Landmark Study Linking Plastics to Preterm Births, Newborn Deaths Kickstarts Demands To End Regulatory ‘Whack-a-Mole’

The shower curtain hanging in your bathroom. The garden hose coiled on the back porch. The vinyl flooring under your feet. The deodorant on the bathroom shelf. These are not your usual suspects in infant mortality.Yet, a landmark study published in April in the peer-reviewed journal eClinicalMedicine makes a case linking chemicals embedded in all of them to one of the most devastating patterns in global public health: babies born too soon and many of them dying.Researchers led by NYU Langone Health estimated that exposure to di-2-ethylhexylphthalate, known as DEHP, may have contributed to approximately 1.97 million preterm births in 2018 alone — more than eight percent of the world’s total — as well as the deaths of 74,000 newbornsThe study also attributed the endocrine-disrupting chemical to shortened lifespans of newborns and disabilities. A disproportionate number of those affected were located in South Asia, the Middle East, and Africa.Findings in the newest study carry a clear public health imperative, says Associate Research Scientist Sara Hyman of NYU Grossman School of Medicine, who led the research.“By estimating how much phthalate exposure may contribute to preterm birth worldwide, our findings highlight that reducing exposure, especially in vulnerable regions, could help prevent early births and the health problems that often follow,” Ms. Hyman told The New York Sun.Omnipresent, InescapableDEHP is a phthalate, a family of synthetic plasticizers so pervasive in modern manufacturing that scientists have taken to calling them “everywhere chemicals.” Multiple scientific studies trace the impact of phthalates on the endocrine system, which creates and modulates hormone function essential to organ and tissue development, reproduction, neurology, and metabolism.DEHP and DiNP are both phthalate plasticizers — synthetic chemicals added to PVC and other plastics to make them soft and flexible. DEHP has been one of the most widely used for decades; DiNP is its increasingly common industrial replacement. Both are now at the center of a mounting scientific indictment.The core problem for parents and researchers is that these chemicals, which have never been proven safe, are woven into the fabric of daily life by a regulatory system that has repeatedly failed to keep pace with the science, leaving millions of unborn children exposed with no warning label and no real recourse.Phthalates are found in children’s toys, art supplies, food storage containers, vinyl flooring, shower curtains, garden hoses, medical devices, deodorants, nail polishes, perfumes, hair gels, shampoos, soaps, and body lotions. They enter the body through food, air, and dust, often without anyone realizing it.Phthalates and other chemicals “may increase preterm birth risk by disrupting placental function through inflammation, weakened placental adhesion, membrane rupture, and impaired nutrient transfer, but there may be multiple pathways,” Ms. Hyman said.Research on phthalates in 2021 connected the same class of chemicals to between 91,000 and 107,000 premature deaths per year among Americans aged 55 to 64, with cardiovascular disease the leading cause.A separate analysis published last spring linked daily phthalate exposure to more than 356,000 cardiovascular-related deaths worldwide in 2018 among adults aged 55 to 64.The NYU Langone study is notable for its scope: Researchers compiled global exposure data from more than 200 countries and territories, using biomonitoring data from large national surveys conducted in the United States, Europe, and Canada. It is the first analysis to attempt a global estimate of preterm births specifically tied to these two chemicals. The researchers were careful to acknowledge the limits of their findings. Their investigation, they note, was not designed to establish that DEHP and DiNP, alone or in combination, directly cause preterm birth, and the uncertainty range indicated the true impact could be up to four times smaller than the main estimate.Even under the most conservative assumptions, however, they say the results point to a substantial association. Prenatal phthalate exposure “is associated with metabolic perturbations in both the mother and the newborn that point to inflammation, oxidative stress, endocrine disruption, and altered amino acid and neurotransmitter-related pathways,” an associate professor, exposure scientist, and molecular epidemiologist, Donghai Liang, told the Sun. Mr. Liang, who works at Emory University’s Rollins School of Public Health, said his own work reinforces concerns raised by recent research. His paper, recently published in Nature Communications, found that prenatal phthalate exposure was linked to newborn metabolic changes involving tyrosine, tryptophan, serine, serotonin, and thyroxine — compounds relevant to brain development and infant behavior.“Together, these findings suggest that phthalates may contribute to broader metabolic disruption during pregnancy,” said Mr. Liang, “which could create an adverse intrauterine environment and increase vulnerability to preterm delivery.”In plain terms: These chemicals may interfere with the biological machinery of pregnancy itself, destabilizing the hormonal and inflammatory processes that keep a baby developing on schedule.The director of the Center for Climate, Environment, and Health at Brown University’s School of Public Health, Professor Joseph Braun, told the Sun that the mechanism also aligns with his research.Phthalates “may increase the risk of preterm birth by increasing inflammation in the placenta,” Mr. Braun said, noting that prior studies have found phthalate levels during pregnancy are associated with rises in biomarkers of that inflammation — alongside broader hormonal disruption. He is unambiguous about what the findings demand.“It is not realistic to assume that women should have to attempt to reduce their exposure to a reproductive toxicant,” Mr. Braun observes. “This is why we need stronger regulations to protect vulnerable populations from phthalates.”Regulatory Whack-a-Mole What makes the new findings particularly troubling is the behavior of the industry’s latest preferred substitute. When DEHP began facing regulatory pressure, manufacturers pivoted to diisononyl phthalate, or DiNP, marketing it as a safer alternative.The study found that DiNP may pose a risk similar to that of DEHP, having contributed to approximately 1.88 million preterm births worldwide in the same year, along with 64,000 deaths and 5.7 million years of life lost. “Years of life lost” is a public health metric that measures the total years of productive, healthy life that a population will never live — not just how many people died, but how early they died.The chemical industry may have in effect traded one hazard for another, and the science is now catching up.Still, while DiNP was linked to considerable preterm birth in the model, the “uncertainty of these estimates was much greater than for DEHP,” Ms. Hyman acknowledged, cautioning that less is known about these replacements globally and more research is needed.Mr. Liang framed it as a systemic failure.“Once one chemical is shown to be unsafe, it is often replaced by a structurally similar alternative that has been less studied, but not necessarily proven safer,” he said. “We often see a cycle of ‘regrettable substitution,’ where one problematic chemical is replaced by another with similar concerns, while the evidence based on their health impacts is still catching up.”Mr. Braun puts the systemic problem even more matter-of-factly, pointing to a regulatory philosophy that has never demanded upfront proof of safety.“This chemical whack-a-mole game continues to happen with numerous chemical classes,” he explained. “In part, this is because the United States regulatory system has assumed that chemicals are safe until proven otherwise” — a standard he contrasts with the scrutiny applied to medications and medical devices, which must demonstrate both safety and efficacy before reaching the market.The United States has not ignored phthalates entirely. Congress banned DEHP from children’s toys and childcare articles under the Consumer Product Safety Improvement Act of 2008, setting a limit of no more than 0.1 percent in accessible components.On January 6, 2026, the EPA published final risk evaluations for five widely used phthalate chemicals — including DEHP — formally concluding they pose unreasonable risks to workers and the environment, and announced it will move to regulate dozens of their applications.Those forthcoming rules, however, focus on specific industrial and occupational settings, not the ambient consumer exposure that pregnant women and their unborn children face daily.Critically, the final evaluations explicitly exclude food, food additives, food packaging, medical devices, and cosmetics from their scope. These are precisely the exposure routes most relevant to pregnant women, a gap that public health advocates say is compounded by the agency’s reliance on scientific literature that, in some cases, has not been updated since 2019.The EPA’s own risk evaluation explicitly found no consumer products with exposure levels posing unreasonable risk to the general population, a conclusion that public health advocates say underestimates cumulative, real-world exposure.The gap between what regulators restrict and where exposure actually occurs is unsettling. For instance, bans on phthalates in children’s toys do not extend to the food packaging that leaches chemicals into a pregnant woman’s lunch, or the medical tubing an infant in a neonatal intensive care unit receives intravenously.Babies born preterm will be exposed to even more plastics; the very environment designed to save them carries fresh chemical risk.The American Chemistry Council told reporters last year that the EPA had conducted a comprehensive risk evaluation of DiNP — one that the industry itself requested — and concluded it does not pose an unreasonable risk to consumers, the general population, or the environment.What the trade association omitted is that the EPA’s evaluation explicitly excluded food additives, cosmetics, and other consumer exposure pathways from its scope — the very routes through which pregnant women encounter these chemicals daily. The new NYU Langone research directly challenges the broader safety claim.An Unequal BurdenThe global toll is unevenly distributed.The Middle East and South Asia bear 54 percent of the worldwide burden of illness linked to DEHP exposure, a toll attributed to rapidly growing plastics industries and high levels of global plastic waste.Africa, which accounted for 26 percent of health problems from DEHP-linked preterm birth, suffers a disproportionate share of deaths compared with its share of overall premature cases — a reflection, the researchers said, of the region’s higher underlying death toll from preterm birth.The study’s authors called on treaty negotiators currently working on global plastics regulations to consider strong regulatory measures for phthalates as a class, rather than the compound-by-compound approach that has allowed the chemical industry to stay one step ahead of the science for decades.Mr. Liang echoed that call, stressing that individual behavior alone cannot close the gap.“The most effective solutions are upstream,” he said, “including stronger regulations, safer product formulations, better labeling, and improved environmental management and regulatory oversight.”Mr. Braun’s advice to a pregnant woman asking what she can do today is practical yet measured: Eat a balanced diet of minimally packaged and processed foods, avoid storing or heating food in plastic containers.He, too, stressed the limits of personal responsibility in a system built around chemical permissiveness.“While our regulatory system is supposed to consider vulnerable populations like pregnant women and babies, it takes a tremendous amount of effort and evidence to show that these chemicals are harmful,” he said.

Landmark Study Linking Plastics to Preterm Births, Newborn Deaths Kickstarts Demands To End Regulatory ‘Whack-a-Mole’

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