AppId is over the quota
A new study finds that exposure to bisphenol A before birth may lead to behavior problems in girls by age 3. The findings, published in Pediatrics, promise to heat up the debate over the safety of BPA, the ubiquitous chemical found in water bottles, linings of cans and even on the register receipts we get at the checkout stand.
Led by Joe Braun, a research fellow at the Harvard School of Public Health, the study suggests that exposure to BPA, especially in developing fetuses, may be long-lasting. Among a group of 244 mothers and their 3-year-olds whose BPA levels were measured in their urine, moms who had higher BPA levels during pregnancy were more likely to have children who were aggressive, anxious and hyperactive and showed poor emotional control, compared with moms with lower levels of BPA. The children's own BPA levels did not have an effect on their behavior patterns.
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The results highlight how important the pregnancy period is to early brain development, and suggest that there are critical windows during which exposure to chemicals like BPA can perhaps permanently influence a child's emotional and behavioral state. "It's possible that the brain is more vulnerable to the effects of BPA during certain parts of pregnancy, such as the early stages, and not as vulnerable later," says Braun. "Certain events take place in the brain, and once they take place, they are done."
Earlier studies in animals have linked BPA exposure in the womb to aggressive and anxious behavior among offspring, and studies in young children have linked the chemical to asthma.
The scientists tested pregnant women for BPA at 16 and 26 weeks gestation and at birth. Their children were tested annually until age 3. About 97% of the moms and children showed some BPA in their urine, confirming previous data from the Centers for Disease Control and Prevention, which show that nearly all Americans have a measurable amount of the chemical in their systems.
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The results held strong even after the researchers adjusted for other possible contributors to the children's behavior, such as breast-feeding, mother's education, depression and marital status, and possible study confounders such as differences in the strength of the urine samples. The results were the first to look at how BPA may affect executive functions of the brain, which regulate reasoning and planning as well as control of emotions. For every 10-fold increase in the mothers' gestational BPA concentrations, the children showed a 9-to-12-point increase in impulsivity and a lack of emotional control.
"The data suggest that at exposures that humans are typically exposed to, there seems to be an effect of BPA on behavior," says Braun.
The effect was more striking in girls than in boys, which hints at differences in the hormonal factors that may regulate development of executive and behavioral activities of the brain. Girls in the study were more than twice as likely as boys to show anxiety and depression if their mothers had been exposed to BPA. It's possible that BPA may be boosting levels of the hormone estradiol in female fetuses, disrupting the normal sexual differentiation of the brain, leading it to become more masculine. In animal studies, the female hormone estradiol has been shown to convert to testosterone in males, resulting in masculinization.
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Braun says it's not exactly clear yet why BPA may affect girl and boys differently, but he is hoping to investigate these results further to find out. More studies will also reveal whether there is a threshold level of BPA that triggers these changes in fetal brain development.
In the meantime, how should an expectant mom reduce her exposure to BPA? The Food and Drug Administration stands by its claim that current use of the chemical in food packaging is safe, but Braun says moms-to-be may reduce their exposure by avoiding canned and packaged foods. Whether or not pregnant women should also avoid handling thermal register receipts is less clear; there's a study currently underway that is investigating whether day-to-day handling of these receipts can significantly increase exposure. "To be precautionary," Braun says, especially for those who work at registers, "it's reasonable to wear gloves."
MORE: Dirty Money: Traces of BPA Found on Currency
Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.
This Tuesday, Oct. 4, 2011 photo shows Debbie Wingard in her office at the University of California-San Diego where she is a professor. Wingard has had breast cancer twice and has been unable to conceive which she believes is due to her mother's use of the drug DES during pregnancy. The drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds. (AP Photo/Lenny Ignelzi)
This Wednesday, Oct. 5, 2011 photo shows Jackie White in Branchville, N.J. White, a breast cancer survivor and a DES daughter who lives in Centerburg, Ohio, north of Columbus, said she had a misshaped uterus and reproductive problems, and found a lump last year that turned out to be breast cancer. Tests showed 20 tumors in one breast, two pre-cancers in the other and spread to her lymph nodes. The drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds. (AP Photo/Julio Cortez)
This Tuesday, Oct. 4, 2011 photo shows Debbie Wingard outside the Stein Clinical Research building at the University of California-San Diego where she is a professor. Wingard has had breast cancer twice and has been unable to conceive which she believes is due to her mother's use of the drug DES during pregnancy. The drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds. (AP Photo/Lenny Ignelzi)
This Wednesday, Oct. 5, 2011 photo shows Jackie White in Branchville, N.J. White, a breast cancer survivor and a DES daughter who lives in Centerburg, Ohio, north of Columbus, said she had a misshaped uterus and reproductive problems, and found a lump last year that turned out to be breast cancer. Tests showed 20 tumors in one breast, two pre-cancers in the other and spread to her lymph nodes. The drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds. (AP Photo/Julio Cortez)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); 
A drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds.Many of these daughters, now over 40, may not even know of their risk if their mothers never realized or told them they had used the drug, a synthetic estrogen called DES.The new study suggests that infertility is twice as common and that breast cancer risk is nearly doubled in these daughters.Debbie Wingard is one of them. The 59-year-old San Diego woman adopted two boys after being unable to conceive and has had breast cancer twice — when she was 39 and 49."There's no knowing what's going to happen as we age. There's always the fear there's going to be another cancer or another outcome," she said. "I don't think I'll ever get to the point where I feel it's behind me."The sons of DES users also face health risks — testicular problems and cysts — but these are less well studied and don't seem to be as common. Even less is known about the third generation — "DES grandchildren." Some research suggests these girls start menstruating late and have irregular periods, possible signs of fertility issues down the road.In the United States alone, more than 2 million women and 2 million men are thought to have been exposed to DES while in the womb and may now want to talk with their doctors about when they should be screened for health problems."We don't want to cause a panic of everyone rushing out thinking they're going to get cervical or breast cancer. They just need to have that conversation with their physician," said Dr. Sharmila Makhija, women's health chief at the University of Louisville.The average woman has about a 1 in 50 chance of developing breast cancer by age 55; for DES daughters it's 1 in 25, the study found. Risks for other health problems vary.DES, or diethylstilbestrol, was widely used in the United States, Europe and elsewhere from the 1940s through the 1960s to prevent miscarriage, premature birth, bleeding and other problems. Many companies made and sold it as pills, creams and other forms.Studies later showed it didn't work. The government told doctors to stop using it in pregnancy in 1971, after DES daughters in their late teens and 20s were found to be at higher risk of a rare form of vaginal cancer. Further research has tied DES to infertility and various pregnancy problems."They've been identified one at a time. Nobody's been able to get the whole picture," said Dr. Robert Hoover, a researcher at the National Cancer Institute. The new study, which he led, "takes the woman and looks at everything that can happen as a result of this drug," and adds evidence for some previously suspected risks like breast cancer, he said.Results are in Thursday's New England Journal of Medicine.The study started in 1992 and involved about 4,600 DES daughters and a comparison group of 1,900 similar women whose mothers had not used DES. Their health was tracked over time through surveys and medical records. Their average age at the last followup was 48.In the study, researchers found these rates of health problems in DES daughters compared to non-exposed women:—Breast cancer, 3.9 percent versus 2.2 percent.—Cervical pre-cancer, 6.9 percent versus 3.4 percent.—Infertility, 33.3 percent versus 15.5 percent.—Early menopause, 5.1 percent versus 1.7 percentThese complications were seen among women who were able to become pregnant:—Preterm delivery, 53.3 percent versus 17.8 percent.—Miscarriage, 50.3 percent versus 38.6 percent.—Tubal pregnancy, 14.6 percent versus 2.9 percent.—Stillbirth, 8.9 percent versus 2.6 percent.—Preeclampsia (high blood pressure during pregnancy), 26.4 percent versus 13.7 percent.The claim of added breast cancer risk is being tested by 53 women in a lawsuit against DES makers under way now in Boston. One of them is Jackie White, 48, who lives in Centerburg, Ohio, north of Columbus. She said she had a misshaped uterus and reproductive problems, and found a lump last year that turned out to be breast cancer. Tests showed 20 tumors in one breast, two pre-cancers in the other and spread to her lymph nodes."I ate a low-fat diet. I exercise faithfully so I was not overweight. I had none of the normal risk factors," she said.When and how often to screen women for breast cancer is the subject of much debate. A government task force recommends that women at average risk of breast cancer get mammograms every other year starting at age 50, and talk to their doctors about screening before then. Many medical groups urge starting at age 40.DES exposure needs to be considered with the whole picture of a woman's risk, said Dr. G. Wright Bates, director of reproductive medicine at the University of Alabama at Birmingham."In some cases, frequent Pap smears and early mammography or breast MRI may be warranted for women with DES exposure," he said.Others are focused on possible risks to the next generation.Sally Keely, who was part of the federal study, and her husband are both offspring of women who took DES during pregnancy. Keely, 49, of Kalama, Wash., had miscarriages and a tubal pregnancy and required fertility treatments to have a daughter, now 9."I would like to push for more funding on the third generation exposed so I would know best how to advise my daughter," she said.Fran Howell, executive director of DES Action USA, an advocacy group based in Jupiter, Fla., adopted a daughter, now 20, after being unable to conceive."So many of the DES daughters worry about problems with their children," she said. "The DES ends with me."___Online:Cancer Institute: http://www.cancer.gov/cancertopics/factsheet/Risk/DES.CDC: http://www.cdc.gov/des/consumers/about/concerns_daughters.htmlAdvocacy group: www.desaction.org___Marilynn Marchione can be followed at http://twitter.com/MMarchioneAPAssociated Press 
This Tuesday, Oct. 4, 2011 photo shows Debbie Wingard in her office at the University of California-San Diego where she is a professor. Wingard has had breast cancer twice and has been unable to conceive which she believes is due to her mother's use of the drug DES during pregnancy. The drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds. (AP Photo/Lenny Ignelzi)
This Wednesday, Oct. 5, 2011 photo shows Jackie White in Branchville, N.J. White, a breast cancer survivor and a DES daughter who lives in Centerburg, Ohio, north of Columbus, said she had a misshaped uterus and reproductive problems, and found a lump last year that turned out to be breast cancer. Tests showed 20 tumors in one breast, two pre-cancers in the other and spread to her lymph nodes. The drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds. (AP Photo/Julio Cortez)
This Tuesday, Oct. 4, 2011 photo shows Debbie Wingard outside the Stein Clinical Research building at the University of California-San Diego where she is a professor. Wingard has had breast cancer twice and has been unable to conceive which she believes is due to her mother's use of the drug DES during pregnancy. The drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds. (AP Photo/Lenny Ignelzi)
This Wednesday, Oct. 5, 2011 photo shows Jackie White in Branchville, N.J. White, a breast cancer survivor and a DES daughter who lives in Centerburg, Ohio, north of Columbus, said she had a misshaped uterus and reproductive problems, and found a lump last year that turned out to be breast cancer. Tests showed 20 tumors in one breast, two pre-cancers in the other and spread to her lymph nodes. The drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds. (AP Photo/Julio Cortez)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); 
