Wednesday, October 9, 2024

New Data Finds That Parabens and Phenols Might Lead to Hypertension During Pregnancy—How Bad Is This?

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A positive pregnancy test might be a cue to overhaul your beauty routine—cancel that injectable appointment, shelve your retinoids, rethink fragrance. Now, you can add parabens (the already controversial preservative used in some personal care products) and phenols (man made chemicals and naturally-occurring substances that may be used as preservatives or plasticizers, in plastic water bottles, packaging, and more) to the list of things you might want to avoid when you’re pregnant, since there’s new research to suggest that both may increase your risk of hypertension during pregnancy.

Today, a study was published in the journal Environmental Health Perspectives that followed more than 1,400 women throughout their pregnancies, measuring their blood pressure between 16 and 20 weeks, then again between 24 and 28 weeks. The researchers also tested urine for biomarkers associated with 12 chemicals found in personal-care products as well as in food and plastic, including bisphenol A (BPA), triclosan, methyl paraben, propylparaben, butyl paraben, and ethyl paraben.

They found that exposure to both parabens and phenols was associated with an increased risk of hypertension—essentially, high blood pressure—during pregnancy, especially in the third trimester. “We looked at the exposures in the first trimester and hypertension in the third trimester,” says Julia Varshavsky, Ph.D., a professor of environmental health at Northeastern University and the lead author of the study. “That showed us that the chemicals in early pregnancy actually matter for later in pregnancy.”

This is especially concerning since hypertensive disorders are the leading cause of pregnancy-related death in the US, contributing to heart attacks and strokes, according to the Centers for Disease Control and Prevention. Even more worrisome: Hypertension during pregnancy is becoming more common, with one study finding that rates doubled between 2008 and 2021.

While the exact way parabens and phenols might increase the risk of hypertension is fuzzy at best, one potential link is the cardiovascular system, which undergoes a huge change when you’re pregnant—your body creates brand-new arteries during placenta development and your blood volume increases, for instance. “Hypertension and hypertensive diseases of pregnancy are characterized by oxidative stress and inflammation during that time period [in early pregnancy],” says Dr. Varshavsky. And the chemicals the researchers measured have previously been shown to increase inflammation and oxidative stress.

Another possible pathway is your endocrine system. “We know these chemicals are hormonally active, which means they can interfere with that normal hormone signaling that occurs to govern that whole process [of cardiovascular changes in the body during early pregnancy],” Dr. Varshavsky says. So, in messing with your hormones, they may inadvertently cause an uptick in your blood pressure.

Let’s pause for a moment: If you’re pregnant, thinking about getting pregnant, or just a person freaked out about how your moisturizer might be trying to destroy you, the findings are scary—and worth factoring into your personal-care decisions, especially if you’re trying to create a safe environment for your growing baby.

But there are some big things worth keeping in mind with these findings. First, “just because you detect something doesn’t mean that it’s the cause,” says Kelly Dobos, a cosmetic chemist in Cincinnati, Ohio. Dr. Varshavsky told Allure this herself: “There are a lot of things that can contribute to increased risk of hypertension, including during pregnancy,” she says. Factors like stress, diet, and lifestyle can all contribute to high blood pressure, and it’s tough to account for what she calls “unmeasured confounders,” which are other things that could be driving a given outcome.

The presence of other factors are almost impossible to avoid with human epidemiological studies like this one. “No study is perfect at adjusting for all the important confounders,” Dr. Varshavsky acknowledges. But the large number of participants and various reasons they excluded people—for known medical conditions, for instance—make her feel confident in the results.

Also worth considering is that both parabens and phenols exist far beyond the beauty realm. Phenols aren’t really used at all in cosmetics at all, says Dobos; they used to be found in packaging, where they’re used as plasticizers to make bottles and tubes more flexible. (You might already know and steer clear of BPA in single-use water bottles, for example.) And the participants in the study live in Puerto Rico, which is one of the most polluted areas in the world; it’s home to 18 Superfund sites, which are contaminated areas filled with hazardous waste. “So you have this cohort that is also exposed to these Superfund sites,” says Dobos. “This area is very likely to contaminate the groundwater and possibly drinking water.” (The study was conducted under the PROTECT Center at Northeastern, which has been investigating prenatal exposure to chemicals and adverse pregnancy outcomes in Puerto Rico since 2010.)

Parabens, meanwhile, are still used in cosmetics; notably, they’re considered safe by governing organizations worldwide—including in Europe, which is usually held up as the standard bearer for “clean” beauty. But skepticism around parabens’ potential as an endocrine disruptor abounds, which is why Dobos has seen a shift firsthand. “I believe the overall rate of paraben usage in the past few years has declined significantly,” she says, noting that this is based on her own formulating work. However, the anti-paraben movement hasn’t quite come for all the other sources of parabens out there. “Parabens are used in food,” she says; they act as preservatives here, too. All to say: It’s hard to say where the phenols and parabens measured in the study are coming from in the first place. Is it the bread? The tap water? The body lotion? There’s no way to know for sure.

So, should you rethink your beauty products that contain parabens? The best answer we’ve got right now is…maybe? Most of the guidance around beauty products during pregnancy is based on what we don’t know—basically, because it’s not possible to ethically test pregnant people to determine the safety of, say, a topical retinol cream or Botox injections, the advice is to simply go without.

In the case of parabens, this study makes the evidence a little firmer, although again, it still doesn’t definitively say whether phenols and parabens cause hypertension so much as they’re associated with it. If you’d rather stick with the status quo of erring on the side of caution, Dr. Varshavsky points to the Environmental Working Group’s Skin Deep database as a good resource for finding ingredients to avoid while pregnant or breastfeeding. And, generally, “looking for products that have the label paraben-free is also a good idea,” she says.

Also worth noting is that both of the (potential, very much yet to be proven) pathways between these compounds and hypertension is that they’re pretty unique to pregnant people, meaning the general population may not have much to worry about just yet. But pregnant or not, these ingredients may be worth revisiting based on your personal risk tolerance.

Ultimately, as it happens so often during pregnancy, there’s no right or perfect answer here. But the study indicates that there’s a link, though not a clear cause, for hypertension during pregnancy—and may lead the way to better, easier, and safer decisions in the future.

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