Chemical Exposures in Utero: Phthalates and Congenital Heart Defects

Background: Congenital heart defects (CHDs) are the most common type of birth defect. Approximately 80% of CHDs have unknown causes, and phthalates may play a contributing role. Phthalates are ubiquitous environmental chemicals used as plasticizers in a wide range of products, including cosmetics and electronic devices. After entering the body, phthalates bind to the progesterone receptor, which is necessary for fetal development. While multiple studies have explored environmental factors in CHD development, few have examined the effects of phthalates on CHDs in humans. Methods: A literature review was conducted to investigate the relationship between parental occupational phthalate exposure and the risk of CHDs. The databases PubMed and Embase were used. Results: The literature suggests a positive association between paternal occupational exposure to phthalates and an increased risk of CHDs in offspring. Maternal exposures did not demonstrate a statistically significant association. Animal studies propose mechanisms such as mitochondrial dysfunction and reduced fetal heart rate as possible pathways for cardiac developmental disruption. Discussion: Based on the results, fathers should be more actively included in reproductive health guidelines. Future studies should further investigate associations between various environmental toxins, specific types of CHDs, and other congenital anomalies. Conclusion: These findings underscore the need to expand reproductive health and environmental guidelines to reduce phthalate exposure and better protect fetal development.