Everyday chemical exposures linked to preterm birth and lower birthweight

by UNC Gillings School of Global Public Health

edited by Stephanie Baum, reviewed by Robert Egan

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In one of the largest studies of chemical exposures during pregnancy to date, new research led by the UNC Gillings School of Global Public Health, Stanford University School of Medicine and Woods Institute for the Environment has found that pregnant women are exposed to dozens of everyday chemicals, many of which can affect how early a child is born or a child's weight at birth. These outcomes influence a child's health throughout life.

The research, published in JAMA Network Open, found that pregnant women in the study were exposed to an average of 45 different chemicals, including phthalates, replacement plasticizers, polycyclic aromatic hydrocarbons (PAHs) and halogenated phenols. These chemicals are found in food, water, air pollution, personal care products, fragrances and other household objects.

"These chemicals are difficult to avoid because they're found in a wide range of products we use every day. It can be difficult to know whether products contain them, and even when we do know, we have limited control over exposures," said first author Jessie Buckley, Ph.D., professor of epidemiology at the Gillings School. "Although there are some practical steps people can take, reducing harmful chemicals at the source is the most effective way to protect children and families."

Phthalates remain a key concern

Phthalates and replacement plasticizers, in particular, are found in many baby care products, such as toys, diaper creams and shampoos. In 2017, the United States Consumer Product Safety Commission permanently banned or severely limited the use of eight common phthalates in children's toys and products because exposures can result in harmful health effects. However, this action did not address other products, including those used in pregnancy. The new study found several additional phthalates, including those that replaced banned phthalates, and plasticizer chemicals in women's samples.

The study included more than 5,000 pairs of mothers and children born between 2000 and 2021 and collected data on chemicals found in maternal urine samples, pregnancy duration and birth weight. Researchers tested for 113 different chemicals commonly found in homes and in air, food and water and found that, on average, 45 were present in each sample (the maximum they observed in a sample was 64). The team then examined how differences in gestational age and birth weight were linked to these chemical exposures.

Several phthalates and alternative plasticizers showed a consistent association with earlier delivery. Phthalates, replacement plasticizers and PAHs were also linked to lower birth weight. Some less-studied chemicals that the researchers identified, including halogenated phenols, were also associated with lower birth weight. The researchers also identified plasticizers recently introduced to replace toxic chemicals like phthalates. However, these newer substances had similar health effects to the chemicals they replaced.

Calls for stronger regulation

"Our study highlights the need for stronger policies to protect people from toxic chemicals," said senior researcher Tracey Woodruff, Ph.D., professor of epidemiology and population health at Stanford. "For example, we found that several newer chemicals used to replace toxic ones are also harmful, which underscores why new and replacement chemicals must be properly evaluated before they are put on the market. Further, government agencies that evaluate the health risks of toxic chemicals like phthalates should incorporate our findings to reduce exposures and ensure healthier pregnancies."

"Our study, along with other similar findings, underscores the importance of reducing chemical exposures that affect pregnancy, as even small changes in birth weight or gestational age can have significant effects on children's health," Buckley said.

"Pregnant people are at risk of chemical exposure through multiple sources, many of them beyond their control," Woodruff said. "Governments and companies need to do a better job of reducing harmful chemicals in everyday products and ensuring new chemicals are safe, which will lead to healthier children and families."

Publication details

Gestational exposure to ten classes of priority chemicals and birth outcomes in the ECHO Cohort, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.18883

Journal information: JAMA Network Open

Key medical concepts

Phthalic AcidsPremature BirthPolycyclic Aromatic Hydrocarbons

Clinical categories

Obstetrics & gynecologyPregnancyWomen's healthPreventive medicinePediatrics Provided by UNC Gillings School of Global Public Health Who's behind this story?

Stephanie Baum

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