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Supplemental Material Exposure to Bisphenol A and Phthalates during Pregnancy and Ultrasound Measures of Fetal Growth in the INMA-Sabadell Cohort Maribel Casas, Damaskini Valvi, Ana Ballesteros-Gomez, Mireia Gascon, Mariana F. Fernández, Raquel Garcia-Esteban, Carmen Iñiguez, David Martínez, Mario Murcia, Nuria Monfort, Noelia Luque, Soledad Rubio, Rosa Ventura, Jordi Sunyer, and Martine Vrijheid
Table of Contents Figure S1. Flowchart of the study population Figure S2. Fetal growth curves for femur length, head circumference, abdominal circumference, and estimated fetal weight in the INMA-Sabadell cohort Table S1. Variables included in each fetal growth model in the INMA-Sabadell cohort Table S2. Characteristics of the study population and average BPA and phthalate metabolites levels (µg/g creatinine) by categories of the different characteristics Table S3. Correlation matrix of the average BPA and phthalate metabolites levels Table S4. Sensitivity analyses I: adjusted associations between maternal urinary BPA, MBzP, MnBP, and MiBP levels (µg/g creatinine) and fetal size and growth and birth outcomes adjusting for creatinine and excluding extreme creatinine values Table S5. Sensitivity analysis II: adjusted associations between maternal urinary BPA, MBzP, MnBP, and MiBP levels (µg/g creatinine) and fetal size and growth and birth outcomes in single- and multi-pollutant models
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Table S6. Adjusted associations between maternal urinary ∑DEHPm and its single metabolites (MEHP, MEHHP, MEOHP, MECPP) levels (µg/g creatinine) and fetal size and growth in the overall population Table S7. Adjusted associations between maternal urinary DEHPm and LMWPm levels (µg/g creatinine) and birth outcomes in the overall population, in girls, and in boys Table S8. Adjusted associations between maternal urinary MBzP, ∑LMWPm and its single metabolites (MEP, MiBP, MnBP) levels (µg/g creatinine) and fetal size and growth in the overall population
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Figure S1. Flowchart of the study population Supplemental Material, Figure S1. Flowchart of the study population Bisphenol A n=485 Phthalates n=397
Both trimesters (included in the analysis): Bisphenol A n=479 Phthalates n=391
Pregnant women at 12 weeks of pregnancy n=657
Pregnant women at 20 weeks of pregnancy
Bisphenol A n=492 Phthalates n=405
FETAL GROWTH PARAMETERS *at least 1 measurement: n=611 Femur length n=611 Head circumference n=608 Abdominal circumference n=611 Biparietal diameter n=610 Estimated fetal weight n=608
Pregnant women at 34 weeks of pregnancy n=628
Newborns at delivery n=622
FINAL DATASET: 488 mother-child pairs: Bisphenol A + Fetal growth parameters or Birth outcomes Phthalates + Fetal growth parameters or Birth outcomes
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3
BIRTH OUTCOMES *at least 1 measurement: n=618 Weight n=603 Length n=590 Head circumference n=591 Placental weight n=547 Gestational length n=612
n=470 n=390
Figure S2. Fetal growth curves for femur length, head circumference, abdominal circumference, and estimated fetal weight in the INMA-Sabadell cohort. *Each curve represents the growth of a specific ultrasound parameter for a standard child. To construct these curves, continuous variables were included as continuous. In case maternal origin was included in the model, Spanish origin was chosen; in case of parity, nulliparous was chosen. Curves show the growth for a standard boy and a standard girl in case sex was included in the model (see Supplementary Material, Table S1).
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Table S1. Variables included in each fetal growth model in the INMA-Sabadell cohort Femur length Biparietal diameter Head circumference Abdominal circumference Estimated fetal weight λ
0.80
0.78
0.76
0.59
0.06
P(T) order
3
3
3
3
3
Maternal age
x
x
x
x
Maternal height
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Paternal height Maternal weight/BMI Paternal weight/BMI
x
x
Parity Maternal country of origen
x x
Child sex Variance structure
x x
21
M ,T
x M
30
parity
Correlation structure was an exponential variogram in all cases and random effects were never incorporated.
5
M
30
a
Table S2. Characteristics of the study population and average BPA and phthalate metabolites levels (µg/g creatinine) by categories of the different characteristics N with BPA data (%) (n=470)
BPA GM (SD)
N with phthalate data (%) (n=390)
Child characteristics Sex Girls
227 (48.2)
2.6 (2.0)
186 (47.7)
Boys
243 (51.8)
2.6 (2.0)
204 (52.3)
Birth season Winter
128 (27.2)
2.6* (2.1)
103 (26.4)
Spring
123 (26.1)
2.2 (1.8)
100 (25.6)
Summer
117 (24.8)
3.2 (2.1)
105 (26.9)
Autumn
103 (21.9)
2.6 (1.9)
82 (21.0)
Maternal characteristics Age (years)
