Exposure to metabolism disrupting chemicals: implications for maternal health in pregnancy - PROJECT SUMMARY Support from this award will provide Maria Cinzori with comprehensive training in environmental epidemiology and clinically-relevant perinatal health research, while providing additional guidance for conducting research using a large national cohort (the Environmental influences on Child Health Outcomes (ECHO) consortium) and applying causal inference-based statistical approaches under the supervision of an exceptional mentoring team with expertise in environmental epidemiology, conducting perinatal health research (including in clinical settings), and confronting the challenges and rewards of working with a large, harmonized dataset. Overall, the proposed research will offer insights into associations between metabolism disrupting chemical (MDC) exposures and maternal metabolic disorders in pregnancy. Pregnant women are exposed to numerous non-persistent (e.g., phthalates, phenols) MDCs through food packaging, personal care products, and household cleaning items. Some limited studies suggest that certain single MDCs are linked to gestational diabetes and hypertensive disorders of pregnancy – conditions that may increase maternal and child risk of developing type II diabetes or obesity. Therefore, MDCs may be potential modifiable risk factors that can be targeted to prevent gestational and cardiovascular complications. However, prior studies addressing this issue have been limited, focusing primarily on non-clinical metabolic outcomes and single chemical classes in homogenous populations. Specific Aim 1 of the current study will address this critical gap by evaluating associations of maternal exposure to many classes of MDCs with gestational diabetes and hypertensive disorders of pregnancy. Completion of the research in Specific Aim 1 will leverage data from ECHO, a diverse national cohort, to provide vital information on how MDCs impact gestational metabolic health. Despite efforts to ban harmful chemicals, pregnant women are ubiquitously exposed to emerging chemicals of concern via continuous introduction of unregulated replacements. Although prior intervention studies evaluating phenols and phthalates suggest that there are plausible individual-level approaches for reducing exposure to chemicals, it is time-consuming to test whether implementing large-scale intervention is effective at improving health outcomes. To address these shortcomings, Specific Aim 2 will apply novel causal inference-based statistical methods to evaluate how a hypothetical intervention to decrease exposure to chemicals of concern would impact risk of developing gestational diabetes or hypertensive disorders of pregnancy in pregnant women enrolled in ECHO. Furthermore, it is critical to identify sources of emerging MDCs to inform future interventions, and therefore an exploratory aim will extensively review the literature to identify targetable sources of novel and emerging MDCs with the goal of informing sustainable policy-relevant interventions. The research accomplished in Specific Aim 2 will provide valuable information about whether reducing MDC exposure can lower the incidence of gestational diabetes and hypertensive disorders of pregnancy.
