Table 14.
Associations between DEHP metabolites and behavior.
| Reference; study confidence; N | Age at outcome measure | Median maternal exposures | Exposure IQR (or as specified) | Internalizing problems overall β (95% CI) | Externalizing problems overall β (95% CI) | Internalizing problems in boys β (95% CI) | Internalizing problems in girl β (95% CI) | Externalizing problems in boys β (95% CI) | Externalizing problems in girl β (95% CI) |
|---|---|---|---|---|---|---|---|---|---|
| Exposure measured during gestation | |||||||||
| Kobrosly et al. (2014); medium; 153 | 6–10 yr | 12 ng/mL (MEOHP), 13 (MEHHP)(GM) | 5‒22, 6‒24 | −0.02 (−0.2,0.1) | −0.04 (−0.2,0.1) | −0.1 (−0.1,0.3) | −0.1 (−0.3,0.1) | 0 (−0.2,0.2) | −0.1 (−0.3,0.1) |
| Gascon et al. (2015); high; 362 | 7 yr | 100 μg/g | 68‒146 | Emotional symptoms RR 1.0 (0.8,1.1) | Conduct problems RR 1.0 (0.8,1.1) | NR | NR | NR | NR |
| Whyatt et aL (2012); medium; 297 | 3 yr | 19 ng/mL (MEOHP), 40 (MEHHP)(GM) | 0.7‒1,320, 3‒1,840 (ranges) | 0.1 (−0.8, 1.0) | “No association” | 02 (−1.2,1.6) | 0.1 (−1.0,1.3) | NR | NR |
| Lien et al. (2015); medium; 122 | 8 yr | 39 μg/g | 1.8 (−0.4, 3.9) | 4.38 (2.07, 6.69)* | 1.3 (−1.5,4.1) | 0.7 (−2.9,4.4) | 3.7 (0.1,7.4)* | 3.7 (0.4,7.0)* | |
| Phillippat et al. (2017); medium; 546 | 3 yr | 0.3 μM/L | 0.2–0.4 (33rd-66th) | NR | NR | IRR 1.0 (1.0,1.1) | NR | IRR 1.0 (1.0,1.0) | NA |
| 5 yr | 1.0 (1.0,1.1) | 1.0 (1.0,1.1) | |||||||
| Engel et al. (2010); medium; 188 | 4–9 yr | 0.4 μM/L | 02‒0.9 | “No association” | “No association” | NR | NR | NR | NR |
| Exposure measured preconception | |||||||||
| Messerlian et al. (2017); high; 166 | 2–9 yr | Preconception Maternal 63 ng/mL | 32–99 | −2.0 (−32,−0.8)* | 0.3 (−1.0,1.7) | −5.0 (−9.3,−0.6)* | −2.2 (−3.7,−0.8)* | −0.7 (−2.8,1.3) | 02 (−1.1,1.5) |
| Paternal 93 ng/mL | 49–177 | −1.8 (−3.1,−0.4). | −0.4 (−1.7,0.8) | −3.1 (−5.9,−0.4)* | −1.6 (−3.1,−0.03)* | 0.2 (−1.5,1.8) | −0.5 (−1.7,0.6) | ||
| Attention-deficient hyperactivity disorder (ADHD), exposure measured during gestation | |||||||||
| Engel et al. (2018); medium; 802 | n/a | 0.2 μM/L | 0.2–0.3 | OR 1.5 (1.1,1.9) | OR 1.4 (1.0,2.0) | OR 1.6 (1.0,2.6) | |||
One low confidence study (Kim et al., 2018) not shown in table because results were incompletely reported.
All studies used 1n-transformed exposure and βs represent 1 ln-unit increase, except for Gascon et al. (2015), which used log2-transformation and β represent doubling of exposure and Philippat et al. (2017) which calculated incidence rate ratios (IRR) for a 1 unit change in test scores for a doubling of exposure. Results that support an adverse association are shaded. This represents one or more of the following: p < 0.05, β ≥ 0.5, OR ≥ 0.5, or exposure-response trend across categories of exposure. NR = not reported, GM = geometric mean.
p < 0.05.
Upon request, author provided re-calculated results with 1n-transformed exposure and 13 representing a ln-unit increase, to improve comparability with other studies.