MATERNAL EXPOSURE TO ENDOCRINE DISRUPTORS AND INFANT DEVELOPMENT: FINDINGS FROM THE LIFE MILCH COHORT STUDY

Endocrine disruptors (EDs) are environmental chemicals capable of interfering with the endocrine system especially during critical developmental periods. Exposure to EDs is pervasive and occurs from conception through the entire individual's lifespan. Major sources of exposure derive from plastics, including micro- and nano-plastics, packaging, food and beverage containers, industrial chemicals, pesticides, cosmetics and personal care products. Several scientific studies report evidence linking the exposure to EDs (in utero or via breastfeeding) to a variety of health and reproductive outcomes, such as precocious puberty, obesity, and diabetes, decreased sperm production, thyroid disease, neurobehavioral disorders. The Life MILCH project (Mother and Infant dyads: Lowering the impact of endocrine disrupting chemicals in milk for a Healthy Life) is a longitudinal prospective cohort study which aims at assessing EDs in breastmilk in relation to mothers’ life and nutritional habits and their effects on infant development during the 1st year of life. To this aim, 690 pregnant women were enrolled in 3 different hospitals (Parma, Reggio Emilia and Cagliari), and recalled with their children at 1 (T1), 3 (T2), 6 (T3) and 12 (T4) months of age for assessing infant growth and neurobehavioral development and collecting urine and breastmilk samples. At any timepoint, mothers filled questionnaires on their lifestyle and nutritional habits. Biological samples were analyzed for 42 different EDs. Our results showed that bisphenols, phthalates, and parabens were detected in more than 50% of breastmilk and urine samples. Significant associations were observed between mothers' lifestyle and diet and ED levels and the presence of a specific chemical in maternal samples was significantly associated with its detection in their infants. While all children showed normal development, several negative correlations emerged between maternal bisphenol and phthalate levels and specific neurodevelopmental scores at T3 and T4. By integrating these environmental, lifestyle, and developmental data, we built a risk assessment model to identify exposure sources. Based on this evidence-driven model, an awareness campaign was developed to reduce maternal ED exposure, targeting pregnant women, breastfeeding mothers, women of childbearing age, and health professionals. The effectiveness of this campaign is currently being evaluated through biomonitoring of ED levels in breastmilk and assessment of infant exposure and development at 6 months of age (II screening phase, ongoing). The findings from the Life MILCH project will provide a scientific basis for developing intervention strategies and public health policies aimed at preventing and reducing ED exposure, particularly among vulnerable populations.