Table 3.
Sex-specific difference between phthalates exposure and child cognition.
| Phthalates/ Phthalate Metabolites |
References/Study Confidence | Outcomes/Years | Child Cognitive Development Effects β (95%CI), OR (95%CI) |
p interaction | |
|---|---|---|---|---|---|
| Females | Males | ||||
| Σ4DEHP | |||||
| Gascon a et al. (2015); high | Cognition (1 year) | β: 0.2 (−3.4, 3.7) | β: 0.3 (−3.1, 3.7) | ||
| Cognition (4 years) | β: 1.3 (−1.7, 4.3) | β: 2.8 (−0.6, 6.2) | |||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) | β: −4.23 (−8.13, −0.32) | β:−1.61 (−5.05, 1.82) | 0.59 | |
| Hyland et al. (2019); high | FSIQ—Full-Scale IQ (7, 10.5 years) | β: 1.6 (0.0, 3.3) | β: −1.7 (−3.8, 0.3) | 0.01 | |
| Doherty et al. (2017); medium | Mental Development Index (2 years) | β: 1.77 (−0.13, 3.67) | β: 0.10 (−1.48, 1.68) | 0.2 | |
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: −0.89 (−5.13, 3.35) | β: −1.45 (−4.73, 1.83) | 0.84 | |
| Olesen * et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.82 (0.61, 1.11) | OR: 1.33 (1.01, 1.75) | ||
| Language complexity scores (20–36 months) | OR: 0.88 (0.65, 1.18) | OR: 1.43 (1.03, 1.97) | |||
| MEHP | |||||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) |
β: −3.05 (−6.75, 0.66) | β: 0.35 (−3.05, 3.75) | 0.42 | |
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: −1.54 (−3.61, 0.53) | β: −0.44 (−2.65, 1.77) | 0.48 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.88 (0.71,1.09) | OR: 1.02 (0.85, 1.23) | ||
| Language complexity scores (20–36 months) |
OR: 1.08 (0.86,1.35) | OR: 1.14 (0.92, 1.42) | |||
| MEHHP | |||||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) | β: −2.92 (−6.81, 0.10) | β: −4.25 (−7.67, −0.82) | 0.57 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.87 (0.67, 1.13) | OR: 1.32 (1.03, 1.70) | ||
| Language omplexity scores (20–36 months) | OR: 0.86 (0.66, 1.11) | OR: 1.38 (1.04, 1.83) | |||
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: −0.73 (−4.89, 3.42) | β: −1.27 (−4.54, 2.01) | 0.85 | |
| MEOHP | |||||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) | β: −3.09 (−6.85, 0.68) | β: −2.27 (−5.79, 1.25) | 0.82 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.81 (0.63, 1.05) | OR: 1.35 (1.04, 1.73) | ||
| Language complexity scores (20–36 months) | OR: 0.89 (0.68, 1.16) | OR: 1.41 (1.06, 1.87) | |||
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: 0.07 (−4.22, 4.35) | β: −2.25 (−5.46, 0.95) | 0.42 | |
| MECPP | |||||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) | β: −2.65 (−6.36, 1.06) | β: −0.09 (−3.58, 3.40) | 0.12 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.83 (0.62, 1.11) | OR: 1.37 (1.02, 1.85) | ||
| Language complexity scores (20–36 months) | OR: 0.90 (0.67, 1.21) | OR: 1.48 (1.04, 2.09) | |||
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: −0.53 (−4.72, 3.66) | β: −2.59 (−5.95, 0.77) | 0.47 | |
| MBzP | |||||
| Gascon a et al. (2015); high | Cognition (1 year) | β: 1.0 (−1.9, 4.0) | β: 0.4 (−2.1, 2.8) | ||
| Cognition (4 years) | β: −0.5 (−3.1, 2.1) | β: 1.1 (−1.3, 3.5) | |||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) |
β:−3.98 (−7.71, −0.25) | β: 2.39 (−1.26, 6.04) | 0.01 | |
| Doherty et al. (2017); medium | Mental Development Index (2 years) | β: −0.58 (−2.25, 1.09) | β: 1.83 (0.07, 3.58) | 0.05 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.93 (0.74, 1.18) | OR: 1.08 (0.89,1.32) | ||
| Language complexity scores (20–36 months) |
OR: 0.96 (0.76, 1.21) | OR: 1.28 (1.02, 1.59) | |||
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: 1.17 (−0.46, 2.80) | β: −1.23 (−3.12, 0.66) | 0.06 | |
| ΣDBP | |||||
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: −0.32 (−3.16, 2.52) | β: −0.16 (−3.22, 2.91) | 0.94 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.81 (0.61, 1.08) | OR: 1.01 (0.77, 1.32) | ||
| Language complexity scores (20–36 months) |
OR: 0.97 (0.74, 1.27) | OR: 1.12 (0.81, 1.54) | |||
| MnBP | |||||
| Gascon a et al. (2015); high | Cognition (1 year) | β: 1.4 (−1.5, 4.2) | β: 1.5 (−1.6, 4.6) | ||
| Cognition (4 years) | β: 0.4 (−2.0, 2.8) | β: 1.7 (−1.4, 4.7) | |||
| Braun et al. (2017); high | Visual-spatial abilities (8 years) | β: −1.7 (−2.8, −0.5) | β: −3.0 (−5.6, −0,4) | ||
| Doherty et al. (2017); medium | Mental Development Index (2 years) | β: −2.78 (−5.03, −0.54) | β: 1.71 (0.08, 3.34) | 0.002 | |
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) | β: −2.40 (−6.13, 1.32) | β: 3.32 (−043, 7.08) | 0.01 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.81 (0.63,1.05 | OR: 1.11 (0.86, 1.42) | ||
| Language complexity scores (20–36 months) | OR: 0.89 (0.69, 1.16) | OR: 1.31 (0.97, 1.77) | |||
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: −0.33 (−2.91, 2.25) | β: −0.28 (−2.92, 2.35) | 0.98 | |
| MiBP | |||||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) | β: −3.12 (−6.66, 0.42) | β: −1.16 (−4.71, 2.39) | 0.35 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.86 (0.65, 1.13) | OR: 0.99 (0.76, 1.30) | ||
| Language complexity scores (20–36 months) |
OR: 1.01 (0.77, 1.32) | OR: 1.03 (0.77, 1.39) | |||
| Doherty et al. (2017); medium | Mental Development Index (2 years) | β: −2.28 (−4.33, −0.22) | β: 1.55 (−0.39, 3.48) | 0.01 | |
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: 0.31 (−1.63, 2.25) | β: 0.63 (−1.48, 2.73) | 0.83 | |
| Gascon a et al. (2015); high | Cognition (1 year) | β: 1.4 (−1.5, 4.2) | β: 0.4 (−2.4, 3.2) | ||
| Cognition (4 years) | β: −0.4 (−3.1, 2.4) | β: −0.4 (−3.1, 2.4) | |||
| MEP | |||||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) | β: −4.39 (−8.29, −0.49) | β:−0.69 (−3.94, 2.56) | 0.55 | |
| Doherty et al. (2017); medium | Mental Development Index (2 years) | β: −0.11 (−1.71, 1.49) | β: 0.97 (−0.46, 2.41) | 0.3 | |
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 1.08 (0.92, 1.27) | OR: 1.24 (1.05, 1.46) | ||
| Language complexity scores (20–36 months) |
OR: 1.10 (0.94, 1.30) | OR: 1.16 (0.97, 1.39) | |||
| Qian et al. (2019); medium | Mental Development Index (2 years) | β: 1.72 (−1.04, 4.49) | β: 1.03 (−1.60, 3.67) | 0.73 | |
| Gascon a et al. (2015); high | Cognition (1 year) | β: −0.8 (−3.0, 1.4) | β: −0.7 (−2.9, 1.4) | ||
| Cognition (4 years) | β: −0.2 (−2.2, 1.8) | β: 2.1 (−0.01, 4.2) | |||
| MCPP | |||||
| Ipapo et al. (2017); medium | Visual recognition memory (27 weeks) | β: −2.32 (−6.12, 1.48) | β: 2.58 (−0.69, 5.84) | 0.08 | |
| Doherty et al. (2017); medium | Mental Development Index (2 years) | β: -2.39 (-4.72, -0.05) | β: 2.03 (−0.02, 4.08) | 0.007 | |
| ΣDiNPm | |||||
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.98 (0.78, 1.23) | OR: 1.18 (0.95, 1.48) | ||
| Language complexity scores (20–36 months) |
OR: 0.88 (0.67, 1.15) | OR: 0.97, 0.76, 1.23) | |||
| MHiNP | |||||
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.96 (0.79, 1.15) | OR: 1.16 (0.96, 1.41) | ||
| Language complexity scores (20–36 months) |
OR: 0.93 (0.76, 1.14) | OR: 0.97 (0.80, 1.18) | |||
| MOiNP | |||||
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 1.00 (0.83, 1.20) | OR: 1.19 (0.99, 1.43) | ||
| Language complexity scores (20–36 months) |
OR: 0.90 (0.74, 1.11) | OR: 1.03 (0.85, 1.24) | |||
| MCiOP | |||||
| Olesen et al. (2018); medium | Vocabulary scores (20–36 months) | OR: 0.98 (0.78, 1.23) | OR: 1.17 (0.95, 1.45) | ||
| Language complexity scores (20–36 months) |
OR: 0.88 (0.66, 1.16) | OR: 0.96 (0.76, 1.21) | |||
a The data contained in the article Radke et al. (2020) were used. The Σ4DEHP metabolites include MEHHP, MEHP, MEOHP, MECP; * ΣDEHPm molar sum of DEHP metabolites expressed as excreted DEHP ng/mL); ΣDBP: sum of molar concentrations nmol/L) of MnBP and MiBP; ΣDiNPm: molar sum of DiNP metabolites expressed as excreted DiNP ng/mL); β: beta coefficients (95% confidence intervals), OR: odds ratio (95% confidence intervals). pinteraction: p-value for interaction between phthalates concentrations.