Exposure to endocrine disruptors during pregnancy is associated with an increased risk of congenital malformations requiring surgery

• A study by Parc Taulí analyzes the impact of common chemical substances on fetal development

• The review points to a particularly relevant relationship with male urogenital anomalies and congenital heart disease.

Exposure of pregnant women to certain Chemical substances present in the everyday environment could increase the risk of babies being born with congenital malformations that require pediatric surgery.

This is the main conclusion of a study recently published in the Journal of Pediatric Surgery, led by Bernardo García Núñez i Natalia Alvarez Garcia, pediatric surgeons from the Parc Taulí University Hospital and researchers from the growth and development disorders group of the Parc Taulí Research and Innovation Institute (I3PT).

The team has carried out a systematic review of all available scientific evidence on the relationship between prenatal exposure to so-called endocrine disruptors —substances capable of interfering with the hormonal system— and the risk of congenital malformations with surgical impact during childhood.

What are endocrine disruptors?

Endocrine disruptors include chemical compounds such as phthalates, the bisphenols or some perfluorinated substancesThey are found in very common products, such as plastics, food packaging, cosmetics, cleaning products or non-stick materials. Several studies have shown that these substances are detectable in more than 95% of pregnant women, which implies almost universal exposure during key periods of fetal development.

"These substances interfere with essential hormonal processes during the first weeks of gestation, when organs are forming", explains Núñez. "That's why it's important to understand what real impact they can have on fetal development."

Among the substances analyzed, phthalates—and especially some such as DEHP and DBP—are the ones that show the strongest association with male urogenital malformations. In the case of bisphenols, the results point to a relevant relationship with congenital heart disease.

"These compounds can alter hormonal synthesis, modify the expression of certain developmental genes or generate oxidative stress in developing tissues, mechanisms that help explain the observed relationship," notes Núñez.

The analysis also highlights that exposure during the first trimester of pregnancy is especially critical, as this is when fundamental processes of organogenesis —the phase of embryonic development in which the organs and major systems of the body are formed.

Clinical and preventive implications

Although researchers insist that most pregnancies exposed to these compounds do not result in malformations, the results reinforce the importance of taking environmental factors into account in prenatal care and in the clinical approach to congenital anomalies.

"This work shows that many of these risks are not inevitable. Reducing exposure to certain products during pregnancy may open up a real avenue for prevention," says Álvarez. The study also highlights the need to promote preventive strategies, both from the advice to pregnant women and from the field of public health policies and the regulation of chemical products.

The review represents a very relevant contribution at an international level and consolidates the role of Parc Taulí in research in pediatric surgery and environmental health, with results that can have a direct impact on both clinical practice and public health.