Table 3.
Associations between DEHP metabolites and cognition.
| Reference; study confidence; N | Age at outcome measure | Median exposurea,b | Exposure IQR(or as specified) | Cognition overall effect estimate β (95% CI) | Cognition in boys β (95% CI) | Cognition in girls β (95% CI) |
|---|---|---|---|---|---|---|
| Included in meta-analysis (age ≤4 yrs, cognition measured using Bayley, medium or high confidence) | ||||||
| Polanska et al. (2014); medium; 150 | 2 yr | 0.02 nmol/mL | 0.3 (95th) | −0.8 (−2.2, 0.6) | NR | NR |
| Kim et al. (2011); medium; 460 | 6 mo | 8 ng/mL (MEOHP) | 3.8–17.1 | −1.0 (−1.9, −0.1)* | −1.6 (−2.9,−0.3)* | −0.5 (−1.9,0.9) |
| Doherty et al. (2017); medium; 258 | 1–3 yr | 0.3 nmol/mL | 3.2 (95th) | 0.6 (−0.,1.9) | 0.1 (−1.5,1.7) | 1.8 (−0.1,3.7) |
| Gascon et al. (2015); high; 367 | 1 yr | 100 μg/g | 68–146 | 0.6 (−1.8,3.1)c | 0.3 (−3.1,3.7)c | 0.2 (−3.4,3.7)c |
| 4 yr | 2.0 (−0.2,4.2) | 2.8 (−0.6,6.2) | 1.3 (−1.7,4.3) | |||
| Tellez-Rojo et al. (2013); medium; 135 | 2–3 yr | 0.4 nmol/mL (GM) | NR | −0.5 (−2.3, 1.3) | 1.5 (−0.8,3.7) | −3.4 (−5.3,−1.6)* |
| Whyatt et al. (2012); medium; 319 | 3 yr | 19 ng/mL (MEOHP GM) | 0.7–1,320 (range) | 0.4 (−0.9, 1.6) | 1.0 (−1.1,3.1) | −0.2 (−1.9,1.5) |
| Huang et al. (2015); medium; 251 | 2–3 yr | 59 μg/g (GM) | NR | 1.3 (−1.3,3.8) | NR | NR |
| Not included in meta-analysis | ||||||
| Kim et al. (2017); medium; 175 | 6 yr | 13 μg/g (MEOHP mean) | NR | 3.0 (−2.8,8.7) | NR | NR |
| Huang et al. (2015); medium; 251 | 2, 5, 8, and 11 yr | 59 μg/g (GM) | NR | −0.1 (−2.2, 2.0) | NR | NR |
| Naldwala et al. (2018); medium; 452 | 5 yr | 23 ng/mL (MEOHP) | 5.8–87 (5th-95th) | NR | −0.04 (−0.1, 0.06) | NR |
|
Factor-Litvak et al. (2014) (same study as Whyatt et al., 2012) |
7 yr | MEHHP | 0.2 (−1.2, 1.5) | 0.3 (−1.9,2.4) | 0.3 (−.14,2.0) | |
| Li et al. (2019); high; 253 | 5, 8 yr | 26 wk gest 87 ng/mL | 27–156 | 0.3 (−1.5,2.1) | NR | NR |
| 3 yr 94 ng/mL | 45–213 | −1.9 (−3.7,−0.2)* | NR | NR | ||
Maternal exposure measured during gestation unless otherwise noted.
Results are for summed DEHP metabolites unless specified. All studies used ln-transformed exposure and βs represent 1 ln-unit increase, except for Gascon, which used log2-transformation and β represent doubling of exposure.
Upon request, author provided re-calculated results with 1n-transformed exposure and β representing a ln-unit increase, to improve comparability with other studies
One low confidence study (Kim et al., 2018) not shown in table because results were incompletely reported.
Results that support an adverse association are shaded. This represents one or more of the following: p < 0.05, β ≥ 0.5, or exposure-response trend across categories of exposure. GM = geometric mean.
p < 0.05.