Supplemental Material for:

Personal care product use and urinary phthalate metabolite and paraben concentrations during

pregnancy among women from a fertility clinic

Authors: Joe M. Braun, Allan C. Just, Paige Williams, Kristen Smith, Antonia M. Calafat, and Russ Hauser

Supplemental Table 1: Univariate statistics of specific gravity standardized urinary phthalate metabolite and paraben concentrations (mg/L or mmol/L) among pregnant women with a live birth from the EARTH Study

Supplemental Table 2: Adjusted geometric mean specific gravity standardized urinary phthalate metabolite and paraben concentrations according to personal care product use in the last 24 hours among pregnant women with a live birth from the EARTH Study

Supplemental Table 3: Adjusted percent change in specific gravity standardized urinary phthalate metabolite and paraben concentrations according to the number of personal care product use in the last 24 hours among pregnant women with a live birth from the EARTH Study

Supplemental Figure 1: Box and whisker plot of specific gravity adjusted urinary phthalate metabolite and paraben concentrations (mmol/L) during pregnancy among women with a live birth from the EARTH Study

Supplemental Figure 2: Box and whisker plot of estrogenic activity weighted urinary phthalate metabolite and paraben concentrations (mmol/L) during pregnancy among women with a live birth from the EARTH Study

Supplemental Figure 3: Adjusted geometric mean specific gravity standardized urinary phthalate metabolite or paraben concentrations according to timing of personal care product use among pregnant women with a live birth from the EARTH Study


Supplemental Table 1: Univariate statistics of specific gravity standardized urinary phthalate metabolite and paraben concentrations (mg/L or mmol/L) among pregnant women with a live birth from the EARTH Study1,2,3

Pre-Pregnancy
Metabolite/Time of Collection / N / % Detect / Median
(25th, 75th percentile) / Min, Max
Monobutyl phthalate(mg/L)
1st Trimester / 155 / 97 / 14.7 (8.7, 25.7) / (0.6, 2,342)
2nd Trimester / 138 / 99 / 15.6 (9.7, 25.8) / (0.8, 1,820)
3rd Trimester / 98 / 97 / 15.5 (8.0, 29.9) / (0.4, 2,385)
Monoethyl phthalate(mg/L)
1st Trimester / 155 / 100 / 39.5 (16.5, 119) / (3.6, 2,755)
2nd Trimester / 138 / 100 / 48.2 (19.4, 125) / (4.3, 5,133)
3rd Trimester / 98 / 100 / 55.1 (17.9, 161) / (5.3, 6,930)
Butyl paraben(mg/L)
1st Trimester / 148 / 72 / 1.1 (0.3, 5.1) / (0.1, 145)
2nd Trimester / 133 / 72 / 0.9 (0.4, 8.2) / (0.1, 171)
3rd Trimester / 97 / 74 / 0.8 (0.4, 7.3) / (0.1, 99.1)
Methyl paraben(mg/L)
1st Trimester / 148 / 100 / 146 (52.5, 538) / (1.7, 4,885)
2nd Trimester / 133 / 100 / 141 (61.5, 347) / (0.9, 1,987)
3rd Trimester / 97 / 99 / 164 (74.8, 322) / (2.1, 2,023)
Propyl paraben(mg/L)
1st Trimester / 148 / 99 / 39.9 (8.2, 149) / (0.1, 855)
2nd Trimester / 133 / 96 / 37.2 (8.3, 120) / (0.1, 698)
3rd Trimester / 97 / 99 / 31.8 (6.8, 71.9) / (0.4, 879)
Molar Sum (mmol/L)1
1st Trimester / 155 / NA / 1.8 (0.6, 6.0) / (0.0, 36.3)
2nd Trimester / 138 / NA / 1.6 (0.8, 3.9) / (0.2, 30.0)
3rd Trimester / 98 / NA / 1.9 (0.9, 4.3) / (0.2, 37.4)
Total Estrogenicity (mmol/L)4
1st Trimester / 155 / NA / 9.7x10-6 (2.4x10-6, 32x10-6) / (<1.0x10-6, 167x10-6)
2nd Trimester / 138 / NA / 11x10-6 (2.5x10-6, 28x10-6) / (<1.0x10-6, 182x10-6)
3rd Trimester / 98 / NA / 8.0x10-6 (2.4x10-6, 24x10-6) / (<1.0x10-6, 170x10-6)

1-The molar sum was computed by dividing each compound by its molecular weight and then summing for all the compounds.

2-Limits of detection were 0.5, <0.99, 0.2, 1.1, and 0.2 mg/L for monobutyl phthalate (MBP), monoethyl phthalate (MEP), butyl paraben (BP), methyl paraben (MP), and propyl paraben (PP), respectively.

3-NA: Not applicable

4-The estrogenicity equivalence factor is computed by weighting MBP, MEP, BP), MP, and PP concentrations according to their potency relative to 17b-estradiol. MBP, MEP, BP, MP, and PP were assumed to be 10,000,000; 2,000,000; 10,000; 2,500,000; and 30,000 times, less potent than 17b-estradiol, respectively. The weighted sum was computed by converting specific-gravity standardized concentrations to mmol/L, weighting, and then summing.

Supplemental Table 2: Adjusted geometric mean specific gravity standardized urinary phthalate metabolite and paraben concentrations according to personal care product use in the last 24 hours among pregnant women with a live birth from the EARTH Study1,2

Phthalate metabolites / Parabens
Predictor / N (%) / GM MBP
(95% CI) / GM MEP
(95% CI) / N (%) / GM BP
(95% CI) / GM MP
(95% CI) / GM PP
(95% CI)
Liquid Soap
No / 27 (15) / 13.2 (10.2, 17.1) / 62.0 (43.9, 87.7) / 26 (15) / 1.6 (1.0, 2.6) / 168 (117, 243) / 36.1 (22.8, 57.4)
Yes / 150 (85) / 15.9 (13.9, 18.2) / 56.4 (46.9, 67.7) / 144 (85) / 1.5 (1.2, 2.0) / 137 (115, 164) / 24.3 (19.3, 30.6)
Deodorant
No / 28 (16) / 13.9 (10.1, 19.2) / 51.2 (33.3, 78.8) / 26 (15) / 1.3 (0.7, 2.3) / 127 (81, 200) / 19.3 (10.9, 34.3)
Yes / 149 (84) / 15.7 (13.7, 17.9) / 58.2 (48.4, 70.0) / 144 (85) / 1.6 (1.2, 2.0) / 144 (120, 172) / 27.1 (21.5, 34.1)
Shampoo
No / 43 (24) / 15.2 (12.2, 18.8) / 73.3 (55.1, 97.5) / 41 (24) / 1.8 (1.2, 2.7) / 160 (118, 217) / 26.4 (18.0, 38.9)
Yes / 134 (76) / 15.5 (13.4, 17.8) / 52.2 (43.1, 63.1) / 129 (76) / 1.4 (1.1, 1.9) / 135 (112, 163) / 25.7 (20.1, 32.8)
Lotion
No / 50 (28) / 12.8 (10.4, 15.8) / 42.6 (32.2, 56.4) / 48 (28) / 0.9 (0.6, 1.3) / 74 (56, 98) / 11.2 (7.8, 16.0)
Yes / 127 (72) / 16.5 (14.3, 19.0) / 63.9 (52.7, 77.5) / 122 (72) / 1.9 (1.4, 2.5) / 181 (151, 217) / 35.9 (28.4, 45.2)
Cosmetics
No / 57 (32) / 13.9 (11.3, 17.2) / 43.0 (32.3, 57.2) / 55 (32) / 1.0 (0.7, 1.5) / 100 (75, 134) / 16.0 (11.1, 23.2)
Yes / 120 (68) / 16.2 (13.9, 18.8) / 65.6 (53.5, 80.5) / 115 (68) / 1.9 (1.4, 2.5) / 167 (136, 205) / 32.8 (25.3, 42.5)
Bar Soap
No / 59 (33) / 15.1 (12.4, 18.4) / 53.7 (41.1, 70.2) / 58 (34) / 1.6 (1.1, 2.2) / 129 (98, 170) / 20.5 (14.5, 29.1)
Yes / 118 (67) / 15.5 (13.4, 18.0) / 58.9 (48.2, 72.0) / 112 (66) / 1.5 (1.2, 2.0) / 148 (121, 180) / 29.0 (22.5, 37.5)
Conditioner
No / 66 (37) / 14.4 (11.9, 17.3) / 69.7 (54.4, 89.2) / 63 (37) / 1.7 (1.2, 2.4) / 157 (121, 203) / 30.1 (21.6, 41.8)
Yes / 111 (63) / 16.1 (13.8, 18.7) / 50.7 (41.3, 62.2) / 107 (63) / 1.4 (1.1, 1.9) / 133 (108, 163) / 23.7 (18.2, 30.8)
Hair Gel
No / 103 (58) / 14.9 (12.8, 17.4) / 51.8 (41.9, 64.0) / 97 (57) / 1.2 (0.9, 1.5) / 124 (101, 153) / 23.6 (18.0, 30.9)
Yes / 74 (42) / 16.3 (13.4, 19.8) / 67.5 (51.9, 87.8) / 73 (43) / 2.5 (1.7, 3.5) / 175 (134, 229) / 30.3 (21.6, 42.5)
Perfume
No / 122 (69) / 14.6 (12.6, 16.9) / 41.5 (34.3, 50.3) / 116 (68) / 1.6 (1.2, 2.1) / 125 (103, 153) / 22.8 (17.7, 29.4)
Yes / 55 (31) / 17.2 (14.1, 21.1) / 111.0 (85.5, 144) / 54 (32) / 1.4 (1.0, 2.1) / 182 (138, 240) / 33.8 (23.8, 48.1)
Hair Products
No / 142 (80) / 15.8 (13.8, 18.2) / 57.0 (47.2, 68.7) / 137 (81) / 1.5 (1.1, 1.9) / 143 (119, 171) / 26.4 (20.9, 33.3)
Yes / 35 (20) / 13.8 (10.7, 17.8) / 58.3 (41.5, 81.7) / 33 (19) / 1.9 (1.2, 3.1) / 137 (96, 196) / 24.5 (15.6, 38.4)
Shave Cream
No / 151 (85) / 15.3 (13.4, 17.4) / 56.5 (47.1, 67.7) / 144 (85) / 1.5 (1.2, 1.9) / 146 (122, 174) / 25.5 (20.3, 32.1)
Yes / 26 (15) / 16.3 (12.1, 22.2) / 62.4 (41.6, 93.8) / 26 (15) / 1.8 (1.0, 3.0) / 117 (77, 179) / 28.5 (16.7, 48.7)
Sun Lotion
No / 153 (86) / 15.7 (13.7, 17.9) / 56.2 (46.7, 67.6) / 146 (86) / 1.6 (1.2, 2.0) / 133 (111, 159) / 24.5 (19.4, 30.9)
Yes / 24 (14) / 14.1 (10.8, 18.5) / 63.6 (44.2, 91.5) / 24 (14) / 1.4 (0.8, 2.2) / 197 (135, 288) / 35.0 (21.6, 56.5)
Nail Polish
No / 170 (96) / 15.1 (13.3, 17.1) / 55.5 (46.6, 66.1) / 163 (96) / 1.5 (1.2, 2.0) / 141 (119, 167) / 25.6 (20.6, 31.9)
Yes / 7 (4) / 28.4 (17.2, 46.9) / 140.0 (72.2, 271.5) / 7 (4) / 1.4 (0.6, 3.3) / 149 (71, 310) / 36.3 (14.5, 91.1)

1-Separate models for each predictor and outcome. Model adjusted for maternal race (white vs. non-white), education (graduate school vs. no graduate school), age (years), body mass index (continuous, time-varying), weeks gestation (time varying), and number of other personal care products used (continuous, time-varying).

2-GM: Geometric Mean, MBP: monobutyl phthalate, MEP: monoethyl phthalate, BP: butyl paraben, MP: methyl paraben, and PP: propyl paraben.

Supplemental Table 3: Adjusted percent change in specific gravity standardized urinary phthalate metabolite and paraben concentrations according to the number of personal care product use in the last 24 hours among pregnant women with a live birth from the EARTH Study 1,2

Phthalates / Parabens / Molar Sum3
Personal Care Product Use / N (%) / % Change MBP
(95% CI) / % Change MEP
(95% CI) / N (%) / % Change BP(95% CI) / % Change MP
(95% CI) / % Change PP
(95% CI) / % Change Molar Sum
(95% CI)
Low (0-5) / 53 (30) / Ref / Ref / 50 (29) / Ref / Ref / Ref / Ref
Medium (6-7) / 72 (41) / 17 (-8, 48) / 47 (7, 101) / 70 (41) / 42 (-7, 116) / 63 (15, 130) / 115 (39, 233) / 56 (17, 109)
High (8-11) / 52 (29) / 61 (22, 111) / 134 (62, 238) / 50 (29) / 114 (30, 251) / 133 (58, 245) / 219 (94, 423) / 120 (58, 208)
Continuous (per product) / 177 / 10 (5, 16) / 19 (11, 28) / 170 / 18 (7, 30) / 20 (12, 30) / 30 (18, 43) / 19 (12, 27)

1-Separate models for each predictor and outcome. Model adjusted for maternal race (white vs. non-white), education (graduate school vs. no graduate school), age (years), body mass index (continuous, time-varying), and weeks gestation (time varying).

2-MBP: monobutyl phthalate, MEP: monoethyl phthalate, BP: butyl paraben, MP: methyl paraben, PP: propyl paraben.

3-Sample size for molar sum is the same as the phthalate sample sizes.

Supplemental Figure 1: Box and whisker plot of specific gravity adjusted urinary phthalate metabolite and paraben concentrations (mmol/L) during pregnancy among women with a live birth from the EARTH Study1,2

1-MBP: monobutyl phthalate, MEP: monoethyl phthalate, BP: butyl paraben MP: methyl paraben, PP: propyl paraben.

2-The molar sum was computed by dividing each compound by its molar mass and then summing.

Supplemental Figure 2: Box and whisker plot of estrogenic activity weighted urinary phthalate metabolite and paraben concentrations (mmol/L) during pregnancy among women with a live birth from the EARTH Study1,2

1- MBP: monobutyl phthalate, MEP: monoethyl phthalate,BP: butyl paraben MP: methyl paraben, PP: propyl paraben. Specific gravity adjusted.

2-The estrogenicity equivalence factor (Sum) is computed by weighting MBP, MEP, BP, MP, and PP according to their potency relative to 17b-estradiol. MBP, MEP, MP, PP, and BP were assumed to be 10,000,000; 2,000,000; 10,000; 2,500,000; and 30,000 times, respectively, less potent than 17b-estradiol. The weighted sum was computed by converting specific-gravity standardized concentrations to mmol/L, weighting, and then summing.

Supplemental Figure 3: Adjusted geometric mean specific gravity standardized urinary phthalate metabolite or paraben concentrations according to timing of personal care product use among pregnant women with a live birth from the EARTH Study 1,2

1-Separate models for each predictor and outcome. Models adjusted for maternal race (white vs. non-white), education (graduate school vs. no graduate school), age (years), body mass index (continuous, time-varying), weeks gestation (time varying), and number of other personal care products used (continuous, time-varying).

2-The molar sum concentration of specific gravity adjusted monobutyl phthalate (MBP), monoethyl phthalate (MEP), butyl paraben (BP), methyl paraben (MP), and propyl paraben (PP) concentrations were summed and the log10-transformed sums were used as the outcome in a linear mixed model