Because assessing pregnant patients for environmental exposure is important. We have robust and growing evidence that prenatal exposure to common toxic chemicals — like BPA, pesticides, and phthalates — has serious and lasting health risks.
But because it’s such a complex topic, most obstetricians don’t talk about it. Only 1 out of 5 routinely counsel pregnant women about common environmental exposures.
It’s time for all primary care clinicians to take an active role and lead the discussion with pregnant patients. PAER makes that conversation easier — by giving providers the customized resources they need to help each individual patient.
Obstetricians — and other clinicians who work with pregnant women — have a special opportunity to prevent or reduce harmful environmental exposures. Helping a woman protect herself from toxic chemicals during pregnancy could have benefits that last her child’s whole life.
5 Reasons Providers Need to Assess Patients for Environmental Exposure
- Toxic chemicals are everywhere — studies show that nearly all pregnant women have detectable levels of at least 43 environmental chemicals in their blood, and many of these chemicals can cross the placenta.
- Some of these toxic chemicals — like mercury, PCBs, and phthalates — are typically found at levels associated with adverse effects.
- Typical exposure to a single chemical may have minimal risks, but pregnant women are exposed to many — and they may have interactive or additive effects.
- Studies show compelling associations between exposure to environmental chemicals and adverse outcomes like preterm birth, pregnancy loss, congenital defects, and adult disease (like cardiovascular disease and cancer).
- Many patients are already worried about exposures — primed by sensational and often misleading media reports. Discussing the topic will help put them at ease.
“Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals.”
— American College of Obstetricians and Gynecologists, Committee Opinion, October, 2013
American College of Obstetricians and Gynecologists (ACOG). (2013, October). Exposure to toxic environmental agents. Committee Opinion No. 575. Obstetrics & Gynecology, 122, 931–5.
http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Exposure-to-Toxic-Environmental-Agents
Di Renzo, G.C., et al. (2015). International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals. International Journal of Gynecology and Obstetrics.
DOI: http://dx.doi.org/10.1016/j.ijgo.2015.09.002
Royal College of Obstetricians and Gynaecologists. (2013, May). Scientific Impact Paper No. 37: Chemical Exposures During Pregnancy: Dealing with Potential, but Unproven, Risks to Child Health, 1-7.
https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_37.pdf
Sathyanarayana, S., Focareta, J., Dailey, T., Buchanan, S. (2012, December). Environmental exposures: how to counsel preconception and prenatal patients in the clinical setting. American Journal of Obstetrics & Gynecology, 207(6), 463-470.
DOI: http://dx.doi.org/10.1016/j.ajog.2012.02.004
Stotland, N., Sutton, P., Trowbridge, J., Atchley, D., Conry, J., Trasande, L., et al. (2014, June). Counseling Patients on Preventing Prenatal Environmental Exposures — A Mixed-Methods Study of Obstetricians. PLoS ONE, 9(6): e98771.
DOI: 10.1371/journal.pone.0098771
Sutton, P., Woodruff, T., Perron, J., Stotland, N., Conry, J., Miller, M., Giudice, L. (2012, September). Toxic environmental chemicals: the role of reproductive health professionals in preventing harmful exposures. American Journal of Obstetrics & Gynecology, 207(3), 164-173.
DOI: 10.1016/j.ajog.2012.01.034
Woodruff, T., Zota, A., Schwartz, J. (2011). Environmental chemicals in pregnant women in the United States: NHANES 2003-2004. Environmental Health Perspectives, 119(6), 878-85.
DOI: 10.1289/ehp.1002727