Antimicrobials and Pregnancy: Should you Worry?
If you're exposed to triclocarban (TCC), an antibacterial chemical found in soaps and lotions, the chemical may potentially transfer from you to your fetus during pregnancy and can interfere with your baby's lipid metabolism, according to a recent study conducted by Lawrence Livermore National Laboratory. "Our results are significant because of the potential risk of exposure to TCC through contaminated water sources and in the living environment, and the potential adverse effects resulting from this exposure during development," said LLNL biologist Heather Enright, the lead author of the paper. "Early life exposure to TCC has the potential to cause irreversible outcomes due to the fragile nature of organ systems and protective mechanisms in developing offspring."
The study is the first report to take stock of the amount of TCC that transfers from mother to offspring. According to the study, TCC is among the top 10 most commonly detected wastewater contaminants—both in concentration and frequency.
The study was conducted on pregnant mice to see if exposure to TCC would transfer from mother to offspring. It was determined that TCC transferred both during the pregnancy and during nursing, through the breast milk. "Exposure to TCC during development may pose a serious health risk to the developing embryo and fetus, as they are more sensitive to alterations in hormone levels, which may result in changes that often are irreversible," says Enright.
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While studies can sometimes sound scary, it's important to talk to your doctors about the real-world ramifications for you.
One thing to keep in mind? "The study was done on mice and needs confirmation with humans," says Amos Grunebaum, MD, FACOG who specializes in high-risk obstetrics at Weill Cornell Medicine in New York City. More research needs to be done to see if what transpired in animals would carry over to people.
"In recent years, scientists have been paying more attention to the role of environmental hormone disruptors, found in chemicals used in common household products, and how that is having negative impact on human health including reproduction," says Salli Tazuke, MD, who is board certified in both obstetrics and gynecology, and reproductive endocrinology and infertility, and is the co-founder and co-medical director of CCRM San Francisco. However, in terms of the recent study, Dr. Tazuke notes, "The only association reported in this paper was about heavier weight in the offspring." He explains that TCC is commonly found in soap and lotion. Both soap and lotion are lipid rich and hence, products in it are lipid soluble and therefore explains how it can accumulate in lipids in our body. Since the developing baby has to build tissue from all sorts of basic chemicals including lipids, it is not surprising that lipid soluble chemicals can end up in fetal tissue at higher concentrations than in the mother. "Whether this is actually harmful or not is not yet known, however, and that will likely be the next story," he explains. "TCC is known to be another hormone disruptor and hence there may be other effects that we do not yet know. We also do not know if it's tied to a certain dosage. I would caution about jumping to the conclusion that soaps and lotions are harmful and would be careful about what to say before more research is done."
What about avoiding TCC? "At the moment, we do not yet know enough about TCC and harm in human health and in pregnant women," says Dr. Tazuke. "It is hard to avoid soap, deodorants, lotions, toothpastes and again we do not know enough to say pregnant women should avoid them currently. If you do not use soap or antimicrobials, you may be at risk of developing infections and illness."
The truth is being pregnant itself is a time of risk. "Pregnant women are exposed to environmental toxins every day. From secondhand smoke to foods we eat, exposure to potential toxins are everywhere," says Sherry Ross, MD, OB/GYN and women's health expert at Providence Saint John's Health Center in Santa Monica, California. ""This study is an important reminder to pregnant women that even everyday products have a potential negative effect on a growing baby. More research is needed to know exactly what that negative consequence may be."
While Dr. Ross explains that antimicrobials are everywhere—including antibiotics, antifungals, antiprotozoals, antiviral, antiseptics, disinfectants and sanitizers—she says, "I don't think pregnant women should be overly concerned about the findings of this study." Instead she explains that the study reminds pregnant women to be more aware of their surroundings in general, but not to panic. "Everything in moderation is often safe while pregnant, especially for everyday products used during our daily routine. The likelihood of using everyday products causing permanent damage to a growing baby is unlikely."
So what is the take-away for pregnant women? "During pregnancy, and more importantly before you get pregnant, patients should consult with their OB/GYN before using all drugs or any questionable products," says Aisha Siddiqui, MD, FACOG, University of Maryland, CMG Women's Health. "It's important for patients to read labels of their commonly used products and discuss with their OB/GYN as part of their preconception counseling. So even before getting pregnant, they can determine which products may be harmful during pregnancy."
Also, on a final note, this may all be a moot point—as triclocarban is on its way out of household products. "On September 2, 2016, the Food and Drug Administration announced that triclosan and triclocarban must be removed from all antibacterial soap products by late 2017," says Dr. Grunebaum. "While about 80% of all antimicrobial bar soap sold in the United States contains triclocarban, soon this shouldn't be an issue."