Phthalates & Pregnancy

What are phthalates?
Phthalates are a group of chemicals that may be found in products such as: personal care products, perfumes, coating of time-release medications, gelling agents, lubricants, liquid soap, shampoos, nail polish, hair spray, cosmetics, and potentially infant lotion/powder/shampoo. These chemicals may also be found in construction material, vinyl, flooring and food packaging.

Phthalates are primarily used as plasticizers, adding flexibility and durability to plastics. There are several types of phthalates including: di-2-ethyl hexyl phthalate (DEHP), diisodecyl phthalate (DIDP) and diisononyl phthalate (DINP).

Unfortunately, phthalates are believed to act as endocrine disrupters and, hence, are a health concern. A couple of recent studies suggest a link between high phthalate levels and preterm birth as well as low birth weights. While the studies are small and require further investigation, the correlations raise concerns. Women who are pregnant or in their reproductive years would do well to become more educated on how to decrease their phthalate exposure. Equally, this is important in infancy and early childhood.

Here are exerts of the two June 2009 studies investigating phthalate levels in pregnancy:

1. Methods: Within a large Mexican birth cohort study, we compared third trimester urinary phthalate metabolite concentrations in 30 women who delivered preterm (<37 weeks gestation) with 30 controls (≥37 weeks gestation). Results: Concentrations of most of the metabolites were similar to those reported among US females, though in the present study mono-n-butyl phthalate (MBP) concentrations were higher and monobenzyl phthalate (MBzP) concentrations lower. [ ] In multivariate logistic regression analysis adjusted for potential confounders, elevated odds of having phthalate metabolite concentrations above the median level were found.
2. A total of 201 newborn–mother pairs (88 LBW [low birth weight] cases and 113 controls) residing in Shanghai were enrolled in this nested case-control study during 2005-2006. Results: No significant differences in gestational age, prepregnancy body mass index, prenatal care, vitamin supplementation, or socioeconomic levels were found between the LBW and control infants. More than 70% of the biosamples had quantifiable levels of phthalates, with higher levels in the LBW infants compared with the controls. Prenatal di-n-butyl phthalate (DBP) exposure was associated with LBW, and di-2-ethylhexyl phthalate (DEHP) was negatively associated with birth length. After adjusting for the potential confounders, DBP concentrations in the highest quartile were associated with an increased risk of LBW. Conclusions: Newborns in China are ubiquitously exposed to phthalates; significantly higher phthalate levels were detected in LBW cases compared with controls. In utero DBP and DEHP exposures were associated with LBW in a dose-dependent manner. Prenatal phthalate exposure may be a risk factor for LBW.

What steps can you take to reduce exposure?

• Become educated about your environment and what is in your shopping bag
• Where possible, choose organic and natural foods: processed foods have been shown to have higher phthalate levels.
• Look for phthalate-free toys/products for infants such as bisphenol-A-free baby products.
• Limit the use of baby care products for your infant (shampoos, powders, lotions). Look for natural alternatives (e.g. olive oil, natural healthcare products). Contact the manufacturer if in doubt of ingredients.
• Ventilate during construction and renovations (renovations are common during pregnancy or early infancy as parents prepare for their new arrival)
• Read ingredients for personal care products (though, phthalates may not be listed: instead, they may simply be labeled as ‘fragrance’)
• Avoid plastic water bottles (opt for glass or stainless steel). Microwave foods in glass instead of plastic containers.

Take positive steps, yet avoid becoming overwhelmed or overly fearful. Each step you take to reduce phthalate exposure will support better overall health. There will always be some exposure to toxins. Remember, a healthy body can cope with small levels of toxin exposure. The aim is to limit exposure amidst creating a healthy terrain.

Additional resources and information:

1. Canada still sells toys banned in Europe
2. Health Canada – Preventing the use of six phthalates in soft vinyl children’s toys and child-care articles
3. Baby Care Products: Possible Sources of Infant Phthalate Exposures
4. www.safemama.com

References:

1. John Meeker et al. Urinary phthalate metabolites in relation to preterm birth in Mexico City. Environmental Health Perspective. 16 June 2009.
2. Yunhui Zhang PhDa et al. Phthalate Levels and Low Birth Weight: A Nested Case-Control Study of Chinese Newborns. Journal of Pediatrics. 23 June 2009.