April 05, 2021
2 min read
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Endocrine-disrupting chemicals found in common plastics may influence hormonal shifts during pregnancy as well as contribute to postpartum depression, according to new data published in The Journal of Clinical Endocrinology & Metabolism.
“We found that higher levels of phthalate exposure during pregnancy was associated with lower prenatal progesterone concentrations and subsequently a higher likelihood of developing postpartum depression,” Melanie Jacobson, PhD, MPH, a research scientist in the division of environmental pediatrics at NYU School of Medicine, told Healio. “Because nearly all pregnant women in the U.S. have detectable levels of phthalates in their systems, this work has important implications for women and children’s health at the population level.”
In a prospective study, Jacobson and colleagues analyzed data from 139 pregnant women recruited between 2016 and 2018. Eight bisphenols and 22 phthalates were measured in early and midpregnancy urine samples; serum sex steroid hormone concentrations were measured in midpregnancy. Researchers assessed postpartum depression 4 months postpartum using the Edinburgh Postnatal Depression Scale (score of 10 defined as postpartum depression). Main outcome measures were serum levels of allopregnanolone, progesterone, pregnanolone and pregnenolone, assessed as log-transformed continuous variables.
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Bisphenol A (BPA) and bisphenol S (BPS) were detected in 71% and 76% of samples in early pregnancy, respectively, and in 77% and 83% of samples in midpregnancy, respectively. Of the 22 phthalate metabolites assessed, 15 were detected in more than half of samples.
Melanie Jacobson, PhD, MPH
Researchers found that di-n-octyl phthalate (DnOP) and diisononyl phthalate (DINP) metabolites were associated with reduced progesterone concentrations. Log-unit increases in DnOP and DINP predicted 8.1% (95% CI, –15.2 to –0.4) and 7.7% (95% CI, –13.3 to –1.7) lower progesterone levels, respectively. Researchers also found that prenatal DnOP was associated with increased odds for developing postpartum depression, with an OR of 1.48 (95% CI, 1.04-2.11).
“Our analyses of midpregnancy hormone concentrations in relation to Edinburgh Postnatal Depression Scale scores did not show significant associations, which suggests that other mechanisms may be at play,” the researchers wrote. “Still, our observation that DnOP was associated with postpartum depression suggests that because phthalate exposure can be reduced through dietary and behavioral interventions, such as avoiding food packaging, certain cosmetics and polycarbonate plastic products, these findings provide preliminary evidence identifying prenatal exposure to phthalates as a potentially modifiable risk factor for postpartum depression.”
The researchers noted that other established risk factors for postpartum depression include genetic predisposition and socioeconomic status, which are less readily alterable, whereas these data could inform a “plausible avenue” to prevent postpartum depression morbidity.
“This was the first study to examine prenatal exposure to these types of chemicals in relation to postpartum depression in humans,” Jacobson told Healio. “More studies in different populations and with larger sample sizes are needed.”
Reproductive & Maternal Health Resource Center