Table 2.
Epidemiology studies of neurodevelopmental effects of phthalates.
| Study description | Outcomes | Includes metabolites of: | Study evaluation | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reference(S) | Population | Exposure | Cognition | Motor | Behavior | Infant | Social | DEHP | DINP | DBP | DIBP | BBP | DEP | Exposure | Outcome | Selection | Confound | Analysis | Overall |
| Braun et at (2014); Yolton et al. (2011); Li et al. (2019) | Birth cohort (N=389) in U.S. | Two urine samples during gest (16 & 26 wk); additional yearly | C | I | C I | ✓ | ✓ | ✓ | ✓ | ✓ | G/A | G | A | G | G | High | |||
| Doherty et al. (2017); Mikodovnik et al. (2011); Engel et al. (2010); Engel et al. (2009) | Birth cohort (N=404) in U.S. | Single urine sample (25–40 wk gest) | C | M | B | I | S | ✓ | ✓ | ✓ | ✓ | ✓ | A/D | A | A | A | A | Medium | |
| Engel et al. (2018) | Nested case-control (N=802) in birth cohort in Norway | Single urine sample (17 wk gest) | B | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | A/D | A | A | G | G | Medium | ||||
| Factor-Litvak et al. (2014); Whyatt et al. (2012); Balalian et al. (2019) | Birth cohort (N=328) in U.S. | Single urine sample (33 wk gest) | C | M | B | ✓ | ✓ | ✓ | ✓ | ✓ | A/D | A | A | G | G | Medium | |||
| Gascon et al. (2015) | Birth cohort (N=657) in Spain | Two urine samples (12 & 32 wk gest) | C | M | B | ✓ | ✓ | ✓ | ✓ | ✓ | G/A | G | G | G | G | High | |||
| Huang et at (2015); Lien et al. (2015) | Birth cohort (N=430) in Taiwan | Single urine sample (28–36 wk gest) | C | B | ✓ | ✓ | ✓ | ✓ | A/D | A | D | A | G | Medium | |||||
| Kim et al. (2011) | Birth cohort (N=417) in Korea | Single urine sample (35–41 wk gest) | C | M | ✓ | ✓ | A/D | A | A | G | G | Medium | |||||||
| Kim et al. (2017) | Birth cohort (N=175) in Korea | Single urine sample (14–27 wk gest) | C | ✓ | ✓ | A/D | A | D | A | A | Medium | ||||||||
| Kim et al. (2018) | Birth cohort (N=86) in Korea | Single urine sample (at delivery) | C | M | B | S | ✓ | ✓ | ✓ | ✓ | D | D | D | A | A | Low | |||
| Kobrosly et at (2014) | Birth cohort (N=153) in U.S. | Single urine sample (10–39 wk gest) | B | ✓ | ✓ | ✓ | ✓ | ✓ | A/D | A | A | G | G | Medium | |||||
| Messerlian et al. (2017) | Preconception cohort (N=166) in U.S. | Multiple urine samples preconception | B | ✓ | ✓ | ✓ | ✓ | ✓ | G | A | A | G | G | High | |||||
| Nakiwala et al. (2018); Philippat et al. (2017) | Birth cohort (N=452 boys) in France | Single urine sample (22–29 wk gest) | C | B | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | A/D | G | G | G | G | Medium | |||
| Polanska et at (2014) | Birth cohort (N=165) in Poland | Single urine sample (30–34 wk gest) | C | M | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | A/D | A | A | A | A | Medium | |||
| Shin et al. (2018) | Birth cohort (N=201) in U.S. | Multiple samples per trimester | S | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | G | G | A | G | G | High | ||||
| Stroustrup et al. (2018) | NICU cohort (N=64) in U.S. | Weekly urine samples in NICU | I | ✓ | A | G | G | D | A | Low | |||||||||
| Téllez-Rojo et al. (2013) | Birth cohort (N=135) in Mexico | Single urine sample (3rd trim) | C | M | ✓ | ✓ | ✓ | ✓ | ✓ | A/D | A | A | A | G | Medium | ||||
| Verstraete et al. (2016) | NICU Cohort (N=549) in Mexico | Multiple plasma samples in NICU | M | ✓ | D | A | D | D | A | Low | |||||||||
| Total included studies per outcome or phthalate: | 11 | 8 | 9 | 3 | 3 | 17 | 4 | 15 | 12 | 12 | 13 | ||||||||
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Excluded
Exposure measured concurrent with outcome - Arbuckle et al. (2016a), Arbuckle et al. (2016b), Cho et al. (2010), Chopra et al. (2014), Hu et al. (2017), Kardas et al. (2015), Kim et al. (2009), Kondolot et al. (2016), Oztop et al. (2018), Park et al. (2014), Park et al. (2015), Testa et al. (2012), Shoaff et al. (2018), Won et al. (2016);
Exposure measurement in blood - Kardas et al. (2015), Minatoya et al. (2016), Minatoya et al. (2018);
Exposure measurement based on type of flooring in home - Larsson et al. (2009);
Exposure measurement based on household dust, which likely does not represent total exposure - Philippat et al. (2015).
C=cognition; M=motor; B=behavior; 1=infant behavior; S=social behavior; G=good; A=adequate; D=deficient; G/A=good for short chain phthalates, adequate for long chain phthalates; A/D=adequate for short chain phthalates, deficient for long chain phthalates; wk gest=weeks gestation.
Sample sizes listed may not be accurate for all publications or results reported (the correct sample sizes for individual results are reflected in summary results tables). Studies may have examined additional outcomes not listed in this table (see supplemental file for full list).
C = cognition; M = motor; B = behavior; I = infant behavior; S = social behavior; G = good; A = adequate; D = deficient; G/A = good for short chain phthalates, adequate for long chain phthalates; A/D = adequate for short chain phthalates, deficient for long chain phthalates; wk gest = weeks gestation.
Sample sizes listed may not be accurate for all publications or results reported (the correct sample sizes for individual results are reflected in summary results tables). Studies may have examined additional outcomes not listed in this table (see supplemental file for full list). (See above-mentioned references for further information.)