Environmental Toxicant Exposure and Hypertensive Disorders of Pregnancy: Recent Findings

  • Linda G. Kahn
  • Leonardo Trasande
Hypertension and Metabolic Syndrome (J Sperati, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hypertension and Metabolic Syndrome


Purpose of Review

To assess the strength of evidence for associations between environmental toxicants and hypertensive disorders of pregnancy, suggest potential biological mechanisms based on animal and in vitro studies, and highlight avenues for future research.

Recent Findings

Evidence is strongest for links between persistent chemicals, including lead, cadmium, organochlorine pesticides, and polycyclic biphenyls, and preeclampsia, although associations are sometimes not detectable at low-exposure levels. Results have been inconclusive for bisphenols, phthalates, and organophosphates. Biological pathways may include oxidative stress, epigenetic changes, endocrine disruption, and abnormal placental vascularization. Additional prospective epidemiologic studies beginning in the preconception period and extending postpartum are needed to assess the life course trajectory of environmental exposures and women’s reproductive and cardiovascular health. Future studies should also consider interactions between chemicals and consider nonlinear associations.


These results confirm recommendations by the International Federation of Gynecology and Obstetrics, the American Society for Reproductive Medicine, the American Academy of Pediatrics, and the Endocrine Society that providers counsel their pregnant patients to limit exposure to environmental toxicants.


Endocrine disruptors Environmental exposures Heavy metals Pesticides Bisphenol A Preeclampsia Gestational hypertension 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PediatricsNew York University School of MedicineNew YorkUSA
  2. 2.Department of Environmental MedicineNew York University School of MedicineNew YorkUSA
  3. 3.Department of Population HealthNew York University School of MedicineNew YorkUSA

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