Counseling Patients on Preventing Prenatal Environmental Exposures - A Mixed-Methods Study of Obstetricians

Stotland, Nada L.; Sutton, Patrice; Trowbridge, Jessica; Atchley, Dylan S.; Conry, Jeanne; Trasande, Leonardo; Gerbert, Barbara; Charlesworth, Annemarie; Woodruff, Tracey J.

doi:10.1371/journal.pone.0098771

Cited by 70 publications

(90 citation statements)

References 30 publications

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“…Our study shows that these recommendations are largely followed by perinatal HPs. For example, more than 90% of the HPs questioned pregnant women about smoking and alcohol consumption, and more than 80% gave advice about washing fruits and vegetables, varying diet and thoroughly cooking food (to prevent against toxoplasmosis); these attitudes were consistent with other studies [18,28,29]. …”

Section: Discussionsupporting

confidence: 81%

“…A lack of knowledge (cited by 58% of the HPs) and insufficient or contradictory scientific evidence (55%) have also been cited in other studies on the prevention of environmental risks in general [16] and during pregnancy [18,33]. Only 6% of the perinatal HPs had received training in environmental health.…”

Section: Discussionmentioning

confidence: 99%

“…To date, few studies have specifically dealt with risks related to exposure during pregnancy. In 2014, US obstetricians acknowledged their role in the prevention of prenatal environmental exposure but less than 20% reported routinely asking about environmental exposures, because they felt insufficiently informed [18]. However, these authors did not study the perception of risk related to different environmental factors or the provision of preventive advice that could help to decrease chemical exposure.…”

Section: Introductionmentioning

confidence: 99%

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Perception of Environmental Risks and Health Promotion Attitudes of French Perinatal Health Professionals

Marie

Lémery

Vendittelli

et al. 2016

IJERPH

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The exposure of pregnant women to environmental contaminants is a subject of international concern. However, the risk perception of these contaminants by health professionals (HP) has not been extensively investigated. The main objective of the PERI–HELPE study (Perception of Risk–HEaLth Professionals & Environment Study) was to assess the risk perception of environmental exposure of pregnant women by perinatal HPs. The secondary objectives were to describe the preventive attitudes of perinatal HPs concerning chemicals exposure of pregnant women and to identify the barriers to preventive attitude. A cross-sectional study was performed in 2015 in France. One hundred eighty-nine HPs (obstetricians, midwives, and general practitioners) replied to an online self-administered questionnaire (participation rate: 11%). Carbon monoxide, pesticides and lead were the contaminants most frequently perceived as a high risk for pregnant women. A minority of HPs asked women about their chemical exposure and advised them to reduce exposure. The lack of information, training and scientific evidence in environmental health were the main difficulties declared by the HPs to advise pregnant women. Despite the low response rate, our findings provide important information to encourage French health authorities to take into account the difficulties encountered by HPs and set up appropriate training programs in Environmental health.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perception of Environmental Risks and Health Promotion Attitudes of French Perinatal Health Professionals

Marie

Lémery

Vendittelli

et al. 2016

IJERPH

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“…An article published by AJOG brought attention to EDCs and discussed the worthwhile endeavor of taking histories regarding environmental exposures from mothers before conception and during pregnancy 97 . Although many obstetricians believe that counseling patients would help avoid environmental contaminants, only 45% routinely discuss mercury, 20% discuss pesticides/insecticides, and 5-10% discuss PCBs, BPA, and phthalates during prenatal care 98 . Presumably, obesogens are discussed with even fewer patients.…”

Section: How To Cope With Obesogen Exposurementioning

confidence: 99%

Obesogens: an emerging threat to public health

Janesick¹,

Blumberg²

2016

American Journal of Obstetrics and Gynecology

189

141

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Endocrine disrupting chemicals (EDCs) are defined as exogenous chemicals, or mixture of chemicals, that can interfere with any aspect of hormone action. The field of endocrine disruption is historically rooted in wildlife biology and reproductive endocrinology where EDCs are demonstrated contributors to infertility, premature puberty, endometriosis, and other disorders. Recently, EDCs have been implicated in metabolic syndrome and obesity. Adipose tissue is a true endocrine organ and, therefore, an organ which is highly susceptible to disturbance by EDCs. A subset of EDCs, called “obesogens” promote adiposity by altering programming of fat cell development, increasing energy storage in fat tissue, and interfering with neuroendocrine control of appetite and satiety. Obesity adds more than $200 billion to U.S. healthcare costs and the number of obese individuals continues to increase. Hence, there is an urgent, unmet need to understand the mechanisms underlying how exposures to certain EDCs may predispose our population to be obese. In this review, we discuss the history of obesogen discovery from its origins in reproductive biology to its latest role in the transgenerational inheritance of obesity in mice. We discuss the development of adipose tissue in an embryo, maintenance of adipocyte number in adults, how EDC disruption programs stem cells to preferentially make more adipocytes, the mechanisms by which chemicals can permanently alter the germline epigenome, and whether there are barriers to EDCs in the gametes.

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“…Nevertheless, there is a present need for vigilance in regard to the 586 potential adverse effects of ubiquitous low-level BPA exposure, and it appears desirable 587 to inform women planning or undergoing pregnancy about measures to reduce or avoid 588 EDC exposure (Groff 2010;Stotland et al 2014). M a n u s c r i p t 36…”

mentioning

confidence: 99%