Scientists Estimate Millions of Preterm Births Are Linked to This Common Household Chemical

In recent years, there’s been growing attention to plastics and their impact on health—and for good reason. Whether it’s microplastics, nanoplastics, or plastic household items themselves, researchers and consumers alike are eager to understand the long-term effects of living in a world full of the stuff. Now, there’s a new study that suggests exposure to phthalates, a group of chemicals that make some plastics flexible, were estimated to contribute to millions of preterm births across the globe.

The study, which was published in eClinicalMedicine, a Lancet journal, looked at the relationship between exposure to certain types of phthalates and preterm birth. Preterm birth is any birth that happens before 37 weeks of pregnancy. These kinds of births come with a risk of health complications for the baby, including death, making this a serious concern.

But what’s behind this link and, more importantly, what can you do about it? We tapped an ob-gyn and a toxicologist for more.

Meet the experts: Daniel J. Martingano, DO, an ob-gyn at Episcopal Health Services, and Jamie Alan, PhD, an associate professor of pharmacology and toxicology at Michigan State University.

What did the study find?

For the study, researchers estimated exposure to di-2-ethylhexylphthalate (DEHP) in 2018 across 200 countries and territories by looking at national surveys. DEHP is part of a group of chemicals called phthalates, which can show up in makeup, detergents, bug repellents, and many other household products you regularly come into contact with.

The researchers then looked at previous research that examined how phthalate exposure may affect preterm birth and combined that with their estimates. From there, they looked at worldwide figures on preterm births and deaths to see what percentage of those could be linked to DEHP.

After analyzing the data, the team estimated that DEHP exposure contributed to about 1.97 million premature births in 2018. That’s more than 8 percent of the total premature births in the world. The researchers also linked DEHP exposure with the deaths of 74,000 newborns.

From there, the researchers looked at another phthalate called diisononyl phthalate (DiNP), which is commonly used as a substitute for DEHP. They found that DiNP was estimated to have contributed to about 1.88 million preterm births around the world. Because the study looked at global data, the researchers were also able to hone in on what areas seemed to be the most affected. They noted that “burden was estimated to be disproportionate in South Asia, the Middle East, and Africa.”

Why would some plasticizers be linked to preterm birth?

It’s not entirely clear, but there are a few theories. Phthalates “cause problems by infiltrating tissues, inducing chronic inflammation, and releasing chemical additives that disrupt metabolic and reproductive systems,” says Daniel J. Martingano, DO, an ob-gyn at Episcopal Health Services.

“These compounds are known endocrine disruptors, which may be a possible explanation,” adds Jamie Alan, PhD, an associate professor of pharmacology and toxicology at Michigan State University.

But the inflammation caused by these plasticizers seems to play a big role, Martingano says. “The immune response is responsible for breaking down foreign material or dealing with pathogens,” he says. “With phthalates, the immune system, specifically macrophages, are unable to completely break them down, leading to a sustained response—chronic inflammation.”

When this happens in the placenta—the temporary organ that grows during pregnancy to support the baby—it could “plausibly” trigger preterm labor, Martingano says.

How concerning is this if you’re not pregnant and don’t plan to be?

Even if you aren’t pregnant and never plan to be, phthalates aren’t something you want in your body. “These chemicals can still have effects on human health,” Alan says. “Even if you do not want to be pregnant, these chemicals could still have health consequences.”

Martingano agrees. “Because DEHP induces a chronic inflammatory state, it can pose health risks beyond preterm labor, albeit by the same mechanism,” he says. “Cardiovascular disease is a significant disease where DEHP has a strong association, which can affect all women.”

How to reduce your exposure to phthalates

Martingano stresses this: The study didn’t conclusively determine that exposure to plasticizers causes preterm birth. Instead, it found a link.

Still, it’s helpful to do what you can to lower your exposure whenever possible. Alan recommends storing your food in glass containers, since glass contains no phthalates. It’s also a good idea to try and use toothbrushes labeled “phthalate-free,” and to avoid microwaving food in plastic containers, according to the National Institutes of Health (NIH).

Environmental exposure may also play a role. “I would expect that some of the exposure is from plastic pollution,” says Alan, adding that in the regions the study authors noted were disproportionately affected, her guess is that drinking water and food sources are potentially contaminated.

Ultimately, just do your best. “DEHP always remains as an association with diseases rather than a direct cause, making it likely that DEHP worsens an already present abnormal health status,” Martingano says. This “should offer reassurance to both pregnant and non-pregnant women that if they maintain an otherwise healthy lifestyle, DEHP exposure in and of itself is unlikely to cause disease development,” Martingano says.

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