Plastic Additives Linked to Millions of Preterm Births

A Chemical in Cosmetics and Food Packaging May Be Triggering Preterm Births Worldwide

Exposure to a chemical commonly used to make plastic more flexible may have contributed to about 1.97 million preterm births in 2018 alone, or more than 8 percent of the world's total, a new analysis of population surveys shows. The chemical was also linked to the deaths of 74,000 newborns, the researchers further estimate.

The toxin, di-2-ethylhexylphthalate (DEHP), is part of a group of chemicals called phthalates, which appear in cosmetics, detergents, bug repellents, and other household products. Experts have found that these substances can break down into microscopic particles and enter the body through food, air, and dust.

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Global Study Puts a Number on Plastic's Pregnancy Risk - and It's Alarming

Led by NYU Langone Health researchers, the new study focused on preterm birth, which is a major risk factor for lasting learning and developmental issues and is a leading cause of infant death, according to the World Health Organization. The new analysis provides the first global estimate of preterm births connected to exposure to DEHP and explores which parts of the world are most affected, according to the authors. A report on the findings will be published online March 31 in the journal eClinicalMedicine.

"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," said study lead author Sara Hyman, MS.

Past studies have linked DEHP exposure to cancer, heart disease, and infertility, among many other health concerns, added Hyman, an associate research scientist at NYU Grossman School of Medicine. There is also a large body of research connecting the chemical to preterm birth.

According to the new work, DEHP exposure may have contributed to 1.2 million years lived with disability, a measure of all the years that people have lived or will live with illnesses, injuries, and other health issues caused by being born prematurely.

Hyman said that while the phthalate is in widespread use, certain regions are estimated to bear a much larger share of the health impacts than others, with the Middle East and South Asia representing 54 percent of estimated illness from preterm birth. These areas have 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, has a disproportionate share of deaths compared with its share of overall premature cases. The researchers said this reflects the region's higher underlying death toll from preterm birth.

How the Study Was Conducted

For the study, the research team estimated DEHP exposure in 2018 across 200 countries and territories by pulling data from large national surveys in the United States, Europe, and Canada. They also used estimates from earlier investigations to fill in regions that did not have their own data. The team then drew on earlier research that assessed how phthalate exposure may affect preterm birth and combined those findings with their global exposure estimates. Finally, they combined this information with worldwide figures on preterm births and deaths to gauge what share of these outcomes might be linked to DEHP.

The scientists repeated these steps for another phthalate called diisononyl phthalate (DiNP), a common replacement for DEHP. According to the results, DiNP may pose a similar risk as DEHP, having contributed to about 1.88 million preterm births around the world. The financial costs associated with newborn deaths ranged from millions to hundreds of billions of dollars for both phthalates.

A Call for Stronger Oversight

"Our analysis makes clear that regulating phthalates one at a time and swapping in poorly understood replacements is unlikely to solve the larger problem," said study senior author Leonardo Trasande, MD, MPP, the Jim G. Hendrick, MD, Professor of Pediatrics at NYU Grossman School of Medicine. "We are playing a dangerous game of Whac-A-Mole with hazardous chemicals, and these findings highlight the urgent need for stronger, class-wide oversight of plastic additives to avoid repeating the same mistakes."

Dr. Trasande, who is also a professor in the Department of Population Health and director of the Division of Environmental Pediatrics and the Center for the Investigation of Environmental Hazards, cautions that the investigation was not designed to establish that DEHP and DiNP directly or alone cause preterm birth, nor did it take into account other types of phthalates.

In addition, because there is some uncertainty in the data, the researchers looked at a range of possible values rather than just one estimate. This uncertainty range showed that the true impact of DEHP could be up to four times smaller than the main estimate or slightly higher. Even under the most conservative estimates, the results point to a substantial health burden, said Hyman.

Despite the limits of this kind of global modeling, added Hyman, the work lays important groundwork for future studies to confirm and refine these results and begins to fill a major gap in understanding the extent to which plastic chemicals affect preterm birth worldwide.

Funding and Disclosures

Funding for the study was provided by National Institutes of Health grant P2CES033423 and by Beyond Petrochemicals. Along with Hyman and Dr. Trasande, an NYU Langone co-investigator was Jonathan Acevedo, MPH.

Insights, Analysis, and Developments

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by NYU Langone Health / NYU Grossman School of Medicine and published on 2026/03/31, this content may have been edited for style, clarity, or brevity.