Early Pregnancy Plasma Per- and Polyfluoroalkyl Substances (PFAS) and Maternal Midlife Adiposity.

CONTEXT: Evidence suggests that exposure to per- and polyfluoroalkyl substances (PFAS) increases the risk of developing cardiometabolic disease risk factors. Limited research has evaluated associations between PFAS, assessed during pregnancy, a sensitive window for maternal endocrine effects, and long-term maternal adiposity. OBJECTIVE: Estimate associations of early pregnancy measures of individual PFAS, and PFAS mixtures, with maternal adiposity in midlife. METHODS: We studied 547 Project Viva participants with measures of early pregnancy (mean gestation 10.0 weeks; mean age 32.5 years) plasma concentrations of 6 PFAS and midlife adiposity outcomes (mean follow-up 17.7 years; mean age 50.7 years), including weight, waist circumference (WC), trunk fat mass (TFM), and total body fat mass (TBFM). We used linear regression and Bayesian Kernel Machine Regression (BKMR). RESULTS: Linear regression estimated higher midlife weight per doubling of perfluorooctane sulfonate (PFOS) (3.8 kg [95% CI: 1.6, 5.9]) and 2-(N-ethyl-perfluorooctane sulfonamido) acetate (2.3 kg [95% CI: 0.9, 3.7]). BKMR analyses of single PFAS plasma concentrations (comparing the 25th percentile concentration to the 75th percentile) showed a positive association between PFOS and midlife adiposity (weight: 7.7 kg [95% CI: 4.0, 11.5]; TFM: 1.2 kg [95% CI: 0.0, 2.3]; TBFM: 3.0 kg [95% CI: 0.8, 5.2]), but inverse associations with perfluorononanoate (weight: -6.0 kg [95% CI: -8.5, -3.5]; WC: -1.8 cm [95% CI: -3.2, -0.3]; TFM: -0.8 kg [95% CI: -1.5, -0.1]; TBFM: -1.4 kg [95% CI: -2.7, -0.3]) and perfluorohexane sulfonate (TFM: -0.8 kg [95% CI: -1.5, -0.1]; TBFM: -1.4 kg [95% CI: -2.6, -0.2]). No associations were observed with the overall PFAS mixture. CONCLUSION: Select PFAS, assessed in pregnancy, may differentially affect maternal midlife adiposity, influencing later-life maternal cardiometabolic health.

Exploring associations between the Phthalate Environmental Reproductive Health Literacy (PERHL) scale & biomarkers of phthalate exposure: A pilot study.

BACKGROUND: Perinatal exposure to phthalates is associated with adverse health impacts for parents and children. The field of environmental health literacy seeks to measure how environmental health information is conceptualized and used to inform behaviors. We assessed whether scores on the validated Phthalate Environmental Reproductive Health Literacy (PERHL) scale were associated with biomarkers of phthalate exposure. METHODS: 42 members of the Environmental Reproductive and Glucose Outcomes (ERGO) cohort completed the PERHL scale and provided spot urine samples. Phthalate summary measures for model outcomes were created by calculating molar sums of specific gravity-corrected metabolite concentrations representing exposure to parent phthalate, Di(2-ethylhexyl)phthalate (DEHP), personal care product (PCP)-associated phthalates, and parent butyl-phthalates. Linear regression models were used to estimate the associations of the PERHL scale scores with phthalate summary measures, controlling for educational attainment (college degree or higher vs. no college degree), age (years), and race and ethnicity (non-Hispanic White vs. non-White). RESULTS: Higher scores on the PERHL Scale and subscales were generally associated with lower ΣDEHP, Σbutyl, and ΣPCP metabolite concentrations. A one-point increase in the 'Protective Behavior/Risk Control' subscale score was significantly associated with a -30.3% (95% CI: -50.1, -2.6) decrease in ΣDEHP, and a -30.6% (95% CI: -51.5, -0.63) decrease in Σbutyl metabolite concentrations.

Phthalates and sex steroid hormones across the perimenopausal period: A longitudinal analysis of the Midlife Women's Health Study.

BACKGROUND: The menopausal transition involves significant sex hormone changes. Environmental chemicals, such as urinary phthalate metabolites, are associated with sex hormone levels in cross-sectional studies. Few studies have assessed longitudinal associations between urinary phthalate metabolite concentrations and sex hormone levels during menopausal transition. METHODS: Pre- and perimenopausal women from the Midlife Women's Health Study (MWHS) (n = 751) contributed data at up to 4 annual study visits. We quantified 9 individual urinary phthalate metabolites and 5 summary measures (e.g., phthalates in plastics (∑Plastic)), using pooled annual urine samples. We measured serum estradiol, testosterone, and progesterone collected at each study visit, unrelated to menstrual cycling. Linear mixed-effects models and hierarchical Bayesian kernel machine regression analyses evaluated adjusted associations between individual and phthalate mixtures with sex steroid hormones longitudinally. RESULTS: We observed associations between increased concentrations of certain phthalate metabolites and lower testosterone and higher sub-ovulatory progesterone levels, e.g., doubling of monoethyl phthalate (MEP), monobenzyl phthalate (MBzP), di-2-ethylhexyl phthalate (∑DEHP) metabolites, ∑Plastic, and ∑Phthalates concentrations were associated with lower testosterone (e.g., for ∑DEHP: -4.51%; 95% CI: -6.72%, -2.26%). For each doubling of MEP, certain DEHP metabolites, and summary measures, we observed higher mean sub-ovulatory progesterone (e.g., ∑AA (metabolites with anti-androgenic activity): 6.88%; 95% CI: 1.94%, 12.1%). Higher levels of the overall time-varying phthalate mixture were associated with lower estradiol and higher progesterone levels, especially for 2nd year exposures. CONCLUSIONS: Phthalates were longitudinally associated with sex hormone levels during the menopausal transition. Future research should assess such associations and potential health impacts during this understudied period.

Cohort profile: the Environmental Reproductive and Glucose Outcomes (ERGO) Study (Boston, Massachusetts, USA) - a prospective pregnancy cohort study of the impacts of environmental exposures on parental cardiometabolic health.

PURPOSE: Pregnancy and the postpartum period are increasingly recognised as sensitive windows for cardiometabolic disease risk. Growing evidence suggests environmental exposures, including endocrine-disrupting chemicals (EDCs), are associated with an increased risk of pregnancy complications that are associated with long-term cardiometabolic risk. However, the impact of perinatal EDC exposure on subsequent cardiometabolic risk post-pregnancy is less understood. The Environmental Reproductive and Glucose Outcomes (ERGO) Study was established to investigate the associations of environmental exposures during the perinatal period with post-pregnancy parental cardiometabolic health. PARTICIPANTS: Pregnant individuals aged ≥18 years without pre-existing diabetes were recruited at <15 weeks of gestation from Boston, Massachusetts area hospitals. Participants completed ≤4 prenatal study visits (median: 12, 19, 26, 36 weeks of gestation) and 1 postpartum visit (median: 9 weeks), during which we collected biospecimens, health histories, demographic and behavioural data, and vitals and anthropometric measurements. Participants completed a postpartum fasting 2-hour 75 g oral glucose tolerance test. Clinical data were abstracted from electronic medical records. Ongoing (as of 2024) extended post-pregnancy follow-up visits occur annually following similar data collection protocols. FINDINGS TO DATE: We enrolled 653 unique pregnancies and retained 633 through delivery. Participants had a mean age of 33 years, 10% (n=61) developed gestational diabetes and 8% (n=50) developed pre-eclampsia. Participant pregnancy and postpartum urinary phthalate metabolite concentrations and postpartum glycaemic biomarkers were quantified. To date, studies within ERGO found higher exposure to phthalates and phthalate mixtures, and separately, higher exposure to radioactive ambient particulate matter, were associated with adverse gestational glycaemic outcomes. Additionally, certain personal care products used in pregnancy, notably hair oils, were associated with higher urinary phthalate metabolite concentrations, earlier gestational age at delivery and lower birth weight. FUTURE PLANS: Future work will leverage the longitudinal data collected on pregnancy and cardiometabolic outcomes, environmental exposures, questionnaires, banked biospecimens and paediatric data within the ERGO Study.

First trimester plasma PER- AND Polyfluoroalkyl Substances (PFAS) and blood pressure trajectories across the second and third trimesters of pregnancy

BACKGROUND: Evidence suggests that exposure to per- and polyfluoroalkyl substances (PFAS) increases risk of high blood pressure (BP) during pregnancy. Prior studies did not examine associations with BP trajectory parameters (i.e., overall magnitude and velocity) during pregnancy, which is linked to adverse pregnancy outcomes. OBJECTIVES: To estimate associations of multiple plasma PFAS in early pregnancy with BP trajectory parameters across the second and third trimesters. To assess potential effect modification by maternal age and parity. METHODS: In 1297 individuals, we quantified six PFAS in plasma collected during early pregnancy (median gestational age: 9.4 weeks). We abstracted from medical records systolic BP (SBP) and diastolic BP (DBP) measurements, recorded from 12 weeks gestation until delivery. BP trajectory parameters were estimated via Super Imposition by Translation and Rotation modeling. Subsequently, Bayesian Kernel Machine Regression (BKMR) was employed to estimate individual and joint associations of PFAS concentrations with trajectory parameters - adjusting for maternal age, race/ethnicity, pre-pregnancy body mass index, income, parity, smoking status, and seafood intake. We evaluated effect modification by age at enrollment and parity. RESULTS: We collected a median of 13 BP measurements per participant. In BKMR, higher concentration of perfluorooctane sulfonate (PFOS) was independently associated with higher magnitude of overall SBP and DBP trajectories (i.e., upward shift of trajectories) and faster SBP trajectory velocity, holding all other PFAS at their medians. In stratified BKMR analyses, participants with ≥ 1 live birth had more pronounced positive associations between PFOS and SBP velocity, DBP magnitude, and DBP velocity - compared to nulliparous participants. We did not observe significant associations between concentrations of the overall PFAS mixture and either magnitude or velocity of the BP trajectories. CONCLUSION: Early pregnancy plasma PFOS concentrations were associated with altered BP trajectory in pregnancy, which may impact future cardiovascular health of the mother.

Contributions of Synthetic Chemicals to Autoimmune Disease Development and Occurrence.

PURPOSE OF REVIEW: Exposure to many synthetic chemicals has been linked to a variety of adverse human health effects, including autoimmune diseases. In this scoping review, we summarize recent evidence detailing the effects of synthetic environmental chemicals on autoimmune diseases and highlight current research gaps and recommendations for future studies. RECENT FINDINGS: We identified 68 recent publications related to environmental chemical exposures and autoimmune diseases. Most studies evaluated exposure to persistent environmental chemicals and autoimmune conditions including rheumatoid arthritis (RA), systemic lupus (SLE), systemic sclerosis (SSc), and ulcerative colitis (UC) and Crohn's disease. Results of recent original research studies were mixed, and available data for some exposure-outcome associations were particularly limited. PFAS and autoimmune inflammatory bowel diseases (UC and CD) and pesticides and RA appeared to be the most frequently studied exposure-outcome associations among recent publications, despite a historical research focus on solvents. Recent studies have provided additional evidence for the associations of exposure to synthetic chemicals with certain autoimmune conditions. However, impacts on other autoimmune outcomes, particularly less prevalent conditions, remain unclear. Owing to the ubiquitous nature of many of these exposures and their potential impacts on autoimmune risk, additional studies are needed to better evaluate these relationships, particularly for understudied autoimmune conditions. Future research should include larger longitudinal studies and studies among more diverse populations to elucidate the temporal relationships between exposure-outcome pairs and to identify potential population subgroups that may be more adversely impacted by immune modulation caused by exposure to these chemicals.

Idiosyncratic effects of interviewer behavior on the accuracy of children's responses.

Children are interviewed to provide information about past events in various contexts (e.g., police interviews, court proceedings, therapeutic interviews). During an interview, various factors may influence the accuracy of children's responses to questions about recent events. However, behavioral research in this area is limited. Sparling et al. (2011) showed that children frequently provided inaccurate responses to questions about video clips they just watched depending on the antecedents (i.e., the way a question was asked) and consequences (i.e., the response of the interviewer to their answers). In the current study, we replicated and extended the procedures reported by Sparling et al. and found that two of five children were sensitive to the various antecedents and consequences that we manipulated. Our findings indicate a need for more research in this area to determine the relevant environmental variables that affect children's response accuracy.

Fathers' subjective childbirth stress predicts depressive symptoms at six months postpartum.

BACKGROUND: Childbirth is a seminal experience in parents' lives. However, little research has investigated the link between fathers' birth experiences and their postpartum mental health. We hypothesized that a more subjectively stressful birth will predict greater self-reported depressive symptoms in fathers at six months postpartum. We also investigated the association between mode of delivery and paternal subjective stress. METHODS: Seventy-seven heterosexual fathers expecting their first child and cohabiting with their pregnant partners participated in the study. Depressive symptoms were assessed in pregnancy and again at six months postpartum. Subjective birth stress was measured within the first few days of the birth, and birth charts were collected to examine mode of delivery. RESULTS: Fathers' ratings of subjective birth stress significantly predicted postpartum depressive symptoms at six months postpartum. Subjective birth stress ratings varied significantly for fathers whose partners delivered via emergency cesarean section compared to those whose partners gave birth via both medicated and the unmedicated vaginal delivery. LIMITATIONS: The study was limited by its small community (non-clinical) sample, which was restricted to heterosexual, cohabitating couples. Additionally, births were mostly uncomplicated and only 14 mothers underwent emergency cesarean section. CONCLUSION: These findings highlight that the days immediately following childbirth are a window of opportunity for early intervention in new fathers at risk for postpartum depression.

Dismantling Structural Racism in Child and Adolescent Psychology: A Call to Action to Transform Healthcare, Education, Child Welfare, and the Psychology Workforce to Effectively Promote BIPOC Youth Health and Development.

The field of clinical child and adolescent psychology is in critical need of transformation to effectively meet the mental health needs of marginalized and minoritized youth. As a field, we must acknowledge and grapple with the racist and colonial structures that support the scientific foundation, education and training of psychologists, and the service systems currently in place to support youth mental health in this country. We argue that to effectuate change toward a discipline that centers inclusivity, intersectionality, anti-racism, and social justice, there are four interrelated systems, structures, or processes that currently support racial inequity and would need to be thoroughly examined, dismantled, and re-imagined: (1) the experience of mental health problems and corresponding access to quality care; (2) the school-to-mental healthcare pathway; (3) the child welfare and carceral systems; and (4) the psychology workforce. A "call to action" is issued to address structural racism in these systems and recommendations are provided to guide clinicians, health care systems, educators, welfare and carceral systems, and those involved in training and retaining psychologists in the field in actions they can take to contribute to transformation. We assert that change will only occur when we individually and collectively take responsibility for the roles we have as agents for radical change within the personal and professional contexts in which we live and work. Only then will the field of clinical child and adolescent psychology be able to address the youth mental health crisis and effectively promote the health and well-being of all children.

Use of personal care products during pregnancy and birth outcomes - A pilot study.

Prenatal exposure to endocrine disrupting chemicals (EDCs) from personal care products may be associated with birth outcomes including preterm birth and low birth weight. There is limited research examining the role of personal care product use during pregnancy on birth outcomes. Our pilot study consisted of 164 participants in the Environmental Reproductive and Glucose Outcomes (ERGO) study (Boston, MA), with data on self-reported personal care product use at four study visits throughout pregnancy (product use in the 48 h before a study visit and hair product use in the month before a study visit). We used covariate-adjusted linear regression models to estimate differences in mean gestational age at delivery, birth length, and sex-specific birth weight-for-gestational age (BW-for-GA) Z-score based on personal care product use. Hair product use in the past month prior to certain study visits was associated with decreased mean sex-specific BW-for-GA Z-scores. Notably, hair oil use in the month prior to study visit 1 was associated with a lower mean BW-for-GA Z-score (V1: -0.71, 95% confidence interval: -1.12, -0.29) compared to non-use. Across all study visits (V1-V4), increased mean birth length was observed among nail polish users vs. non-users. In comparison, decreased mean birth length was observed among shave cream users vs. non-users. Liquid soap, shampoo, and conditioner use at certain study visits were significantly associated with higher mean birth length. Suggestive associations were observed across study visits for other products including hair gel/spray with BW-for-GA Z-score and liquid/bar soap with gestational age. Overall, use of a variety of personal care products throughout pregnancy was observed to be associated with our birth outcomes of interest, notably hair oil use during early pregnancy. These findings may help inform future interventions/clinical recommendations to reduce exposures linked to adverse pregnancy outcomes.

Fear of negative evaluation and suicidal ideation among college students: the moderating role of impulsivity-like traits.

Objective: Fear of negative evaluation (FNE) is a key trait of social anxiety and has been linked to isolation and low self-esteem. Impulsivity has been shown to amplify the risk of socially anxious individuals engaging in risky behaviors such as suicidal behaviors; yet little research has examined associations between FNE and suicidality or the relationship between FNE and impulsivity. Participants/Methods: This study tested whether FNE was associated with suicidal ideation in a sample of 1,816 college students from 10 universities. Analyses also examined whether impulsivity-like traits moderated the relationship between FNE and suicidal ideation. Results: Results showed that FNE was significantly associated with suicidal ideation and the positive association between FNE and suicidal ideation was strongest among individuals with higher negative urgency and lower perseverance. Conclusions: These findings highlight FNE as an important risk factor of suicidal ideation in college students and illuminates potential influence of impulsivity on this relationship.

Early-pregnancy plasma per- and polyfluoroalkyl substance (PFAS) concentrations and hypertensive disorders of pregnancy in the Project Viva cohort.

BACKGROUND: Hypertensive disorders of pregnancy (HDP), defined here as hypertensive disorders with onset in pregnancy (i.e., gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension), affect up to 10% of pregnancies in the United States and are associated with substantial maternal and neonatal morbidity and mortality. Per- and polyfluoroalkyl substances (PFAS) are associated with adverse cardiometabolic outcomes during pregnancy, but associations between PFAS and HDP are inconsistent and joint effects of PFAS mixtures have not been evaluated. METHODS: We studied 1,558 pregnant individuals from the Project Viva cohort, recruited during 1999-2002. We quantified concentrations of eight PFAS in plasma samples (median 9.7 weeks of gestation). Using clinical records, we calculated trimester-specific mean systolic (SBP) and diastolic (DBP) blood pressure and categorized HDP status [no HDP (normotensive & chronic hypertension), gestational hypertension, preeclampsia]. We estimated associations of individual PFAS with HDP using multinomial logistic regression and estimated associations with blood pressure using linear regression. We used Bayesian kernel machine regression (BKMR) and quantile g-computation to assess joint effects of the PFAS mixture on HDP and blood pressure measures. RESULTS: Four percent of participants developed preeclampsia and 7% developed gestational hypertension. We observed higher odds of gestational hypertension, but not preeclampsia, per doubling of perfluorooctanoate (PFOA) [OR = 1.51 (95% confidence interval: 1.12, 2.03)], perfluorooctane sulfonate (PFOS) [OR = 1.38 (1.04, 1.82)], and perfluorohexane sulfonate [OR = 1.28 (1.06, 1.54)] concentrations. We observed higher mean DBP per doubling of PFOA [2nd trimester (T2): 0.39 mmHg (-0.01, 0.78); 3rd trimester (T3): 0.56 mmHg (0.14, 0.98)] and PFOS [T2: 0.46 mmHg (0.11, 0.82); T3: 0.43 mmHg (0.05, 0.80)]. The PFAS mixture was positively associated with odds of gestational hypertension [75th vs. 50th percentile: OR = 1.14 (95% credible interval:1.03, 1.25), BKMR] and mean DBP [T2 = 0.17 mmHg (-0.06, 0.40); T3 = 0.22 mmHg (-0.03, 0.48), BKMR]. CONCLUSIONS: These findings suggest that exposure to certain PFAS may increase the odds of gestational hypertension during pregnancy, with potential implications for subsequent maternal and child health outcomes.

Urinary phthalate metabolite concentrations and personal care product use during pregnancy - Results of a pilot study.

INTRODUCTION: Phthalates are reproductive toxicants commonly found in personal care products (PCPs). These endocrine disrupting chemicals are associated with pregnancy complications, including gestational diabetes. Yet, little is known about PCP use as a contributor to urinary phthalate metabolite concentrations in pregnancy. METHODS: We conducted a pilot study among 108 pregnant participants to examine the associations of self-reported PCP use with 14 phthalate and 2 DINCH (di(isononyl) cyclohexane-1,2-dicarboxylate) metabolite concentrations measured in single spot urine samples during pregnancy (median: 36 weeks of gestation). At the time of urine collection, participants self-reported use of hair products (within the last month) and other PCPs (within the last 48 h). We used linear regression to estimate associations for natural log-transformed, specific gravity-corrected concentrations of common PCP-associated phthalate metabolites (monoethyl phthalate [MEP], mono-n-butyl phthalate [MBP], and mono-isobutyl phthalate [MIBP]) in our primary analyses, and additional phthalate metabolites in secondary analyses. RESULTS: Most urinary metabolites were detected for >90% of participants. Participants who reported using hair oil within the past month had MEP concentrations 125% higher (95% confidence interval [CI]: -0.1, 408) than non-users. For other personal care products, we observed the greatest percent difference in PCP-associated metabolites for MIBP among hair gel users (39.3%, 95% CI: -6.3, 107) and for MEP among conditioner/crème rinse users (-55.4%, 95% CI: -76.4, -15.6) compared to non-users. CONCLUSION: Findings suggest that self-reported use of hair oils during late pregnancy may be associated with higher urinary concentrations of MEP. Hair gel use in late pregnancy may also be associated with higher urinary phthalate metabolite concentrations, while conditioner/crème rinse use may be associated with lower levels if MEP.

Reducing impulsive choice: VIII. Effects of delay-exposure training in female rats.

Impulsive choice may play an important role in serious health-related decisions, like addiction tendencies. Thus, there is merit in exploring interventions that reduce impulsive choice. Delay-exposure training involves extended experience with delayed reinforcement. Following training, delay-exposed rats make fewer impulsive choices than control rats. The reducing effects of delay exposure training on impulsive choice have been replicated in male rats seven times. For the first time, this study evaluated the effects of delay exposure training in female rats. Thirty-six rats were randomly assigned to either delay-exposure or immediacy-exposure training. Then, rats underwent two impulsive choice assessments in which they chose between one immediate pellet or three delayed pellets. In the first assessment, delays increased within-sessions, across trial blocks from 0, 8, 16, to 32 s. In the second assessment, delays to the larger reward increased between-sessions, from 8, 16, 32, to 4 s. Unlike findings with male rats, delay-exposure training produced a reduction in impulsive choice only in the initial five sessions in female rats. Possible reasons for the lack of lasting effect in female rats are discussed and future research directions are identified.

Inter-segmental coordination amplitude and variability differences during gait in patients with Ehlers-Danlos syndrome and healthy adults.

BACKGROUND: There is limited research examining gait and inter-segmental coordination in patients with Ehlers-Danlos syndrome. The objective was to compare lower extremity inter-segmental coordination amplitude and variability during gait between patients with Ehlers-Danlos syndrome and healthy adults. METHODS: This cross-sectional study included participants with Ehlers-Danlos syndrome (n = 13) and healthy adults (n = 14). Gait data were acquired using a motion capture system and force plates. Participants ambulated at self-selected speeds for five trials. Inter-segmental coordination was quantified using continuous relative phase, which examined the dynamic interaction between the thigh-shank and shank-foot paired segments (i.e. phase space relation). A 2-way mixed analysis of variance examined the effects of groups (Ehlers-Danlos and healthy) and gait phases (stance and swing phase) on inter-segmental coordination amplitude and between-trial variability. Effect sizes were calculated using Cohen's d. FINDINGS: The Ehlers-Danlos group had greater inter-segmental coordination variability compared to the healthy group for foot-shank and shank-thigh segment pairs in the sagittal plane over stance and swing phases (P = 0.04; small to large effect sizes). The Ehlers-Danlos group also had greater variability in the frontal plane at the foot-shank segment pair during stance phase (P = 0.03; large effect). There were no differences in inter-segmental coordination amplitude between groups (P = 0.06 to 0.85). INTERPRETATION: Patients with Ehlers-Danlos syndrome have more variability between gait trials in lower limb motor coordination than healthy adults. This may be related to the impaired proprioception, reduced strength, pain, or slower gait speed seen in this population.

Endocrine disrupting chemical-associated hair product use during pregnancy and gestational age at delivery: a pilot study.

BACKGROUND: Prenatal endocrine disrupting chemical (EDC) exposure has been associated with increased risk of preterm birth. Non-Hispanic Black women have higher incidence of preterm birth compared to other racial/ethnic groups and may be disproportionately exposed to EDCs through EDC-containing hair products. However, research on the use of EDC-associated hair products during pregnancy and risk of preterm birth is lacking. Therefore, the objective of this pilot study was to estimate associations of prenatal hair product use with gestational age at delivery in a Boston, Massachusetts area pregnancy cohort. METHODS: The study population consisted of a subset of participants enrolled in the Environmental Reproductive and Glucose Outcomes (ERGO) Study between 2018 and 2020. We collected self-reported data on demographics and hair product use using a previously validated questionnaire at four prenatal visits (median: 12, 19, 26, 36 weeks' gestation) and abstracted gestational age at delivery from medical records. We compared gestational age and hair product use by race/ethnicity and used linear regression to estimate covariate-adjusted associations of product use and frequency of use at each study visit with gestational age at delivery. Primary models were adjusted for maternal age at enrollment and delivery method. RESULTS: Of the 154 study participants, 7% delivered preterm. Non-Hispanic Black participants had lower mean gestational age at delivery compared to non-Hispanic White participants (38.2 vs. 39.2 weeks) and were more likely to report ever and more frequent use of hair products. In regression models, participants reporting daily use of hair oils at visit 4 had lower mean gestational age at delivery compared to non-users (ß: -8.3 days; 95% confidence interval: -14.9, -1.6). We did not find evidence of associations at earlier visits or with other products. CONCLUSIONS: Frequent use of hair oils during late pregnancy may be associated with shorter gestational duration. As hair oils are more commonly used by non-Hispanic Black women and represent potentially modifiable EDC exposure sources, this may have important implications for the known racial disparity in preterm birth.

Hormonal activity in commonly used Black hair care products: evaluating hormone disruption as a plausible contribution to health disparities.

BACKGROUND: Certain types of hair products are more commonly used by Black women. Studies show hair products contain several endocrine-disrupting chemicals that are associated with adverse health outcomes. As chemical mixtures of endocrine disruptors, hair products may be hormonally active, but this remains unclear. OBJECTIVE: To assess the hormonal activity of commonly used Black hair products. METHODS: We identified six commonly used hair products (used by >10% of the population) from the Greater New York Hair Products Study. We used reporter gene assays (RGAs) incorporating natural steroid receptors to evaluate estrogenic, androgenic, progestogenic, and glucocorticoid hormonal bioactivity employing an extraction method using bond elution prior to RGA assessment at dilutions from 50 to 500. RESULTS: All products displayed hormonal activity, varying in the amount and effect. Three samples showed estrogen agonist properties at levels from 12.5 to 20 ng/g estradiol equivalent concentrations All but one sample showed androgen antagonist properties at levels from 20 to 25 ng/g androgen equivalent concentrations. Four samples showed antagonistic and agonistic properties to progesterone and glucocorticoid. SIGNIFICANCE: Hair products commonly used by Black women showed hormonal activity. Given their frequent use, exposure to hormonally active products could have implications for health outcomes and contribute to reproductive and metabolic health disparities.

Socioeconomic and racial/ethnic differences in use of endocrine-disrupting chemical-associated personal care product categories among pregnant women.

Personal care products (PCPs) are important and modifiable sources of exposure to endocrine disrupting chemicals (EDCs). Research is limited on how EDC-associated PCP use differs by race/ethnicity and socioeconomic status (SES), particularly during the sensitive period of pregnancy. We investigated differences in PCP use by race/ethnicity and SES among 497 participants in the LIFECODES pregnancy cohort (Boston, Massachusetts). Participants self-reported race/ethnicity, SES indicators (maternal education; insurance status), and recent PCP use via questionnaire at ≤4 prenatal visits. We evaluated trimester-specific differences in use of individual PCP categories by race/ethnicity and SES indicators. We used Poisson regression to estimate trimester-specific mean total product categories used by race/ethnicity and SES indicators. In the first trimester, compared to non-Hispanic White women, Hispanic women reported higher use of hair gel (45% vs. 28%), perfume (75% vs. 39%), and "other" hair products (37% vs. 19%). Compared to women with a college degree, women without a college degree reported higher use of perfume (79% vs. 41%) and bar soap (74% vs. 56%); patterns were similar for insurance status. The estimated mean total product categories used was significantly lower in Asian compared to non-Hispanic White women in all trimesters (e.g., Trimester 1: 4.8 vs. 6.7 categories; p<0.001). Patterns of PCP use differed by race/ethnicity and SES, with implications for potentially modifiable differential EDC exposure and associated pregnancy outcomes.

Selective internal radiation therapy in the management of primary and metastatic disease in the liver.

Selective internal radiation therapy is a type of brachytherapy used to provide targeted radiotherapy, most commonly to treat primary or metastatic disease within the liver. This review outlines current clinical practice, dosimetric considerations, the pre-treatment workup and safety considerations before treatment. It also examines the clinical evidence for its use in patients with both primary and metastatic disease within the liver.

Endocrine-Disrupting Chemical Exposures in Pregnancy: a Sensitive Window for Later-Life Cardiometabolic Health in Women.

Purpose of Review: Pregnancy can be seen as a "stress test" with complications predicting later-life cardiovascular disease risk. Here, we review the growing epidemiological literature evaluating environmental endocrine-disrupting chemical (EDC) exposure in pregnancy in relation to two important cardiovascular disease risk factors, hypertensive disorders of pregnancy and maternal obesity. Recent Findings: Overall, evidence of EDC-maternal cardiometabolic associations was mixed. The most consistent associations were observed for phenols and maternal obesity, as well as for perfluoroalkyl substances (PFASs) with hypertensive disorders. Research on polybrominated flame retardants and maternal cardiometabolic outcomes is limited, but suggestive. Summary: Although numerous studies evaluated pregnancy outcomes, few evaluated the postpartum period or assessed chemical mixtures. Overall, there is a need to better understand whether pregnancy exposure to these chemicals could contribute to adverse cardiometabolic health outcomes in women, particularly given that cardiovascular disease is the leading cause of death in women.