Skip to content

Informing pregnant women about environmental health hazards is absolutely necessary, especially because steps can be taken to avoid them (such as pesticides, mercury in fish, lead and BPA). Why isn't it happening routinely? Hey obstetricians - are you listening? From Huffington Post:

Doctors Fail To Counsel Pregnant Women On Toxic Chemical Risks

...dozens of environmental chemicals can course through a pregnant woman's body, cross the umbilical cord and wreck havoc on a developing fetus. Birth defects, IQ losses and childhood cancers are just some of the potential risks scientists have now tied to even low levels of exposure.

Among more than 2,500 doctors consulted for the survey, nearly all of them reported counseling patients on factors such as diet, exercise and cigarette smoking. However, only about 20 percent said they addressed environmental exposures. They pegged their hesitation to a number of factors, from the fear of overwhelming patients with anxiety-inducing worries to limited appointment time to a lack of environmental health education.

Just one in 15 doctors said they had received training on the harmful reproductive effects of toxic chemicals. "Medical school and residencies tend to frame their curriculum around the boards and required licensing exams," said Stotland. "This material is not yet on those tests." ... The American College of Obstetrics and Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM) issued a statement in October that underscored mounting evidence of "significant and long-lasting effects" caused by industrial chemicals, and emphasized doctors' role in protecting pregnant women.

The actual study from Plos One summed up the importance of knowing about exposures to environmental hazards during pregnancy very nicely in the introduction:

Counseling Patients on Preventing Prenatal Environmental Exposures - A Mixed-Methods Study of Obstetricians

Exposure to hazardous environmental chemicals, i.e., manufactured chemicals and metals, is linked to adverse health outcomes across all stages of the human life cycle including fertility, conception, pregnancy, child and adolescent development, and adult health [1][5]. Human exposure to environmental chemicals is ubiquitous. A population-based study found that virtually all pregnant women in the U.S. had measureable levels of at least 43 different environmental chemicals in their bodies, including chemicals that were measured at levels similar to those associated with adverse developmental and reproductive health outcomes in epidemiologic studies [6]. There are currently over 80,000 chemicals in commerce [7][8], and exposure occurs through air, water, food and consumer products in the home and workplace. The majority of industrial chemicals have not been tested for potential reproductive/developmental harm [9].

Obstetricians are uniquely positioned to help prevent exposures to environmental chemicals with adverse developmental and reproductive health effects [2]. Pregnancy is a time when exposure to environmental contaminants can disrupt or interfere with the physiology of a cell, tissue, or organ [4], leading to permanent and lifelong adverse health outcomes that may be passed down to future generations [10]. Pregnancy is also an opportune time to prevent harmful exposures as it is a period when patient interest about health can be extremely high.

The researchers of this study looked at proximity to farm fields (how close a pregnant woman lives to a farm) and certain farm pesticides and found a link between exposure to farm pesticides during pregnancy and having a child with autism. But too bad they didn't also include pesticide exposures from homes (for pest control), gardens, and yards which would have given a more accurate measure of total exposure. However, it's a start. From Science Daily:

Association found between maternal exposure to agricultural pesticides and autism

Pregnant women who lived in close proximity to fields and farms where chemical pesticides were applied experienced a two-thirds increased risk of having a child with autism spectrum disorder or other developmental delay, a study by researchers with the UC Davis MIND Institute has found. The associations were stronger when the exposures occurred during the second and third trimesters of the women's pregnancies.

The large, multisite California-based study examined associations between specific classes of pesticides, including organophosphates, pyrethroids and carbamates, applied during the study participants' pregnancies and later diagnoses of autism and developmental delay in their offspring. It is published online in Environmental Health Perspectives. "... the message is very clear: Women who are pregnant should take special care to avoid contact with agricultural chemicals whenever possible."

California is the top agricultural producing state in the nation, grossing $38 billion in revenue from farm crops in 2010. Statewide, approximately 200 million pounds of active pesticides are applied each year, most of it in the Central Valley, north to the Sacramento Valley and south to the Imperial Valley on the California-Mexico border. While pesticides are critical for the modern agriculture industry, certain commonly used pesticides are neurotoxic and may pose threats to brain development during gestation, potentially resulting in developmental delay or autism.

The study was conducted by examining commercial pesticide application using the California Pesticide Use Report and linking the data to the residential addresses of approximately 1,000 participants in the Northern California-based Childhood Risk of Autism from Genetics and the Environment (CHARGE) Study. The study includes families with children between 2 and 5 diagnosed with autism or developmental delay or with typical development. "We mapped where our study participants' lived during pregnancy and around the time of birth. In California, pesticide applicators must report what they're applying, where they're applying it, dates when the applications were made and how much was applied," Hertz-Picciotto said. "What we saw were several classes of pesticides more commonly applied near residences of mothers whose children developed autism or had delayed cognitive or other skills."

Organophosphates applied over the course of pregnancy were associated with an elevated risk of autism spectrum disorder, particularly for chlorpyrifos applications in the second trimester. Pyrethroids were moderately associated with autism spectrum disorder immediately prior to conception and in the third trimester. Carbamates applied during pregnancy were associated with developmental delay.

Exposures to insecticides for those living near agricultural areas may be problematic, especially during gestation, because the developing fetal brain may be more vulnerable than it is in adults. Because these pesticides are neurotoxic, in utero exposures during early development may distort the complex processes of structural development and neuronal signaling, producing alterations to the excitation and inhibition mechanisms that govern mood, learning, social interactions and behavior.

Children's brain development being harmed by chemicals in the environment - both before birth and in childhood -  is such an important topic that here are excerpts from two articles about the same report that was just released (in Lancet Neurology).  From Time:

Children Exposed to More Brain-Harming Chemicals Than Ever Before

In recent years, the prevalence of developmental disorders such as autism, attention deficit/hyperactivity disorder (ADHD) and dyslexia  have soared. While greater awareness and more sophisticated diagnoses are partly responsible for the rise, researchers say the changing environment in which youngsters grow up may also be playing a role.

In 2006, scientists from the Harvard School of Public Health and the Icahn School of Medicine at Mount Sinai identified five industrial chemicals responsible for causing harm to the brain — lead, methylmercury, polychlorinated biphenyls (found in electric transformers, motors and capacitors), arsenic (found in soil and water as well as in wood preservatives and pesticides) and toluene (used in processing gasoline as well as in paint thinner, fingernail polish and leather tanning). Exposure to these neurotoxins was associated with changes in neuron development in the fetus as well as among infants, and with lower school performance, delinquent behavior, neurological abnormalities and reduced IQ in school-age children.

Now the same researchers have reviewed the literature and found six additional industrial chemicals that can hamper normal brain development. These are manganese, fluoride, chlorpyrifos, dichlorodiphenyltrichloroethane, tetrachloroethylene and polybrominated diphenyl ethers. Manganese, they say, is found in drinking water and can contribute to lower math scores and heightened hyperactivity, while exposure to high levels of fluoride from drinking water can contribute to a seven-point drop in IQ on average. The remaining chemicals, which are found in solvents and pesticides, have been linked to deficits in social development and increased aggressive behaviors.

But they say the growing body of research that is finding links between higher levels of these chemicals in expectant mothers’ blood and urine and brain disorders in their children should raise alarms about how damaging these chemicals can be. The developing brain in particular, they say, is vulnerable to the effects of these chemicals, and in many cases, the changes they trigger are permanent. The consequence of such brain damage is impaired [central nervous system] function that lasts a lifetime and might result in reduced intelligence, as expressed in terms of lost IQ points, or disruption in behavior,” they write in their report, which was published in the journal Lancet Neurology.

Same report, from Science Daily: Growing number of chemicals linked with brain disorders in children

"The greatest concern is the large numbers of children who are affected by toxic damage to brain development in the absence of a formal diagnosis. They suffer reduced attention span, delayed development, and poor school performance. Industrial chemicals are now emerging as likely causes," said Philippe Grandjean, adjunct professor of environmental health at HSPH.

The study outlines possible links between these newly recognized neurotoxicants and negative health effects on children, including:  - Manganese is associated with diminished intellectual function and impaired motor skills  - Solvents are linked to hyperactivity and aggressive behavior - Certain types of pesticides may cause cognitive delays.

Grandjean and co-author Philip Landrigan, Dean for Global Health at Mount Sinai, also forecast that many more chemicals than the known dozen or so identified as neurotoxicants contribute to a "silent pandemic" of neurobehavioral deficits that is eroding intelligence, disrupting behaviors, and damaging societies. But controlling this pandemic is difficult because of a scarcity of data to guide prevention and the huge amount of proof needed for government regulation. "Very few chemicals have been regulated as a result of developmental neurotoxicity," they write.

The authors say it's crucial to control the use of these chemicals to protect children's brain development worldwide. They propose mandatory testing of industrial chemicals and the formation of a new international clearinghouse to evaluate industrial chemicals for potential developmental neurotoxicity.