# Exposure to phthalates and OP flame retardants and long-term maternal cardiovascular and metabolic health

> **NIH ES R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2026 · $682,377

## Abstract

ABSTRACT
Cardiovascular disease (CVD) is the leading cause of death among U.S. women, accounting for approximately
1 of every 3 female deaths. Cumulative evidence has identified pregnancy complications as well as fertility
measures, as CVD risk factors. However, there is very limited knowledge on the impact of environmental
exposures during pregnancy and both short and long-term maternal cardiovascular and metabolic health.
Environmental chemicals with potential cardiometabolic impact include phthalates and organophosphate (OP)
flame retardants, which widespread use leads to ubiquitous general population exposure. Experimental studies
demonstrated that both phthalates and OP flame retardants bind to human peroxisome proliferator-activated
receptors (PPARs), a master nuclear receptor that is involved in lipid metabolism regulation. Among subfertile
women enrolled in the Environment and Reproductive Health (EARTH) Study, we observed worse pregnancy
outcomes, including decreased live birth rates, increased pregnancy loss and elevated glucose levels during
pregnancy, with increasing urinary concentrations of phthalate and/or OP flame retardant metabolites.
However, it is unstudied whether phthalate and OP flame retardant exposure during pregnancy is associated
with long-term (midlife) maternal cardiovascular and metabolic health. We propose to evaluate associations of
preconception, pregnancy and midlife urinary phthalate and OP flame retardant metabolite concentrations
(individually and as a mixture) with long-term cardiometabolic health (anthropometry, glucose and lipid
metabolism, blood pressure and inflammatory biomarkers). We will also identify the most important window(s)
of exposure associated with cardiometabolic health, evaluate the joint and interactive effects of urinary
metabolite concentrations and modifiable lifestyle risk factors for CVD (BMI, diet, physical activity, smoking)
with cardiometabolic health, and investigate trajectories of cardiovascular hea

## Key facts

- **NIH application ID:** 11319786
- **Project number:** 5R01ES033651-05
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** BRENDA M BIRMANN; Lidia  Minguez Alarcon
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ES
- **Fiscal year:** 2026
- **Award amount:** $682,377
- **Award type:** 5
- **Project period:** 2022-07-05T00:00:00 → 2027-04-30T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11319786

## Citation

> US National Institutes of Health, RePORTER application 11319786, Exposure to phthalates and OP flame retardants and long-term maternal cardiovascular and metabolic health (5R01ES033651-05). Retrieved via AI Analytics 2026-06-25 from https://api.ai-analytics.org/grant/nih/11319786. Licensed CC0.

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