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Environmental Toxicant Exposure and Hypertensive Disorders of Pregnancy: Recent Findings

  • Hypertension and Metabolic Syndrome (J Sperati, Section Editor)
  • Published:
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Abstract

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.

Summary

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.

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Authors and Affiliations

  1. Department of Pediatrics, New York University School of Medicine, New York, NY, USA

    Linda G. Kahn & Leonardo Trasande

  2. Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA

    Leonardo Trasande

  3. Department of Population Health, New York University School of Medicine, New York, NY, USA

    Leonardo Trasande

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  1. Linda G. Kahn
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Kahn, L.G., Trasande, L. Environmental Toxicant Exposure and Hypertensive Disorders of Pregnancy: Recent Findings. Curr Hypertens Rep 20, 87 (2018). https://doi.org/10.1007/s11906-018-0888-5

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