Phthalate

New ECHO Research Investigates Relationship Between Phthalate Exposure and High Blood Pressure, Related Complications During Pregnancy

Posted on by Jodi Snare

Collaborative ECHO research led by John Meeker, ScD of the University of Michigan, and Jordan Kuiper, PhD of George Washington University, investigates the relationship between phthalate exposure and high blood pressure during pregnancy. This research, titled “Urinary concentrations of phthalate metabolites in relation to preeclampsia and other hypertensive disorders of pregnancy in the Environmental influences on Child Health Outcomes (ECHO) program,” is published in Environment International.

This study aimed to evaluate whether phthalate exposures could be linked to ongoing high blood pressure during pregnancy and more severe pregnancy complications like preeclampsia or eclampsia.

“The findings of this study suggest that exposure to certain phthalates found in plastics and other consumer products may be associated with pregnancy complications such as gestational hypertension or preeclampsia,” said Meeker.

Researchers evaluated data from 3,430 participants from eight ECHO sites across the U.S., which enrolled pregnant participants from 1999 to 2019. In the study, researchers measured the levels of 13 metabolites linked to phthalate exposure in urine samples collected at least once during pregnancy. They then evaluated the association between individual phthalates, as well as the combined mixture of phthalates, with the risk of developing preeclampsia, eclampsia, or ongoing high blood pressure during pregnancy.

The researchers measured phthalate exposure by checking urine levels of certain small molecules, called metabolites, that the body makes when it breaks down chemicals. They found that higher levels of these metabolites were linked to a higher risk of pregnancy complications like preeclampsia, eclampsia, and ongoing high blood pressure. For example, if the level of a metabolite called mono (3-carboxypropyl) phthalate (MCPP) doubled, the risk of developing preeclampsia or eclampsia increased by 12%. MCPP is related to phthalates found in PVC plastics and insect repellents.

The researchers also examined combined phthalate exposure by dividing participants into four groups based on their exposure levels. Each increase in exposure level was linked to a 27% higher risk of preeclampsia or eclampsia, which was generally higher for pregnant women carrying female fetuses.

Future studies can help researchers understand how exposure to phthalates might be linked to high blood pressure during pregnancy, how this happens in the body, and what we can do to reduce the risk of these pregnancy complications.

Read the research summary.

ECHO Study Investigates Relationship Between Phthalate Exposure and High Blood Pressure, Related Complications During Pregnancy

<< Back to Research Summaries

ECHO Study Investigates Relationship Between Phthalate Exposure and High Blood Pressure, Related Complications During Pregnancy

Authors: John Meeker, Jordan Kuiper, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

High blood pressure during pregnancy, which can develop into the more serious conditions of preeclampsia* or eclampsia*, can pose significant health risks to pregnant women and their children. Potential environmental risk factors for ongoing high blood pressure during pregnancy and more severe pregnancy complications like preeclampsia or eclampsia have not been well-studied. Phthalates are chemicals used in various products, including plastics, personal care products, and food packaging. There is evidence, though limited, that exposure to some phthalates may be associated with preeclampsia and ongoing high blood pressure during pregnancy.

*Preeclampsia and eclampsia are pregnancy-related high blood pressure disorders. In preeclampsia, the mother’s high blood pressure reduces the blood supply to the fetus, which may get less oxygen and fewer nutrients. Eclampsia is when pregnant women with preeclampsia develop seizures or coma.

Link to source

 

What were the study results?

The researchers evaluated phthalate exposure by measuring urine levels of certain metabolites, which are small molecules the body makes when it breaks down foods, drugs, chemicals, or its own tissues (for example, fat or muscle tissue). This study found that higher levels of these metabolites were associated with a higher risk of developing preeclampsia, eclampsia, and/or ongoing high blood pressure during pregnancy. For example, a doubling of mono (3-carboxypropyl) phthalate (MCPP)—a metabolite linked to phthalates found in PVC-based plastics and insect repellents—was associated with 12% increased risk of developing preeclampsia or eclampsia.

For combined exposures, researchers divided participants into four groups, or quartiles, by increasing level of exposure. A quartile increase in the combined phthalate mixture was associated with a 27% increased risk of preeclampsia or eclampsia. This effect was generally larger among pregnant participants carrying female fetuses.

 

What was this study's impact?

The findings of this study suggest that exposure to certain phthalates found in plastics and other consumer products may be associated with pregnancy complications like gestational hypertension or preeclampsia.

 

Who was involved?

The study included data from 3,430 participants from eight ECHO sites across the U.S. which enrolled pregnant participants from 1999 to 2019.

 

What happened during the study?

The researchers measured the levels of 13 metabolites linked to phthalate exposure in urine samples collected at least once during pregnancy. They then evaluated the association between individual phthalates, as well as the combined mixture of phthalates, with the risk of developing preeclampsia, eclampsia, or ongoing high blood pressure during pregnancy.

Note: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

Additional well-designed studies are needed to better understand the association between phthalate exposure and high blood pressure during pregnancy, the underlying biological mechanisms, and effective interventions that could reduce the risk of these kinds of pregnancy complications.

 

Where can I learn more?

Access the full journal article, titled “Urinary concentrations of phthalate metabolites in relation to preeclampsia and other hypertensive disorders of pregnancy in the Environmental influences on Child Health Outcomes (ECHO) program,” in Environment International.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published May, 2024

 

Access the associated article.

Download this summary

ECHO Study Investigates Relationship Between Phthalate Exposure and High Blood Pressure, Related Complications During Pregnancy

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Study Finds Link Between Phthalate Exposure During Pregnancy and Development of Multiple Health Outcomes in Children

Authors: Drew Day, Kaja Z. LeWinn, et al.

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New ECHO Research Reveals Link Between Phthalate Exposure During Pregnancy and Multiple Health Outcomes in Children

Posted on by Jodi Snare

Drew Day, PhD

Collaborative ECHO research led by Drew Day, PhD of Seattle Children’s Research Institute uses machine learning statistical algorithms to explore patterns of health outcomes in children. The researchers also investigated how exposures during pregnancy to phthalates—chemicals widely used in plastics that have previously been linked with preterm birth—can influence the development of multiple health conditions during childhood. This research, titled “Subpopulations of children with multiple chronic health outcomes in relation to chemical exposures in the ECHO-PATHWAYS consortium,” is published in Environment International.

Chronic health conditions, such as asthma and obesity, can develop together during childhood but are usually studied separately. The goal of this study was to use data from ECHO Cohort research sites across six U.S. cities to characterize “clusters,” or patterns, of obesity-related, lung health, and brain development outcomes in children and to investigate how these patterns relate to mothers’ exposures to phthalates during pregnancy.

ECHO researchers looked at 15 health outcomes in 1,092 children between the ages of 4 and 9 across six U.S. cities and collected measurements of phthalate exposure during pregnancy from 856 of these children’s mothers. Outcomes collected during this study included body mass index (BMI), IQ, anxiety, depression, irritability, learning disabilities, speech problems, asthma, wheeze, and nasal allergies. The researchers evaluated how children developed multiple outcomes and investigated how the probability of being in a particular group was affected by exposure to 15 plastic-associated phthalate chemicals during pregnancy. The researchers measured phthalate exposure during pregnancy using urine samples collected from 2007–2014 from mothers during late pregnancy.

The researchers identified three groups of children with a pattern of health outcomes that occurred together:

  1. A group of relatively healthy children;
  2. A group of children with lower IQs, elevated obesity, and slightly elevated asthma-related outcomes such as asthma, wheezing, and allergies; and
  3. Another group of children with high asthma-related outcomes along with elevated obesity and some increase in anxiety- and depression-related outcomes.

Compared to children in the healthy group, other groups had more male children, mothers with higher BMI and lower education attainment, and lower household incomes. The researchers found that children—particularly boys—were more likely to be in the third group if their mothers were exposed to phthalates during pregnancy.

These findings suggest that exposure to phthalates during pregnancy might be associated with an increased risk of developing not only asthma and related lung outcomes, but also obesity and mental health issues such as anxiety and depression. This study also suggests that low-income households are at higher risk for worse childhood health outcomes.

“The three patterns of health outcomes seen in this study reveal more about how pediatric diseases might arise together,” said Dr. Day. “The insights from this study could help inform future research on what biological processes contribute to these health outcome patterns as well as better treatments and interventions to enhance child health.”

This study’s multi-outcome approach can be used in future studies to identify public health risks that may affect central biological processes that result in multiple negative health outcomes. ECHO Cohort researchers are working to extend this method to include several additional U.S. research sites, which will allow them to evaluate whether similar patterns are observed in a larger dataset. Larger studies will also help researchers characterize how demographic differences like income and sex may influence the development of multiple health outcomes during childhood.

Read the research summary.

Study Finds Link Between Phthalate Exposure During Pregnancy and Development of Multiple Health Outcomes in Children

<< Back to Research Summaries

Study Finds Link Between Phthalate Exposure During Pregnancy and Development of Multiple Health Outcomes in Children

Authors: Drew Day, Kaja Z. LeWinn, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Chronic health conditions, such as asthma and obesity, can develop together during childhood but are usually studied separately. ECHO researchers used new machine learning tools to explore patterns of health outcomes in children and then looked at how common exposures are associated with multiple health conditions.

The goal of this study was to use data from ECHO Cohort research sites across six U.S. cities to characterize “clusters,” or patterns of obesity-related, lung health, and brain development outcomes in children and to investigate how these patterns relate to mothers’ exposures to chemicals called phthalates during pregnancy. Phthalates are chemicals widely used in plastics, and maternal exposure to certain phthalates have been linked to preterm birth.

 

What were the study results?

The researchers identified three groups of children with a pattern of health outcomes that occurred together:

  1. A group of relatively healthy children;
  2. A group of children with lower IQ, elevated obesity,
    and slightly elevated asthma-related outcomes such as asthma, wheezing, and allergies; and
  3. Another group of children with high asthma-related outcomes along with elevated obesity and some increase in anxiety- and depression-related outcomes.

Compared to children in the healthy group, other groups had more male children, mothers with higher BMI and lower education attainment, and lower household incomes. The researchers found that children—particularly boys—were more likely to be in the third group if their mothers were exposed to phthalates during pregnancy.

 

What was this study's impact?

These findings suggest that exposure to phthalates during pregnancy might be associated with an increased risk of developing not only asthma and related lung outcomes, but also obesity and mental health issues such as anxiety and depression. This study also suggests that low-income households are at higher risk for worse childhood health outcomes.

The three patterns of health outcomes seen in this study also reveal more about how pediatric diseases might arise together, which could help inform future research on what biological processes contribute to those health outcome patterns as well as better treatments and interventions to enhance child health.

 

Who was involved?

Researchers looked at health outcomes in 1,092 children across six U.S. cities. Researchers were able to collect measurements of phthalate exposure during pregnancy from 856 of these children’s mothers.

 

What happened during the study?

The researchers measured 15 health outcomes in children between the ages of 4 and 9 years—including body mass index (BMI), IQ, anxiety, depression, irritability, learning disabilities, speech problems, asthma, wheeze, and nasal allergies. The researchers evaluated how children developed multiple outcomes and investigated how the probability of being in a particular group was affected by exposure to 15 plastic-associated phthalate chemicals during pregnancy. The researchers measured phthalate exposure during pregnancy using urine samples collected from 2007–2014 from mothers during late pregnancy.

Note: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

This study’s multi-outcome approach can be used in future studies to identify public health risks that may affect central biological processes that result in multiple negative health outcomes. ECHO Cohort researchers are working to extend this method to include several additional U.S. research sites, which will allow them to evaluate whether similar patterns are observed in a larger dataset. Larger studies will also help researchers characterize how demographic differences like income and sex may influence the development of multiple health outcomes during childhood.

 

Where can I learn more?

Find the full research article, titled “Subpopulations of children with multiple chronic health outcomes in relation to chemical exposures in the ECHO-PATHWAYS consortium,” in the journal Environment International.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published March, 2024

 

Access the associated article.

Download this summary

Study Finds Link Between Phthalate Exposure During Pregnancy and Development of Multiple Health Outcomes in Children

Read More Research Summaries about Exposures and Pregnancy

ECHO Study Finds Flame-Retardant Chemicals May Increase Risk Of Preterm Birth and Higher Birth Weight

Authors: Deborah Bennett, Jiwon Oh, et al.

Does prenatal PFAS exposure affect a child’s risk for developing autism-related traits?

Authors: Jennifer Ames, Ghassan Hamra, et al.

Exposures to environmental chemicals and their effect on important molecules during pregnancy

Author(s): Brett T. Doherty, Megan E. Romano, et al.

Do chemicals that break down slowly in the environment affect how long it takes to become pregnant?  

Author(s): Linda Kahn, Alison Hipwell, Kim Harley, Pam Factor-Litvak, Michele Klein-Fedyshin, Christine Porucznik, Eva Siegel, Yeyi Zhu

A review of studies that look at whether exposure to common non-persistent chemicals in consumer products delays the time it takes to become pregnant

Author(s): Alison E. Hipwell, Linda G. Kahn, Pam Factor-Litvak, et al

ECHO Researchers Find Link Between Phthalate Exposure and Preterm Birth, Estimate Potential Costs

Posted on by Jodi Snare

 

Collaborative ECHO research led by Leonardo Trasande, MD, MPP of NYU Langone Health investigates the potential connections between phthalates, their metabolites in the urine of pregnant individuals, and birth outcomes. This research, titled “Prenatal phthalate exposure and adverse birth outcomes in the USA: a prospective analysis of births and estimates of attributable burden and costs,” is published in The Lancet Planetary Health.

Phthalates are widely used chemicals found in some consumer products, and previous research has linked phthalate exposure to preterm birth. In response, the use of di-2-ethylhexyl phthalate (DEHP), a common type of phthalate, has decreased in recent years. However, there is limited research on the effects of the replacement phthalates, and the costs associated with phthalate exposure remain unquantified.

The study included 5,006 mother-child pairs from 13 ECHO Cohort Study Sites across the U.S.  Researchers analyzed levels of 20 phthalate metabolites in urine samples collected at three different points during each participant’s pregnancy. Then, the team looked for associations between these metabolite levels and preterm birth. The team also investigated the differences between specific types of phthalates, comparing di-2-ethylhexyl phthalate (DEHP), a common type of phthalate, with several newer alternatives developed to replace it.

When the researchers grouped mothers based on the amount of DEHP metabolites (substances produced when the body breaks down DEHP) found in their urine, they found that the 10% with the highest levels had a 50% higher chance of giving birth before the 37th week of pregnancy compared to the 10% with the lowest levels.

Some common alternatives to DEHP were associated with an even higher risk of preterm birth. Women exposed to the highest amounts of these alternative chemicals—phthalic acid, di-isodecyl phthalate (DIDP), di-n-octyl phthalate (DnOP), and diisononyl phthalate (DiNP)—had twice the risk of preterm birth compared to those with little to no exposure to these alternatives. The team also calculated the costs associated with phthalate exposure.

“The number of premature births in the U.S. that could be linked to phthalate exposure in 2018 was between 24,000 and 120,000, potentially costing between $1.6 billion and $8.1 billion in medical expenses over the lifetime of the children,” Dr. Trasande said.

Future research could look at how exposure to replacement phthalates affects child development after birth. The European Union has prohibited the use of certain phthalates in some consumer products—as have California and a few other U.S. states.

Read the research summary here.