Table 4.

Adjusted associations [$\mathrm{\beta }$ (95% CI)] of prenatal urinary phthalate biomarker concentrations (nmol/mL; ${\log }_2\text{-transformed}$ and specific gravity-adjusted)^a with behavior and social cognition outcomes at 7, 9, 10.5, 12, 14, and/or 16 y using GEE models, CHAMACOS.

Outcomes	Orientationb	$n$	k	$\mathrm{\Sigma }\text{LMW}$	$\mathrm{\Sigma }\text{HMW}$	$\mathrm{\Sigma }\text{DEHP}$
Social cognitionc
SRS Total Score (14 y)	($+$)	245	245	0.4 ($-0.2$, 0.9)	$-0.3$ ($-1.1$, 0.5)	$-0.3$ ($-1.1$, 0.5)
ENI (9 y)	($-$)	313	313	0.0 ($-0.1$, 0.1)	0.1 ($-0.1$, 0.2)	0.1 (0.0, 0.2)
NEPSY-II (12 y)	($-$)	310	310	$-0.1$ ($-0.3$, 0.2)	$-0.3$ ($-0.7$, 0.1)	$-0.2$ ($-0.5$, 0.2)
Behavior
BASC-2—parent-report (T-score)
Internalizing problems (7, 10.5, 14, 16 y)	($+$)	1,226	328	0.4 ($-0.1$, 1.0)	0.5 ($-0.4$, 1.4)	0.4 ($-0.5$,1.2)
Depression scalec (7 y)	($+$)	322	322	0.4 ($-0.1$, 1.0)	0.4 ($-0.5$, 1.3)	0.3 ($-0.6$, 1.1)
Anxiety scalec (7 y)	($+$)	313	313	0.3 ($-0.3$, 1.0)	0.8 ($-0.4$, 1.9)	0.6 ($-0.5$, 1.7)
Externalizing problems (7, 10.5, 14, 16 y)	($+$)	1,219	328	0.1 ($-0.4$, 0.5)	0.2 ($-0.6$, 0.9)	0.1 ($-0.6$, 0.7)
Hyperactivity scale (7, 10.5, 14, 16 y)	($+$)	1,226	328	0.0 ($-0.4$, 0.4)	$-0.1$ ($-0.7$, 0.6)	$-0.1$ ($-0.8$, 0.5)
Attention problems scale (7, 10.5, 14, 16 y)	($+$)	1,226	328	0.0 ($-0.5$, 0.5)	$-0.1$ ($-1.0$, 0.7)	$-0.1$ ($-0.9$, 0.7)
BASC-2—teacher-report (T-score)c
Internalizing problems (7 y)	($+$)	265	265	$-0.7$ ($-1.6$, 0.2)	$-0.4$ ($-1.8$, 1.0)	$-0.3$ ($-1.6$, 1.0)
Depression scale (7 y)	($+$)	265	265	$-0.6$ ($-1.4$, 0.1)	$-0.2$ ($-1.4$, 0.9)	$-0.2$ ($-1.4$, 0.9)
Anxiety scale (7 y)	($+$)	265	265	$-0.9$ ($-1.8$, 0.1)	$-0.8$ ($-2.1$, 0.5)	$-0.7$ ($-2.0$, 0.6)
Externalizing problems (7 y)	($+$)	265	265	$-0.1$ ($-0.8$, 0.6)	0.0 ($-1.0$, 1.0)	0.2 ($-0.7$, 1.1)
Hyperactivity scale (7 y)	($+$)	265	265	0.0 ($-0.7$, 0.7)	$-0.2$ ($-1.4$, 0.9)	$-0.1$ ($-1.1$, 0.9)
Attention problems scale (7 y)	($+$)	265	265	0.2 ($-0.8$, 0.4)	$-0.5$ ($-1.4$, 0.4)	$-0.3$ ($-1.2$, 0.5)
CADS—parent-report (T-score)
ADHD Index (7, 9, 12 y)	($+$)	920	332	$-0.3$ ($-0.7$, 0.1)	$-0.2$ ($-1.0$, 0.5)	$-0.2$ ($-1.0$, 0.5)
DSM-IV Total Scale (7, 9, 12 y)	($+$)	921	332	$-0.3$ ($-0.7$, 0.1)	$-0.1$ ($-1.0$, 0.7)	$-0.2$ ($-1.0$, 0.5)
Inattentive scale (7, 9, 12 y)	($+$)	920	332	$-0.3$ ($-0.7$, 0.1)	$-0.3$ ($-1.0$, 0.5)	$-0.3$ ($-0.9$, 0.4)
Hyperactive/impulsive scale (7, 9, 12 y)	($+$)	920	332	$-0.2$ ($-0.7$, 0.2)	0.0 ($-0.9$, 0.9)	$-0.1$ ($-1.0$, 0.7)
CADS—teacher-report (T-score)c
ADHD Index (7 y)	($+$)	261	261	$-0.4$ ($-1.2$, 0.5)	$-0.5$ ($-1.9$, 0.9)	$-0.4$ ($-1.6$, 0.9)
DSM-IV Total Scale (7 y)	($+$)	260	260	$-0.2$ ($-0.9$, 0.5)	$-0.2$ ($-1.4$, 1.0)	$-0.1$ ($-1.2$, 1.0)
Inattentive scale (7 y)	($+$)	264	264	$-0.1$ ($-0.8$, 0.5)	$-0.1$ ($-1.2$, 0.9)	$-0.1$ ($-1.0$, 0.9)
Hyperactive/impulsive scale (7 y)	($+$)	264	264	$-0.1$ ($-0.8$, 0.6)	0.1 ($-1.1$, 1.3)	0.2 ($-0.9$, 1.3)
CPT-II (T-score)
Errors of omission (9, 12 y)	($+$)	595	317	0.9 (0.0, 1.8)	$-0.1$ ($-1.2$, 1.1)	$-0.2$ ($-1.2$, 0.9)
Errors of commission (9, 12 y)	($+$)	595	317	0.3 ($-0.2$, 0.8)	$-0.1$ ($-1.0$, 0.8)	$-0.3$ ($-1.1$, 0.6)
ADHD confidence index (9, 12 y)	($+$)	596	317	0.7 ($-0.5$, 1.9)	$-1.0$ ($-2.7$, 0.8)	$-1.0$ ($-2.6$, 0.6)

Note: Models were adjusted for maternal age at enrollment, education, country of birth, years in the U.S., depression at time of assessment; child sex, child age at time of assessment, language of assessment, HOME score, and household income at time of assessment. CPT-II models were also adjusted for children’s video game usage at time of assessment. ADHD, Attention Deficit Hyperactivity Disorder; BASC-2, Behavior Assessment System for Children, 2nd edition; CADS, Conners' ADHD/DSM-IV Scales; CPT-II, Continuous Performance Test, 2nd edition; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th edition; ENI, Evaluación Neuropsicológica del Niño; k, number of children with data for at least one time point; $n$, number of observations from all time points; NEPSY-II, A Developmental Neuropsychological Assessment, 2nd Edition; $\mathrm{\Sigma }\text{LMW}$, sum of metabolites of low-molecular-weight phthalates; $\mathrm{\Sigma }\text{HMW}$, sum of metabolites of high-molecular-weight phthalates; $\mathrm{\Sigma }\text{DEHP}$, sum of di(2-ethylhexyl) phthalate metabolites. SRS, Social Responsiveness Scale, version 2.

^aSeparate models created for each sum of metabolites ($\mathrm{\Sigma }\text{DEHP}$, $\mathrm{\Sigma }\text{HMW}$, $\mathrm{\Sigma }\text{LMW}$).

^b($+$) Higher scores indicate poorer performance/more symptomatic behavior; ($-$) lower scores indicate poorer performance/more symptomatic behavior.

^cMeasured at one time point and modeled using linear regression.