impact on multiple areas of child health, public health policies targeting these chemical compounds are recommended.