The average person may be well aware of the risks of alcohol, opioids and tobacco of risk particularly to pregnant women and their unborn babies. Surgeon Generals’ warnings are now a law of the land in the U.S. But what about other hazards like persistent organic pollutants, and what about countries where chemicals in manufacturing are ubiquitous and unregulated, seeping into the groundwater? In a Maternova blog series we will be exploring the impact of environmental toxins on our populations.
There are some 4700 chemicals just in this one category tracked by the OECD. Let’s take PFOA in the United States as an example of what happens when a chemical enters the bloodstream of an entire population. The CDC states that PFOAs “can affect growth and development, reproduction, and injure the liver.” Other studies have associated PFOAs with increased risk of preeclampsia for women. CDC scientists found PFOA in the serum i.e. the blood) of nearly all the people tested, indicating that PFOA exposure is widespread in the U.S. population.
PFOAs are one subset of a class of chemicals widely in use in manufacturing for the last 60 years. In the case of PFOA, increasing concerns about toxicity led the government to call for voluntary phase-outs One study estimates that this phaseout prevented between 10,000 and 17,000 low-weight births in the United States, per year.
The EPA introduced the PFOA Stewardship Program to work with companies in the U.S. as well as their global operations to phase out some of the harmful chemicals used by companies like 3M and Dupont. This brief timeline shows the results of a voluntary phase-out program:
2003-2008 PFOA levels rose to a peak level of 3.5 nanograms per mL in US population 2006 The U.S. EPA introduced the voluntary phase out of PFOAs by 8 major companies 2009 The trend starts to reverse when the U.S. government began a voluntary phaseout 2014 PFOA blood levels in the U.S. dropped to 1.6 nanograms per mL
Most sobering are the words used in a Minnesota study of these chemicals and their ability to cross the placenta, transfer from the mother during breastfeeding or transfer from groundwater in mixed formula: bioaccumulation and transgenerational exposure. We will be following up this post with more on PFOAs, Minnesota and the rest of the world. Questions remain about how this, and other chemicals, accumulate in populations and are transferred between generations. In areas with extremely high levels of PFOA levels above normal, what does this mean for the ethics of recommending breastfeeding for all women?
Identification of anemia in pregnant women is important, since it is an important cause of multiple complications during pregnancy (preterm delivery, low birth weight and perinatal death), so it is recommended to all pregnant women, in the first prenatal visit and at 28 weeks of gestation, the measurement of serum concentrations of hemoglobin and hematocrit as a screening test for anemia.
Prenatal assessment seeks to identify, through clinical history, sociodemographic characteristics, mean blood pressure, Doppler of the uterine arteries and biochemical markers such as pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PlGF), those women who are at high risk of developing preeclampsia in order to take appropriate measures. that can help reduce that risk.