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Table 1 Characteristics of the included studies

From: Association of maternal exposure to endocrine disruptor chemicals with cardio-metabolic risk factors in children during childhood: a systematic review and meta-analysis of cohort studies

Author, Year

Country

Total/ subclasses of EDCs

Mother age, yrs

(mean ± SD)

Pre-preg BMI

(kg/m2)

Sample size (F/M)

Outcome

Sample

Adjustments/match

Total quality score

Montazeri, 2022

Spain

BPA, Phthalate, phenols

31.9 ± 4.1

23.8 ± 4.5

150/155

BP

Spot urine

For child age and height at visit, child sex, mother’s age at delivery, pre-pregnancy BMI, gestational weight gain, social class, parental cardiovascular history, smoking during pregnancy and gestational age

7

Zuo, 2022

USA

BPA

48 ± 17.75

NM

4065/3831

BMI

Spot urine

Age, urinary creatinine, marital status, total energy intake, race/ethnicity, education, ratio of family income to poverty, smoking, drinking, and exercise

9

Yang, 2021

China

Pesticide

28.2 ± 3.2

NM

495/544

BMI

Cord

Infant gender, maternal age, maternal education, pre-pregnancy BMI, pregnancy weight gain, maternal height, parity, passive smoking, and duration of breastfeeding

7

Serum

Güil-Oumrait, 2021

Spain

POPs

29.84 ± 4.48

NM

187/192

WC

Cord serum

Maternal characteristics (i.e. parity history, pre-pregnancy BMI, education, socioeconomic status, smoking, and age at pregnancy), and child’s follow up visit. Body fat % model was additionally adjusted by sex

7

BMI

BP

Berger, 2021

USA

MBzP, MEP, MBP, MiBP MCPP, MCOP, MCNP, DEHP

26.7 ± 5.3

NM

Total: 309

BMI

Urine

Age at delivery, maternal education, years lived in the U.S. at delivery, poverty status during pregnancy (at or below vs. above poverty threshold), and the childhood frequency of fast-food intake at age five (< 1 time per week, 1–2 times per week, and 3 + times per week)

7

Kupsco, 2020

USA

Phthalates

27.9 ± 5.7

26.4 ± 4.1

235/228

TG

Serum

Phthalate metabolite concentrations are vary throughout pregnancy, and from day to day and throughout a 24-h period

5

TC

HDL.C

Jensen, 2020

Denmark

BPA, POPs, PFOS, PFHxS, PFOA, PFDA, PFNA

30.2 ± 4.5

NM

275/318

WC

Serum

Maternal age, parity, pre-pregnancy BMI, educational level, smoking, sex, and adiposity marker at birth

6

BMI

TG

TC

LDL-C

HDL-C

Warner, 2020

Italy

Dioxins

27.8 ± 4.8

NM

222/204

TG

Serum

Age at interview, sex, primary wage earner education, and maternal age at pregnanc

7

TC

LDL-C

HDL-C

FBS

Sol, 2020

Netherland

Phthalate

30.9 ± 4.6

22.7 (18.5–34.9)

526/538

BP

Urine

Child’s age and standardized height and maternal age, education, parity, ethnicity, pre-pregnancy body mass index, alcohol consumption and smoking habits (specifically in early, mid and late pregnancy)

6

Ouyang, 2020

China

BPA

30.6 ± 3.5

21.7 ± 3.3

105/113

BP, FBS

Urine

(1) Child age; (2) birthweight for gestational age (LGA and non-LGA); (3) child urinary BPA (low, medium and high level in tertiles) and weight-for-length z-score; (4) maternal passive smoking (yes or no), child passive smoking (yes or no), and infant 0–6 months breastfeeding type (formula, exclusive breastfeeding, and mixed feeding)

9

Lee, 2019

Korea

DEHP, MnBP, MEHHP, MEOHP

NM

NM

226/255

BMI

Urine

Age, body mass index, household income level, and maternal education level

8

Manzano-Salgado, 2017

Spain

PFHxS, PFOA, PFNA, PFOS,

31.5 ± 5.5

NM

600/630

WC

Plasma

Maternal region of residence, country of birth, parity, pre-pregnancy BMI, previous breastfeeding, and by the age at follow-up and sex of the child

8

BMI

TG

TC

LDL-C

HDL-C

Bae, 2017

Korea

BPA

31.2 ± 3.6

NM

227/259

BP

Urine

Adjusted for age, sex, height, weight, birth weight, gestational age at birth, maternal age at enrollment, parental history of hypertension, father’s education, environmental tobacco smoke, duration of vigorous physical activity per week, and current infection

6

Vuong, 2016

USA

PBDEs

29.3 ± 2.7

25.7 ± 4.3

200/118

WC

Serum

Maternal age, race, education, income, maternal smoking status, maternal depression, fresh fruit and vegetable intake during pregnancy. Additionally adjusted by maternal height

7

BMI

Maresca, 2016

USA

Phthalate, MCPP, MiBP, MBP, MBzP

28.5 ± 3.4

NM

181/156

WC

Urine

Age (in months) at time of measurement, maternal pre-pregnancy obesity, birth weight, maternal race/ethnicity, receipt of public assistance during pregnancy, and urinary specific gravity. Metabolite concentrations

8

BMI

Were ln-transformed for analyses

Vafeiadi, 2016

Spain

BPA

29.4 ± 5.1

24.4 ± 4.9

219/275

WC

Urine, Serum

Maternal educational level, maternal age, pre-pregnancy BMI, working status during pregnancy, child sex, Z-score of birth weight for gestational age and breastfeeding status

6

BMI

TG

TC

HDL-C

BP

Buckley, 2016

USA

MEP, MnBP, MiBP, MCPP, MBzP, DEHP

NM

NM

129/126

BMI

Urine

Adjusted for cohort, maternal race/ethnicity, maternal age at delivery, maternal education, maternal work status during pregnancy, maternal pre- pregnancy BMI, maternal height, gestational weight gain, maternal smoking during pregnancy, natural log creatinine, calendar date of urine collection, parity, child’s sex, breastfeeding, and months of age at follow-up

9

Braun, 2016

Canada

PFOA, PFNA, PFHxS, PFOS

29 ± 5.9

NM

110/175

WC

Serum

Maternal age, race, education, income, parity, employment, marital status, depressive symptoms, BMI at 16 weeks gestation, fruit/vegetable consumption, fish consumption, prenatal vitamin use, and maternal serum cotinine concentrations. The waist circumference model is also adjusted for child age in months

6

BMI

Vafeiadi, 2015

Greece

PCBs, DDE, HCB

29.9 ± 5

24.4 ± 4.7

331/358

BMI

Serum

Maternal variables: triglycerides and cholesterol, age, BMI before pregnancy, parity, educational level, smoking during pregnancy

7

WC

Variables of the child: weight at birth, sex, lactation, gestational age and exact age at the time of measurement

BP

Kim, 2015

Korea

diethylhexyl phthalate

33.5 ± 4.5

NM

65/63

TG

Urine, umbilical cord blood samples

NM

6

TC

Erkin-Cakma, 2015

Canada

PBDEs

27.5 ± 5

NM

125/99

WC

Serum

Maternal age, education, pre-pregnancy BMI, years lived in the United States, gestational weight gain, poverty during pregnancy; and child gestational age, duration of breastfeeding, and fast food and soda consumption at age 7

7

BMI

Valvi, 2015

Spain

HMWPm, LMWPm

39.7 ± 1.4

NM

186/205

WC

Urine

adjusted for child sex, exact age at examination, and maternal characteristics (country of origin, age at delivery, parity, education, social class, pre-pregnancy BMI, and smoking in pregnancy

7

BMI

BP

Agay-Shay, 2014

Spain

HCB, MEP, MnBP, MiBP, MBzP, MEcPP, MEHHP, DDE, BPA

NM

NM

total: 470

BMI

Urine

child’s sex (male, female), gestational age (continuous in weeks), birth weight (continuous, in grams), exact age at the time that the outcome was measured (continuous, in months), and maternal country of origin (Spain, non-Spain), maternal age at delivery (continuous, in years), maternal pre-pregnancy BMI (continuous, in kilograms per meter squared), maternal weight gain during pregnancy (low, recommended, or high)

9

Tang-Peronard, 2014

USA

PCBs, DDE

27.1 ± 4.7

23.9 ± 3.9

271/290

WC

Serum

NM

8

BMI

Warner, 2014

USA

o,p-DDT, p,p-DDT, p,p-DDE

26.1 ± 5

NM

118/143

WC

Serum

Maternal pre-pregnancy BMI, birth weight, and child television time

8

BMI

Harlely, 2013

USA

BPA

26 ± 4.5

NM

167/123

WC

Urine

Maternal pre-pregnancy BMI, household income, maternal education level, maternal years of residence in the United States, smoking during pregnancy, soda consumption during pregnancy, and child’s fast food and sweet consumption at age 9 year

8

BMI

Andersen, 2013

Denmark

PFOS, PFOA

30.6 ± 6.2

22.9 ± 4.7

387/400

WC

Serum

Including child’s age, maternal age, parity, pre-pregnancy BMI, smoking, socioeconomic status, and gestational age at blood drawing

9

BMI

Cupul-Uicab, 2013

USA

HCH, p,p-DDT, HCB, PCBs, p,p-DDE

NM

NM

641/1042

BMI

Serum

(1)Total cholesterol, triglycerides, study center, mother’s race, socioeconomic index, education, smoking during pregnancy, prepregnancy BMI, and child’s sex and birth order. (2) child’s exact age at anthropometric measurements

6

Delvaux, 2013

Belgium

PCBs, HCB

30 ± 5.5

NM

57/57

WC

Serum

Total cholesterol, triglycerides, study center, mother’s race, socioeconomic index, education, and smoking during pregnancy, pre-pregnancy BMI, and child’s sex and birth order. Additionally adjusted for child’s exact age at anthropometric measurements

7

BMI

Smink, 2008

Spain

HCB, total PCBs

NM

NM

482

BMI

Serum

(1) Age and sex, (2) maternal age, height, pre-pregnancy over-weight or obesity, education, parity and child’s sex and current age. (3) 2 + birthweight

7

  1. BPA bisphenol-A, POPs Persistent organic pollutants, MBzP monobenzyl phthalate, MEP monoethyl phthalate, MBP mono-n-butyl phthalate, MiBP mono-isobutyl phthalate, MCPP mono-(3-carboxypropyl) phthalate, MCOP Mono-carboxy-isooctyl phthalate, MCNP mono-carboxyisononyl phthalate, DEHP three di-(2-ethylhexyl) phthalate, PFOS perfluorooctanesulfonic acid, PFHxS perfluorohexanesulfonic acid, PFOA perfluorooctanoic acid, PFDA perfluorodecanoic acid, PFNA perfluorononanoic acid, MnBP mono-n-butyl phthalate, MEHHP mono(2-ethyl-5-hydroxyhexyl)-phthalate, MEOHP Mono(2-ethyl-5-oxohexyl)-phthalate, PBDEs polybrominated diphenyl ethers, PCBs polychlorinated biphenyls, DDE Dichloro-2,2-bis (p, p’-chlorophenyl) ethylene, HCB hexachlorobenzene, HMWPm high molecular weight phtalate, LMWPm low molecular weight phtalate, MEP monoethyl phthalate, MECPP mono-(2-ethyl-5-carboxypentyl) phthalate, DDT 1,1,1-trichloro-2,2-bis (p-chlorophenyl)-ethane, HCH hexachlorocyclohexane, BMI body mass index, WC waist circumference, BP blood pressure, TG triglyceride, TC total cholesterol, FBS fasting blood sugar, HDL-C high density lipoprotein-cholesterol, LDL-C low density lipoprotein-cholesterol