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Reprod Toxicol. 2019 May 2. pii: S0890-6238(18)30434-9. doi: 10.1016/j.reprotox.2019.04.004. [Epub ahead of print]

Heightened Susceptibility: A Review of How Pregnancy and Chemical Exposures Influence Maternal Health.

Author information

1
University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA. Electronic address: julia.varshavsky@ucsf.edu.
2
University of California, Berkeley, School of Public Health, Berkeley, CA, USA.
3
University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA; University of California, San Francisco, Bakar Computational Health Sciences Institute, San Francisco, CA, USA.
4
University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA.

Abstract

Pregnancy is a unique period when biological changes can increase sensitivity to chemical exposures. Pregnant women are exposed to multiple environmental chemicals via air, food, water and consumer products, including flame retardants, plasticizers, and pesticides. Lead exposure increases risk of pregnancy-induced hypertensive disorders, although women's health risks are poorly characterized for most chemicals. Research on prenatal exposures has focused on fetal outcomes and less on maternal outcomes. We reviewed epidemiologic literature on chemical exposures during pregnancy and three maternal outcomes: preeclampsia, gestational diabetes, and breast cancer. We found that pregnancy can heighten susceptibility to environmental chemicals and women's health risks, although variations in study design and exposure assessment limited study comparability. Future research should include pregnancy as a critical period for women's health. Incorporating biomarkers of exposure and effect, deliberate timing and method of measurement, and consistent adjustment of potential confounders would strengthen research on the exposome and women's health.

KEYWORDS:

Endocrine disruption; blood pressure; chemical breast cancer; environmental chemicals; gestational diabetes; gestational hypertension; impaired glucose tolerance; maternal outcomes; placenta; preeclampsia; pregnancy complications; pregnancy-induced hypertensive disorders; women’s health

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