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Table 2 Studies of maternal prenatal urinary phthalate metabolites and fetal growth outcomes measured in utero

From: Fetal growth in environmental epidemiology: mechanisms, limitations, and a review of associations with biomarkers of non-persistent chemical exposures during pregnancy

Reference Country, years N Urinary phthalate metabolites Timing of urine collection in utero outcome(s) Timing of outcome assessment Notes1 All2 Girls2 Boys2
Zhao et al. 2014 [97] China 2012-2013 126 MBP, MMP ∑DEHP: MEHP, MEHHP, MEOHP 3rd trimester IUGR 3rd trimester   + IUGR (MEHHP)   
Zhao et al. 2015 [126] China 2011-2013 119 MBP, MMP ∑DEHP: MEHP, MEHHP, MEOHP 3rd trimester Growth restricted (IUGR or low birth weight) not specified   + Growth restricted (MEHP, MEHHP, MEOHP, ∑DEHP)   
<37 weeks only NS   
≥37 weeks only + Growth restricted (MEHHP, MEOHP, ∑DEHP)   
Botton et al. 2016 [99] France 2003-2006 520 ∑LMW: MEP, MBP, MiBP ∑HMW: MBzP, MCOP, MCPP, MCNP, MECPP, MEHHP, MEOHP, MEHP ∑DEHP: MECPP, MEHHP, MEOHP, MEHP 26 weeks EFW AC BPD HC FL 12 weeks     ̵ BPD (MBzP, ∑HMW, MECPP, MEHHP, MEOHP, ∑DEHP)
overall pregnancy     - EFW (∑HMW, MECPP, MEHHP) - BPD (MBzP, ∑HMW, MECPP, MEOHP, ∑DEHP) + FL (MCNP)
Casas et al. 2016 [100] Spain 2004-2006 390 MBzP ∑LMW: MEP, MiBP, MnBP; ∑DEHP: MEHP, MEHHP, MEOHP, MECPP 12, 32 weeks** EFW AC BPD HC FL 12 weeks not adjusted for GA NS NS NS
20 weeks - HC (MnBP) NS NS
34 weeks + FL (MBzP) + FL (MBzP) NS
growth rate 12-20 weeks - EFW (MnBP) - HC (MnBP) - HC (MnBP) - HC (MnBP)
growth rate 20-34 weeks + FL (MBzP) + FL (MBzP) + EFW (MnBP) + AC (MnBP)
Ferguson et al. 2016 [101, 102] USA 2006-2008 482 MEP, MBP, MiBP, MBzP, MCPP ∑DEHP: MECPP, MEHHP, MEOHP, MEHP 10, 18, 26, 35 weeks** EFW AC HC FL 26, 35, 38 weeks   - EFW (MEOHP, MECPP, ∑DEHP) - AC (MECPP, ∑DEHP) - HC (MECPP, MBzP) - FL (MECPP, ∑DEHP) - EFW (MECPP, ∑DEHP) - HC (MEP) - AC (∑DEHP) - FL (MEHHP, MEOHP, ∑DEHP)
  1. 1Unless otherwise specified, studies included term, preterm, parous, and nulliparous births, and models of birth outcomes adjusted for or standardized to gestational age.
  2. 2Blank cells indicate associations were not examined; NS indicates that associations within that category were examined but not statistically significant at p<0.05.
  3. *Average of two or more urine samples.
  4. Abbreviations. AC, abdominal circumference; BPD, biparietal diameter; EFW, estimated fetal weight; FL, femur length; GA, gestational age; HC, head circumference; IUGR, intrauterine growth restriction, defined as estimated fetal weight below the 10th centile for gestational age; MBP, monobutyl phthalate; MBzP, monobenzyl phthalate; MCOP, monocarboxy-isooctyl phthalate; MCNP, monocarboxy-isononyl phthalate; MCPP, mono-3-carboxypropyl phthalate; MEP, monoethyl phthalate; MECPP, mono-2-ethyl-5-carboxypentyl phthalate; MEHHP, mono-2-ethyl-5-hydroxyhexyl phthalate; MEHP, mono-2-ethylhexyl phthalate; MEOHP, mono-2-ethyl-5-oxohexylphthalate; MiBP, monoisobutyl phthalate; MMP, monomethyl phthalate; MnBP, mono-n-butyl phthalate; ∑DEHP, molar sum of the di-2-ethylhexyl phthalate metabolites that follow; ∑HMW, molar sum of the high molecular weight phthalate metabolites that follow; ∑LMW, molar sum of the low molecular weight phthalate metabolites that follow.