BPA and Fetal Health Outcomes

EHOH 6614 Group 2

Navjot Kaur, Jennifer Piwonski, Danielle Reynolds,

Sara Schievelbein & Alexandra Schneider

General Overview of BPAWhat is BPA?• Bisphenol A (BPA) is a chemical used to make polycarbonate plastics that

are used in some food/drink packaging (e.g, water bottles, sippy cups, baby bottles) and epoxy resins that can be used to coat metal products (e.g., food cans, bottle tops)

Why should people be concerned about BPA?• BPA used in food/drink containers can seep into food

o BPA in baby bottles and infants’ sippy cups is especially concerning

• Widespread human exposure to BPA

• Possible health effects of BPA on the brain, behavior in fetuses, infants and children

BPA Exposure● Exposure is ubiquitous

● More than 90% of us have BPA in our bodies right now

● Exposure to BPA is predominantly oral through dietary intake

● BPA can also be absorbed in the mouth and can pass directly into the bloodstream bypassing detoxification in the liver

● BPA also readily passes through the skin

BPA as an Endocrine Disruptor• Endocrine disruptors are chemicals that may interfere with the body’s

endocrine system and produce adverse developmental, reproductive, neurological and immune effects in humans.

• BPA’s molecular structure is similar to that of estradiol, one of the human body’s three main estrogens, suggesting that BPA binds to estrogen receptors.

• MBP a metabolite of BPA: a molecule produced when BPA is metabolized or broken down by the body has a 100-fold to 1,000-fold stronger bond to the estrogen receptor than BPA.

• In binding to the estrogen receptor, BPA can disrupt the body’s endocrine or hormone system, with consequences especially worrisome for fetuses, infants and young children.

BPA Metabolism• Upon ingestion, free BPA is carried through the digestive system where

it is absorbed in the gastrointestinal tract and taken to the liver for metabolism.

• BPA’s inactive metabolites and free BPA can cross the placenta barrier and can remain in its estrogenically active form in fetus.

• Fetuses are exposed to much higher doses of free BPA than adults due to immaturity of the fetus's metabolic system.

• Exposure to estrogens during this time of development can cause adverse effects in development of many organs and systems.

Fetal Outcome: Low Birth Weight

• In a 2011 study, 50 mothers with occupational exposure to BPA during

pregnancy, had lower birth rate children than 444 mothers who did not

have exposure to BPA.

• Kaiser Permanente found a decrease in birth weight among children

whose mothers were exposed to high levels of BPA in 2011.

• A pilot study of a Mexican birth cohort found women who delivered

premature infants to have higher BPA concentrations.

• The Generation R study reported in 2013 that high concentrations of BPA

in prenatal urine may result in lower fetal weight or head circumference.

Effect of BPA on Birth Weight • Fetus liver unable to metabolize BPA

• Inappropriate exposure during critical times of fetal development has an effect on fetal growth

• Fetal exposure to diethylstilbestrol (DES), which has similar chemical structure as BPA, has been found to be associated with growth restrictions during gestation

• University of California San Francisco and University of Michigan are both currently conducting a studies to examine the relationship between BPA and fetal development

Low Birth Weight Health Outcomes

• Higher rates of subnormal growth, poor neurodevelopment and

illnesses

• Decreased brain and reproductive tract development

• Pulmonary problems, respiratory distress syndrome

• Heart problems

• Alterations in metabolic enzymes and tissues

• Feeding concerns

Adverse Health Outcomes in Male Fetuses• Lower sperm count

● Poor sperm motility

● Decreased levels of testosterone, estrogen, and other

reproductive hormones

● Shortened Anogenital distance (AGD)

● Increased size of prostate

● Possible fertility issues

Fetal Outcomes: Males• In a 2011 occupation cohort study, 153 sons of BPA-exposed Chinese

workers and non-exposed Chinese workers were analyzed to determine

the effect of in utero BPA exposure on male offspring.

● Parental occupational exposure to BPA during pregnancy was associated

with shortened AGD in male offspring.

● There was a strong dose-response relationship with increased BPA

exposure levels in pregnancy associated with greater magnitude of

shortened AGD in male offspring.

Fetal Outcomes: Males ● Rodent Study

● Effects BPA had on the male rodent offspring: lower sperm

count, poor sperm motility, cellular defects in testes, lower levels of

testosterone, estrogen and other reproductive hormones.

● Other findings:

○ The male offspring that were exposed were heavier than

the control offspring

○ Observations suggest that the exposed male offspring had lower

sexual motivation

○ Sons and grandsons of the exposed rats were subfertile

Adverse Health Outcomes in Female Fetuses• Change in taste preference

• Masculinization

• Recurrent miscarriage

• Oxidative stress and inflammation in postmenopausal women

• Externalizing behaviors in two-year old female children

Fetal Outcomes: Females• A 2011 rodent study showed increased masculinization of females when

exposed to BPA.

• A 2011 study using the rhesus monkey found that prenatal exposure to

BPA causes changes in female primates' uterus development.

• A 2009 rodent study found that BPA, at the reference safe limit for

human exposure, was found to impact intestinal permeability and may

represent a risk factor in female offspring for developing severe colonic

inflammation in adulthood.

• A 2007 rodent study showed that BPA changes the expression of key

developmental genes that form the uterus.

Action Taken in Public Health● Food and Drug Administration (FDA)

○ BPA is safe at low levels (i.e. levels found in food)○ Supports reasonable steps to reduce BPA exposure such as

industry’s actions to stop producing BPA-containing bottles and infant feeding cups and facilitating development of alternatives to BPA

● National Toxicology Program (NTP)○ “Some concern” for effects on the brain, behavior, and prostate

gland○ “Minimal concern” for effects on the mammary gland earlier onset of

puberty○ “Negligible concern” that exposure of pregnant women to BPA will

result in fetal or neonatal mortality, birth defects, or reduced birth weight and growth in their offspring

Gaps in Action Taken by Public Health

• Additional Research Neededo Insufficient data from human studies to reach a conclusion

about the reproductive or developmental risks of BPA exposure.

• Communicationo Challenging to effectively communicate information on BPA

when uncertainty exists.

Works CitedBraniste, V., A. Jouault, E. Gaultier, A. Polizzi, C. Buisson-Brenac, M. Leveque, P. G. Martin, V. Theodorou, J. Fioramonti, and E. Houdeau. "Impact of oral bisphenol A at reference doses on intestinal barrier function and sex differences after perinatal exposure in rats." Proceedings of The National Academy of Sciences 107.1 (2010): 448-53. Web. 22 Mar. 2014.

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Myers, J. P. (2013). Bpa is absorbed in the mouth; could explain high blood levels. EnvironmentalHealth News , Retrieved from http://www.environmentalhealthnews.org/ehs/newscience/2013/06/2013-0614-bpa-absorbed-in-the-mouth

National Institute of Enviornmental Health Sciences. Endocrine disruptors. Retrieved from http://www.niehs.nih.gov/health/materials/endocrine_disruptors_508.pdf

Works CitedNational Institute of Enviornmental Health Sciences. Endocrine disruptors. Retrieved from http://www.niehs.nih.gov/health/materials/endocrine_disruptors_508.pdf

National Toxicology Program. Bisphenol A (BPA). Retrieved from http://www.niehs.nih.gov/health/assets/docs_a_e/bisphenol_a_bpa_508.pdf.

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