Preconception and early pregnancy exposure to environmentally and biologically persistent chemicals: impacts on establishing a healthy pregnancy

The National Institute of Environmental Health Sciences awarded the University of Massachusetts $752,690 on August 13, 2026, for research on preconception and early pregnancy exposure to endocrine-disrupting chemicals under the Environmental Health grant program (CFDA 93.113).

The project investigates how exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS), polybrominated diphenyl ethers (PBDEs), and trace elements affects women's reproductive health and the ability to achieve healthy live births. The research leverages secondary data from the Effects of Aspirin in Gestation and Reproduction (EAGER) trial, a preconception cohort that enrolled 1,228 women attempting pregnancy with a history of one to two prior pregnancy losses between 2007 and 2011 across Salt Lake City, Utah; Denver, Colorado; Buffalo, New York; and Scranton, Pennsylvania. The team will add new measurements of preconception PFAS and PBDEs in serum and trace elements in urine from stored biospecimens collected at study enrollment to evaluate the independent and combined impact of these persistent pollutants on reproductive outcomes.

The award is a Project Grant with a performance period extending through May 31, 2031. Work is performed at the University of Massachusetts in Hadley, Massachusetts.

Abstract

Among couples seeking to grow their family, approximately 12-15% will experience infertility and, of those who become pregnant, 25% will be affected by pregnancy loss. Preconception exposure to endocrine-disrupting chemicals, including perfluoroalkyl and polyfluoroalkyl substances (PFAS), polybrominated diphenyl ethers (PBDES), and heavy metals, may disrupt the biologic processes necessary for establishing a healthy pregnancy, including ovulatory function, implantation, endometrial receptivity, and placentation. While exposure to select long-chain PFAS, bpdes, and some heavy metals, such as lead, have decreased in the past years and decades, their persistence in the environment results in continuing population-level exposures in the united states. The endocrine-disrupting properties of PFAS, PBDES, and trace elements are well- established; however, few studies have prospectively investigated their impact, both independently and in mixture, on the ability of women to achieve a healthy live birth. We will leverage a unique cohort study and bring together an interdisciplinary team with expertise in environmental epidemiology, epidemiologic methods, and exposure assessment to provide novel evidence for the impact of PFAS, PBDES, and trace elements on women's reproductive health. We will incorporate secondary data from the effects of aspirin in gestation and reproduction (EAGER) trial, a preconception time-to-pregnancy study that enrolled 1,228 women attempting pregnancy with a history of 1-2 prior pregnancy losses between 2007-2011 from salt lake city, UT; denver, CO; buffalo, NY; and scranton, PA. Using stored biospecimens collected at study enrollment, we will add new measures of preconception PFAS and PBDES in serum and trace elements in urine to evaluate the impact of selected persistent pollutants, separately and in mixture, on ability of women attempting pregnancy to achieve a healthy live birth. To accomplish this, we will evaluate the following 3 study aims: 1) identify the relationship of preconception exposure to PFAS, PBDES, and heavy metals with alterations in reproductive hormones and markers of ovulatory function, 2) determine the impact of preconception exposure to PFAS, PBDES on fecundability, the menstrual cycle-specific probability of pregnancy, and 3) determine the impact of preconception exposure to PFAS, PBDES on risk of pregnancy loss, pregnancy complications, and whether women are able to achieve a healthy live birth. The rich data collected in the EAGER trial provides a unique opportunity to evaluate preconception impacts on earliest detection of pregnancy and pregnancy loss, as well as investigation of biologic underlying mechanisms. Findings will add to the evidence base for policy development around persistent environmental pollutants and provide women and their clinicians critical information around potential environmental risks.