SAN FRANCISCO – Pregnant women, more than anyone, face a challenge that Rachel Carson described in her 1962 book "Silent Spring": "What we have to face is not an occasional dose of poison which has accidentally got into some article of food, but a persistent and continuous poisoning of the whole human environment."
Modern science suggests that this is truer than ever, and that the danger especially applies to fetuses, Dr. Marya G. Zlatnik said.
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Pregnant women should take extra steps to avoid exposing their unborn babies to pesticides and other unwanted chemicals, says Dr. Marya G. Zlatnik.
One study reported that 43 of 163 (26%) unwanted chemicals could be detected in 99% of pregnant women in the United States, even though some chemicals had been banned for years (Environ. Health Perspect. 2011;119:878-85).
What’s a woman – and her physician – to do? Physicians can recommend 10 relatively simple steps that their pregnant patients can take today to protect themselves and their babies, she said at a meeting on antepartum and intrapartum management sponsored by the University of California, San Francisco.
• Buy organic. It’s not cheap, but buying organic foods such as fruit and produce make a big difference in reducing exposure to pesticides, said Dr. Zlatnik, a high-risk ob.gyn. and perinatologist at the university. One study of 23 schoolchildren substituted organic food for their conventional diets and found a dramatic drop in organophosphorus pesticide levels in their urine while eating organically, but not before or after (Environ. Health Perspect. 2006;114:260-3).
• Don’t microwave plastic. Taking that plastic tub of leftovers directly from the refrigerator to the microwave oven may be convenient, but it can contaminate your food with bisphenol A (BPA) or other endocrine disrupting chemicals that may be in the plastic container. Why does that matter? A growing number of studies suggest that fetal exposure to BPA increases the risks for multiple health problems.
One study of 244 mothers and their children showed that each 10-fold increase in maternal serum BPA levels was associated with more anxious and depressed behavior in the children by age 3 years (Pediatrics 2011;128:873-882). Another study in mice found that BPA may increase the risk for metabolic disorders and diabetes and that the fetal development stage was the critical window of susceptibility to BPA exposure (PLoS One 2013;8:e64143). Swedish investigators showed in a separate study that BPA increases angiogenesis in human endometrial cells in vitro, suggesting that the chemical could disturb normal endometrial functioning related to pregnancy and fertility.
• Avoid plastic contact with food/drinks. Plastic storage containers for food aren’t the only problem. Even without heating in a microwave, plastic can leach BPA or other endocrine-disrupting chemicals into your food or drinks. And plastic is ubiquitous – it’s in the linings of most canned foods, in polycarbonate water bottles, and in the plastic pouches or soft-box linings of wet foods. Try to avoid any food item with substantial plastic content.
• Don’t accept the receipt. Carbonless receipts – the kind you get at the ATM or in any store where you pay by credit card – commonly contain BPA, phthalates, or other endocrine disruptors. In response to concerns about BPA, some stores have started to use BPA-free receipts, "but many times when the BPA is removed, another phthalate gets added, so don’t even take the receipts," Dr. Zlatnik advised. Workers who have to handle carbonless receipts should wear gloves and/or wash their hands frequently, she added.
• Limit pesticide use around the home. A good principle in general, this is especially important during pregnancy.
• Be thoughtful about personal care products. Cosmetics and other personal care products can contain BPA or other endocrine disruptors. Skip the lipstick during pregnancy if you can’t verify that it’s free of harmful chemicals, for example.
• Mop daily. Dust mopping or damp mopping to remove dust that may contain lead or potentially harmful chemicals. "Along those lines, don’t wear shoes in the house," because they track these substances into the home, Dr. Zlatnik said.
• Replace foam furniture. Ubiquitous laws require furniture or mattresses containing foam to be treated with flame-retardant chemicals to reduce fire risk, but now it’s becoming clear that polybrominated diphenyl ethers (PBDEs) in the those chemicals can pose health risks.
Maternal prenatal PBDE concentrations were associated with impaired attention in children at age 5 years, poorer fine-motor coordination at ages 5 and 7 years, and lower scores on some sections of IQ tests at age 7 years in a study of 323 mothers and children (Environ. Health Perspect. 2013;121:257-62). A separate study of 210 cord blood samples found lower scores on tests of mental and physical development (including IQ) at 12-72 months of age in children who had higher concentrations of PBDEs at birth (Environ. Health Perspect. 2010;118:712-9). Serum levels of PBDE in the second trimester of pregnancy were associated with thyroid-stimulating hormone levels in a study of 25 pregnant Californians (Environ. Sci. Technol. 2011;45:7896-905).