Table 3.

Associations between DEHP exposure and pubertal development.

Reference; Study confidence; N	Outcome	Effect estimatea	Mean exposure (IQR) (ng/mL)	Pubertal development timing effect estimate
∑DEHP
Childhood Exposure
Wolff et al. (2017) and Wolff et al. (2014); Medium; 1,141	Age at menarche (n=1,051) Age at 1st breast stage 2 Age at 1st pubic hair stage 2	HR (95% CI)	Median 142 μg/g creatinine	1.00 (0.94, 1.06) 1.01 (0.94, 1.09) 0.92 (0.85, 0.99)*
Mouritsen et al. (2013) ; Low; 84	Age at breast stage 2+ Age at pubic hair stage 2+	Medians in high vs. low exposure	115 (14–4,627)	“no significant difference”
Prenatal Exposure
Watkins et al. (2014) ; Medium; 120	Menarche Breast stage 2+ Pubic hair stage 2+	OR (95% CI)	0.24 μmol/L	1.89 (0.57,6.22) 0.66 (0.26,1.69) 2.15 (0.62,7.48)
Hart et al. (2013); Low; 121 Su et al. (2014); Low; 69	Age at menarche Tanner stage > 1	Correlation coefficient OR (95% CI)	4.3 (2.7–7.1) 47 mg/g creatinine	−0.17, p = 0.07 Stage 2: 1.00 (1.00, 1.00) Stage 3: 1.00 (0.99, 1.01)

^aOR and hazard ratio (HR) < 1 indicate later pubertal development. Bolding of the effect estimate indicates evidence that suggests later onset of puberty, while grey shading indicates evidence that suggests earlier onset of puberty. NR = not reported; Q = quartile, y/n = yes/no

^*p < 0.05.