Endocrine-disrupting chemicals (EDCs) increasingly have been a subject of concern and study in the past few decades. These chemicals can interfere directly or indirectly with normal physiology of endocrine system organs or organs under the influence of hormones. EDCs have been shown to cause a range of adverse effects, such as developmental abnormalities, abnormal growth patterns in children, reproductive abnormalities, hormone-sensitive cancers, and alterations in immune function. Some have been shown to contribute to obesity. Most EDCs are synthetically developed compounds that are ubiquitous in food packaging, consumer products, and the environment. They are found in pesticides, herbicides, plastics, solvents, flame retardants, and in the environment as industrial byproducts and waste. These substances are poorly regulated and exposures are not tracked. It is virtually impossible to avoid contact with EDCs in everyday life. Populations at greatest risk of adverse health effects include fetuses, newborns, and pregnant individuals. Comprehensive preconception and prenatal care can help family members and caregivers identify sources of and minimize EDC exposure in newborns and infants. For individuals, the clinical significance of these exposures is unknown and there is no current role for testing. For patients with possible exposure, a pertinent history should be taken and counseling provided to help minimize exposure.

Case 4. MS is a 26-year-old gravida 1, para 0 patient who comes to your office at 28 weeks’ gestation for a prenatal visit. Her pregnancy has been uneventful and she has no ongoing medical concerns. She plans to breastfeed and pump and store breast milk when she returns to work. At her baby shower, she was given bottles labeled “BPA-free” and in an online parenting group she read information about the effects of bisphenol A (BPA) on the endocrine system. She is worried about BPA exposure for her fetus and would like more information.