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Environmental Exposures and Adverse Pregnancy Outcomes: A Review of the Science

Physicians for Social Responsibility University of California

Donald R. Mattison, MD

Obstetric and Pediatric Pharmacology Branch, Center for Research for Mothers and Children, NICHD, National Institutes of Health, University of California

Linda C. Giudice, MD, PhD, MSc

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California

Tracey J. Woodruff, PhD, MPH

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, woodrufft{at}obgyn.ucsf.edu

To better understand the science linking environmental contaminants exposures with adverse pregnancy outcomes, we reviewed the relevant epidemiologic literature. We searched PubMed (primarily 1995-2006) using the key word combinations for select environmental exposures and pregnancy outcomes. Environmental tobacco smoke is a risk factor for reduced birth weight and preterm delivery. Outdoor air pollution is associated with reduced term birth weight and preterm delivery. Suggestive evidence associates pesticides and polychlorinated biphenyls with decreased fetal growth and length of gestation. Stronger evidence, primarily occupational, links certain birth defects with exposure to organic solvents and chlorophenoxy herbicides. Evidence suggests dichlorodiphenyltrichloroethane and bisphenol-A could be associated with pregnancy loss. Exposures in utero can also increase the risk of developmental delays (ie, impaired neurological function), adult chronic illnesses (ie, heart disease, diabetes, cancer), and next generation effects (ie, reduced reproductive capacity). Further research, education, and improved public health policy are needed to reduce potentially adverse exposures.

Key Words: Adverse pregnancy outcomes • environmental contaminants • preterm delivery • low birth weight • environmental exposures.

Reproductive Sciences, Vol. 15, No. 7, 631-650 (2008)
DOI: 10.1177/1933719108322436


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