# Pregnancy Exposures to Chemical Mixtures and Later Metabolic Health and Endocrine Function Among Women in the Puerto Rico PROTECT Cohort

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $397,701

## Abstract

A rapidly growing body of research shows that exposure to common environmental chemicals can disrupt
endocrine and metabolic function, and negatively impact pregnancy outcomes and child development. Studies
also demonstrate that certain pregnancy conditions (e.g., preeclampsia) and outcomes (e.g., preterm birth) are
associated with adverse health later in the life of the mother. However, research is lacking on the relationships
between exposures in pregnancy and later health of the mother, and how pregnancy outcomes impact those
associations. Puerto Rico suffers from elevated rates of numerous morbidities compared to the mainland U.S.,
including preterm birth and Type II diabetes. Puerto Rico also has a history of extensive contamination with
increased human exposure to a range of pollutants. We established the PROTECT cohort in the northern coast
of Puerto Rico to study the impacts of exposure to an array of environmental chemicals during gestation and
adverse pregnancy outcomes. We have developed an incredibly rich dataset on exposures, biomarkers of
intermediate effects, questionnaires, and health record information. PROTECT is also a participating cohort
within the newly established US-wide ECHO study, following the development of children born into PROTECT.
We propose building upon this vast dataset and continued recruitment in PROTECT, along with the repeated
participant contact during the ECHO follow-up visits, to investigate status and longitudinal trajectories of
maternal metabolic health and endocrine function for up to five years following pregnancy among 1000 women
in Puerto Rico. We have exposure biomarker data from repeated samples collected in pregnancy on urinary
phthalate metabolites, phenols/parabens, and PAH metabolites, as well as 17 metals measured in both urine
and blood. In this study, with new data and sample collection on PROTECT mothers at 6 months, 1 year, 2
years, and 5 years following delivery, we aim to: 1) Determine whether maternal exposures during pregnancy
are associated with measures and trajectories of metabolic health (i.e., body size, body composition, physical
strength, clinical diagnoses, blood pressure, and blood glucose, insulin, lipids, HbA1c) in short- and long-term
follow-up assessments after delivery; 2) Investigate the relationships between maternal exposures during
pregnancy and longitudinal measures of endocrine function (e.g., estradiol, testosterone, SHBG, FSH and
AMH) in the follow-up assessments after delivery; and 3) Explore effect modification of the associations
between pregnancy exposures and later women’s health from the first two aims by pregnancy complications
(gestational diabetes, preeclampsia, preterm birth), and/or by social determinants (socioeconomic status,
social support, depression, stress, life experiences, and others) and other physical determinants of health
(body size, physical activity, breast feeding, polycystic ovarian syndrome, menstrual patterns, and others). The
expect...

## Key facts

- **NIH application ID:** 10245293
- **Project number:** 5R01ES032203-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Carrie Anne Karvonen-Gutierrez
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $397,701
- **Award type:** 5
- **Project period:** 2020-08-21 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10245293

## Citation

> US National Institutes of Health, RePORTER application 10245293, Pregnancy Exposures to Chemical Mixtures and Later Metabolic Health and Endocrine Function Among Women in the Puerto Rico PROTECT Cohort (5R01ES032203-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10245293. Licensed CC0.

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