Table 12.
Reference | Study description | Includes metabolites of: | Study evaluation | |||||||||||||
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Population | Exposure | Outcome | DEH-P | DIN-P | DB-P | DIB-P | BB-P | DE-P | Exposur | Outcome | Selection | Confounding | Analysis | Overall confidence | ||
Included | Casas et al. (2016) a | Pregnancy cohort in Spain (N = 390) | Two urine samples at ~12 and 32 wk gestation | GD calculated from ultrasound and last menstrual period | ✓ | ✓ | ✓ | ✓ | ✓ | G | G | G | G | G | High | |
Ferguson et al. (2014a); Ferguson et al. (2014b); Chen et al. (2015); | Nested c as e-control within pregnancy cohort in U.S. (N= 130 cases preterm birth, 352 controls) | Up to four urine samples menstrual period | GD calculated from ultrasound and last | ✓ | ✓ | ✓ | ✓ | ✓ | G | G | A | A | G | High | ||
Gao et al. (2016) a | Pregnancy cohort in China (N= 3,103) | Single urine sample in 1st trimester | GD calculated using last menstrual period or ultrasound | ✓ | ✓ | ✓ | ✓ | A/P | A | A | A | A | Medium | |||
Meeker et al. (2009) | Nested c as e-control in pregna cohort in Mexico (N = 30 cases and 30 controls) | Single urine sample in 3rd trimester | GD calculated from last menstrual period (recall) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | A/P | A | A | A | A | Medium | |
Polanska et al. (2016) | Pregnancy cohort in Poland (N= 165) | Single urine sample in 3rd trimester | GD estimated using last menstrual period or ultrasound | ✓ | ✓ | ✓ | ✓ | ✓ b | ✓ | A/P | A | A | G | D | Medium | |
Shoaff et al. (2016) | Pregnancy cohort in U.S. (N = 368) | Two urine samples at ~16 and 26 wk gestation | GD calculated from last menstrual period or other method | ✓ | ✓ | ✓ | ✓ | ✓ | G | A | A | G | A | High | ||
Smarr et al. (2015) a | Preconception cohort in U.S. (n= 233) | Single urine sample at baseline of trying to conceive | GD calculated from conception identified pro spectively | ✓ | ✓ b | ✓ | ✓ | ✓ | ✓ | D | G | A | A | A | Medium | |
Watkins et al. (2016) | Pregnancy cohort in U.S. (N = 68) | Two urine samples in 1st trimester and at delivery | GD calculated using last menstrual period or ultrasound | ✓ | ✓ | ✓ c | ✓ | ✓ | G | A | A | A | D | Medium | ||
Total Studies per Phthalate | 6 | 2 | 6 | 5 | 6 | 6 |
Excluded studies: Exposure based on tissues other than urine: Brucker-Davis et al. (2010), Huang et al. (2009), Huang et al. (2014), Huang et al. (2014), Latini et al. (2003), Li et al. (2016). Exposure based on occupational exposure with unvalidated matrix: Burdorf et al. (2011). Study entry late in pregnancy (most or all enrollment in 3rd trimester): Adibì et al. (2009), Su et al. (2014), Suzuki et al. (2010), Weinberger et al. (2014), Whyatt et al. (2009), Wolff et al. (2008).
G = good; A = adequate; D = deficient; A/D = adequate for short chain phthalates, deficient for long chain phthalates; GD = gestational duration.
Additional analyses pertaining to preterm birth obtained from the study authors.
Considered critically deficient for this phthalate due to > 50% less than the LOD.
Results presented for summed DBP (MBP and MIBP), and included in analysis under DBP due to higher exposure levels.