Hormoonverstorende stoffen

Geschreven door: Nil Schubert
Gepubliceerd op: 20 december 2024

Hoi, mijn naam is Nil Schubert. Qua achtergrond ben ik hier misschien een vreemde eend in de bijt; ik ben namelijk medisch bioloog, met weinig wetenschappelijke kennis van de verloskunde. Mijn expertise ligt vooral op het gebied van de moleculaire biologie en de oncologie, maar óók bij het doen van literatuuronderzoek. Ik vind dat ieder mens recht heeft op juiste, goed onderbouwde en zoveel mogelijk ongekleurde informatie. Ik vind het heel leuk om die wetenschappelijke informatie om te zetten naar begrijpelijke taal. Sinds mijn eigen zwangerschap en de geboorte van mijn dochter in 2023, is mijn interesse in alles wat met zwangerschap te maken heeft gewekt. En omdat Vraag de Vroedvrouw een kennisbank naar mijn hart is, leek het me ontzettend leuk om hiervoor te schrijven.

Hormoonverstorende stoffen zijn de laatste jaren veel in het nieuws. Vrijwel iedereen heeft inmiddels wel van PFAS en BPA gehoord, maar het is niet bij iedereen bekend dat er veel méér stoffen zijn met hormoonverstorende eigenschappen. Deze stoffen kunnen in allerlei producten zitten die we dagelijks eten of gebruiken.

Hoewel de hoeveelheid van losse hormoonverstoorders in de EU streng gereguleerd wordt, maken wetenschappers zich zorgen om het feit dat mensen worden blootgesteld aan veel verschillende stoffen en gedurende lange perioden. Het is lastig om goed onderzoek te doen naar de gevolgen van blootstelling aan hormoonverstorende stoffen. Desondanks wordt vermoed dat de toename in onvruchtbaarheid, genitale afwijkingen en hormoongevoelige kankers deels is toe te schrijven aan deze stoffen.

Welke exacte risico’s de blootstelling aan hormoonverstoorders met zich meebrengt, is dus lastig te zeggen. Dit is namelijk afhankelijk van verschillende factoren, zoals de geografische locatie, de mate en duur van blootstelling en iemands individuele gevoeligheid. Wat we wél weten, is dat mensen in bepaalde levensfasen extra kwetsbaar zijn. Het gaat hierbij vooral om zwangere vrouwen en hun ongeboren kind, baby’s, jonge kinderen en kinderen in de puberteit.

In dit artikel gaan we in op wat hormoonverstorende stoffen precies zijn en in welke producten ze voornamelijk kunnen zitten. We behandelen ook het (mogelijke) effect van hormoonverstoorders op de vruchtbaarheid van zowel vrouwen als mannen. Ook de invloed van blootstelling op het verloop van de zwangerschap en het ongeboren kindje wordt besproken. Tot slot is er ook aandacht voor hormoonverstorende stoffen in de postpartumperiode.

We zijn ons ervan bewust dat de inhoud van dit artikel overweldigend kan zijn. Het is zeker niet ons doel om iedereen bang te maken. Wel willen we jullie bewust maken van de mogelijke gevolgen van een hoge blootstelling aan hormoonverstorende stoffen, zodat iedereen voor zichzelf de risico’s beter kan inschatten. Door een paar simpele dingen (in de loop van de tijd) te veranderen, kun je de blootstelling al verminderen. Aan het einde van het artikel geven we hiervoor wat tips.

Acoglu, B., & Omeroglu, P. Y. (2021). Effectiveness of different type of washing agents on reduction of pesticide residues in orange (Citrus sinensis). LWT, 147, 111690. https://doi.org/https://doi.org/10.1016/j.lwt.2021.111690 Adu-Gyamfi, E. A., Rosenfeld, C. S., & Tuteja, G. (2022). The impact of bisphenol A on the placenta. Biology of Reproduction, 106(5), 826–834. https://doi.org/10.1093/biolre/ioac001 Alavian-Ghavanini, A., Lin, P.-I., Lind, P. M., Risén Rimfors, S., Halin Lejonklou, M., Dunder, L., Tang, M., Lindh, C., Bornehag, C.-G., & Rüegg, J. (2018). Prenatal Bisphenol A Exposure is Linked to Epigenetic Changes in Glutamate Receptor Subunit Gene Grin2b in Female Rats and Humans. Scientific Reports, 8(1), 11315. https://doi.org/10.1038/s41598-018-29732-9 Albadrani, M. S., Aljassim, M. T., & El-Tokhy, A. I. (2024). Pesticide exposure and spontaneous abortion risk: A comprehensive systematic review and meta-analysis. Ecotoxicology and Environmental Safety, 284, 117000. https://doi.org/https://doi.org/10.1016/j.ecoenv.2024.117000 Baartman, M. (2015). Hormoonverstorende stoffen op de kinderafdeling: schadelijk en onnodig. Nataal, 26. https://www.nataal.nl/artikelen/artikelen/zorg-na-geboorte/hormoonverstorende-stoffen-op-de-kinderafdeling-schadelijk-en-onnodig-4145/ Bakker, J., Biesenbeek, J.-D. te, Boon, P., Bos, P., Broekhuizen, F. van, Geertsma, R., Liesbeth, Mennes, W., Palmen, N., Piersma, A., Schuur, G., Sijm, D., Ven, L. van der, Verbist, K., Wouters, M., & Zeilmaker, M. (2014). Bisphenol A part 1. Facts and figures on human and environmental health issues and regulatory perspectives. In RIVM Report 601351001/2014 (RIVM Report 601351001/2014). Boberg, J., Taxvig, C., Christiansen, S., & Hass, U. (2010). Possible endocrine disrupting effects of parabens and their metabolites. In Reproductive Toxicology (Vol. 30, Issue 2, pp. 301–312). Elsevier Inc. https://doi.org/10.1016/j.reprotox.2010.03.011 Bouchard, M. F., Bellinger, D. C., Wright, R. O., & Weisskopf, M. G. (2010). Attention-deficit/hyperactivity disorder and urinary metabolites of organophosphate pesticides. Pediatrics, 125(6), e1270-7. https://doi.org/10.1542/peds.2009-3058 Bowman, A., Peterson, K. E., Dolinoy, D. C., Meeker, J. D., Sánchez, B. N., Mercado-Garcia, A., Téllez-Rojo, M. M., & Goodrich, J. M. (2019). Phthalate Exposures, DNA Methylation and Adiposity in Mexican Children Through Adolescence. Frontiers in Public Health, 7, 162. https://doi.org/10.3389/fpubh.2019.00162 Braun, J. M. (2017). Early-life exposure to EDCs: role in childhood obesity and neurodevelopment. Nature Reviews. Endocrinology, 13(3), 161–173. https://doi.org/10.1038/nrendo.2016.186 Buck Louis, G. M., Rios, L. I., McLain, A., Cooney, M. A., Kostyniak, P. J., & Sundaram, R. (2011). Persistent organochlorine pollutants and menstrual cycle characteristics. Chemosphere, 85(11), 1742–1748. https://doi.org/10.1016/j.chemosphere.2011.09.027 Carlsen, E., Giwercman, A., Keiding, N., & Skakkebaek, N. E. (1992). Evidence for decreasing quality of semen during past 50 years. BMJ (Clinical Research Ed.), 305(6854), 609–613. https://doi.org/10.1136/bmj.305.6854.609 Caserta, D., Costanzi, F., De Marco, M. P., Di Benedetto, L., Matteucci, E., Assorgi, C., Pacilli, M. C., Besharat, A. R., Bellati, F., & Ruscito, I. (2021). Effects of Endocrine-Disrupting Chemicals on Endometrial Receptivity and Embryo Implantation: A Systematic Review of 34 Mouse Model Studies. International Journal of Environmental Research and Public Health, 18(13). https://doi.org/10.3390/ijerph18136840 Cooper, G. S., Klebanoff, M. A., Promislow, J., Brock, J. W., & Longnecker, M. P. (2005). Polychlorinated biphenyls and menstrual cycle characteristics. Epidemiology (Cambridge, Mass.), 16(2), 191–200. https://doi.org/10.1097/01.ede.0000152913.12393.86 Costa, E. M. F., Spritzer, P. M., Hohl, A., & Bachega, T. A. S. S. (2014). Effects of endocrine disruptors in the development of the female reproductive tract. Arquivos Brasileiros de Endocrinologia e Metabologia, 58(2), 153–161. https://doi.org/10.1590/0004-2730000003031 Czarnywojtek, A., Jaz, K., Ochmanska, A., Zgorzalewicz-Stachowiak, M., Czarnocka, B., Sawicka-Gutaj, N., ZioŁkowska, P., Krela-Kazmierczak, I., Gut, P., Florek, E., & RuchaŁa, M. (2021). The effect of endocrine disruptors on the reproductive system - Current knowledge. European Review for Medical and Pharmacological Sciences, 25(15), 4930–4940. https://doi.org/10.26355/eurrev_202108_26450 Darbre, P. D. (2018). Overview of air pollution and endocrine disorders. International Journal of General Medicine, 11, 191–207. https://doi.org/10.2147/IJGM.S102230 Diamanti-Kandarakis, E., Bourguignon, J.-P., Giudice, L. C., Hauser, R., Prins, G. S., Soto, A. M., Zoeller, R. T., & Gore, A. C. (2009). Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocrine Reviews, 30(4), 293–342. https://doi.org/10.1210/er.2009-0002 Dutta, S., Haggerty, D. K., Rappolee, D. A., & Ruden, D. M. (2020). Phthalate Exposure and Long-Term Epigenomic Consequences: A Review. Frontiers in Genetics, 11(May), 1–27. https://doi.org/10.3389/fgene.2020.00405 Endocrine Society. (2022). Common EDCs and Where They Are Found. https://www.endocrine.org/topics/edc/what-edcs-are/common-edcs Gingrich, J., Ticiani, E., & Veiga-Lopez, A. (2020). Placenta Disrupted: Endocrine Disrupting Chemicals and Pregnancy. Trends in Endocrinology and Metabolism, 31(7), 508–524. https://doi.org/10.1016/j.tem.2020.03.003 Golub, M. S., Collman, G. W., Foster, P. M. D., Kimmel, C. A., Rajpert-De-Meyts, E., Reiter, E. O., Sharpe, R. M., Skakkebaek, N. E., & Toppari, J. (2008). Public health implications of altered puberty timing. Pediatrics, 121(SUPPL.3). https://doi.org/10.1542/peds.2007-1813G Ha, S., Ghimire, S., & Martinez, V. (2022). Outdoor Air Pollution and Pregnancy Loss: a Review of Recent Literature. Current Epidemiology Reports, 9(4), 387–405. https://doi.org/10.1007/s40471-022-00304-w Hlisníková, H., Petrovičová, I., Kolena, B., Šidlovská, M., & Sirotkin, A. (2020). Effects and mechanisms of phthalates’ action on reproductive processes and reproductive health: A literature review. In International Journal of Environmental Research and Public Health (Vol. 17, Issue 18, pp. 1–37). MDPI AG. https://doi.org/10.3390/ijerph17186811 Hubinger, J. C., & Havery, D. C. (2006). Analysis of consumer cosmetic products for phthalate esters. Journal of Cosmetic Science, 57(2), 127–137. IKNL (2024). Netherlands Cancer Registry (NCR), Netherlands Comprehensive Cancer Organisation (IKNL). Derived via nkr-cijfers.iknl.nl, on 28-11-2024. Jacobson, M. H., Stein, C. R., Liu, M., Ackerman, M. G., Blakemore, J. K., Long, S. E., Pinna, G., Romay-Tallon, R., Kannan, K., Zhu, H., & Trasande, L. (2021). Prenatal Exposure to Bisphenols and Phthalates and Postpartum Depression: The Role of Neurosteroid Hormone Disruption. The Journal of Clinical Endocrinology and Metabolism, 106(7), 1887–1899. https://doi.org/10.1210/clinem/dgab199 Kabir, E. R., Rahman, M. S., & Rahman, I. (2015). A review on endocrine disruptors and their possible impacts on human health. In Environmental Toxicology and Pharmacology (Vol. 40, Issue 1, pp. 241–258). Elsevier. https://doi.org/10.1016/j.etap.2015.06.009 Kim, S. A., Moon, H., Lee, K., & Rhee, M. S. (2015). Bactericidal effects of triclosan in soap both in vitro and in vivo. Journal of Antimicrobial Chemotherapy, 70(12), 3345–3352. https://doi.org/10.1093/jac/dkv275 Kioumourtzoglou, M.-A., Coull, B. A., O’Reilly, É. J., Ascherio, A., & Weisskopf, M. G. (2018). Association of Exposure to Diethylstilbestrol During Pregnancy With Multigenerational Neurodevelopmental Deficits. JAMA Pediatrics, 172(7), 670–677. https://doi.org/10.1001/jamapediatrics.2018.0727 Kundakovic, M., & Champagne, F. A. (2011). Epigenetic perspective on the developmental effects of bisphenol A. Brain, Behavior, and Immunity, 25(6), 1084–1093. https://doi.org/10.1016/j.bbi.2011.02.005 Lauritzen, H. B., Larose, T. L., Øien, T., Sandanger, T. M., Odland, J. Ø., van de Bor, M., & Jacobsen, G. W. (2017). Maternal serum levels of perfluoroalkyl substances and organochlorines and indices of fetal growth: a Scandinavian case-cohort study. Pediatric Research, 81(1–1), 33–42. https://doi.org/10.1038/pr.2016.187 Leemans, M., Couderq, S., Demeneix, B., & Fini, J.-B. (2019). Pesticides With Potential Thyroid Hormone-Disrupting Effects: A Review of Recent Data. Frontiers in Endocrinology, 10, 743. https://doi.org/10.3389/fendo.2019.00743 Li, N., Papandonatos, G. D., Calafat, A. M., Yolton, K., Lanphear, B. P., Chen, A., & Braun, J. M. (2019). Identifying periods of susceptibility to the impact of phthalates on children’s cognitive abilities. Environmental Research, 172, 604–614. https://doi.org/10.1016/j.envres.2019.03.009 Merrill, A. K., Sobolewski, M., & Susiarjo, M. (2023). Exposure to endocrine disrupting chemicals impacts immunological and metabolic status of women during pregnancy. Molecular and Cellular Endocrinology, 577(May), 112031. https://doi.org/10.1016/j.mce.2023.112031 Mnif, W., Hassine, A. I. H., Bouaziz, A., Bartegi, A., Thomas, O., & Roig, B. (2011). Effect of endocrine disruptor pesticides: A review. International Journal of Environmental Research and Public Health, 8(6), 2265–2303. https://doi.org/10.3390/ijerph8062265 Mouritsen, A., Aksglaede, L., Sørensen, K., Mogensen, S. S., Leffers, H., Main, K. M., Frederiksen, H., Andersson, A. M., Skakkebaek, N. E., & Juul, A. (2010). Hypothesis: Exposure to endocrine-disrupting chemicals may interfere with timing of puberty. International Journal of Andrology, 33(2), 346–359. https://doi.org/10.1111/j.1365-2605.2010.01051.x Müller, J. E., Meyer, N., Santamaria, C. G., Schumacher, A., Luque, E. H., Zenclussen, M. L., Rodriguez, H. A., & Zenclussen, A. C. (2018). Bisphenol A exposure during early pregnancy impairs uterine spiral artery remodeling and provokes intrauterine growth restriction in mice. Scientific Reports, 8(1), 9196. https://doi.org/10.1038/s41598-018-27575-y Pan, J., Liu, P., Yu, X., Zhang, Z., & Liu, J. (2024). The adverse role of endocrine disrupting chemicals in the reproductive system. Frontiers in Endocrinology, 14(January), 1–31. https://doi.org/10.3389/fendo.2023.1324993 Peltier, M. R., Fassett, M. J., Arita, Y., Chiu, V. Y., Takhar, H. S., & Getahun, D. (2022). Exposure to polybrominated diphenyl ether-47 increases the risk of post-partum depression . The Journal of Maternal-Fetal & Neonatal Medicine, 35(25), 8350–8354. https://doi.org/10.1080/14767058.2021.1974386 Rana, I., Nguyen, P. K., Rigutto, G., Louie, A., Lee, J., Smith, M. T., & Zhang, L. (2023). Mapping the key characteristics of carcinogens for glyphosate and its formulations: A systematic review. Chemosphere, 339(February), 139572. https://doi.org/10.1016/j.chemosphere.2023.139572 Rattan, S., Zhou, C., Chiang, C., Mahalingam, S., Brehm, E., & Flaws, J. A. (2017). Exposure to endocrine disruptors during adulthood: Consequences for female fertility. Journal of Endocrinology, 233(3), R109–R129. https://doi.org/10.1530/JOE-17-0023 Reed, C. E., & Fenton, S. E. (2013). Exposure to diethylstilbestrol during sensitive life stages: a legacy of heritable health effects. Birth Defects Research. Part C, Embryo Today : Reviews, 99(2), 134–146. https://doi.org/10.1002/bdrc.21035 Richtlijn 2009/48/EG, Pub. L. No. Richtlijn 2009/48/EG van het Europees Parlement en de Raad van 18 juni 2009 betreffende de veiligheid van speelgoed (2009). https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2009:170:0001:0037:nl:PDF Richtlijn 2011/8/EU, Pub. L. No. Richtlijn 2011/8/EU van de commissie van 28 januari 2011 tot wijziging van Richtlijn 2002/72/EG wat de beperking op het gebruik van bisfenol A in zuigflessen van kunststof voor zuigelingen betreft (2011). https://eur-lex.europa.eu/legal-content/NL/TXT/?uri=CELEX%3A32011L0008 RIVM. (n.d.). Maximale Residu Limiet (MRL). Retrieved August 22, 2024, from https://rvs.rivm.nl/onderwerpen/normen/consumenten/MRL Rochester, J. R., & Bolden, A. L. (2015). Bisphenol S and F: A systematic review and comparison of the hormonal activity of bisphenol a substitutes. Environmental Health Perspectives, 123(7), 643–650. https://doi.org/10.1289/ehp.1408989 Schepens, M., Biesebeek, J. te, Hartmann, J., Aa, N. van der, Zijlstra, R., & Boon, P. (2023). Risk assessment of exposure to PFAS through food and drinking water in the Netherlands. In National Institute for Public Health and the Environment, RIVM (RIVM report 2023-0011). https://doi.org/https://doi.org/10.21945/RIVM-2023-0011 Schjenken, J. E., Green, E. S., Overduin, T. S., Mah, C. Y., Russell, D. L., & Robertson, S. A. (2021). Endocrine Disruptor Compounds-A Cause of Impaired Immune Tolerance Driving Inflammatory Disorders of Pregnancy? Frontiers in Endocrinology, 12, 607539. https://doi.org/10.3389/fendo.2021.607539 Shelton, J. F., Geraghty, E. M., Tancredi, D. J., Delwiche, L. D., Schmidt, R. J., Ritz, B., Hansen, R. L., & Hertz-Picciotto, I. (2014). Neurodevelopmental disorders and prenatal residential proximity to agricultural pesticides: the CHARGE study. Environmental Health Perspectives, 122(10), 1103–1109. https://doi.org/10.1289/ehp.1307044 Skakkebaek, N. E., Rajpert-De Meyts, E., Buck Louis, G. M., Toppari, J., Andersson, A.-M., Eisenberg, M. L., Jensen, T. K., Jørgensen, N., Swan, S. H., Sapra, K. J., Ziebe, S., Priskorn, L., & Juul, A. (2015). Male Reproductive Disorders and Fertility Trends: Influences of Environment and Genetic Susceptibility. Physiological Reviews, 96(1), 55–97. https://doi.org/10.1152/physrev.00017.2015 Skakkebæk, N. E., Rajpert-De Meyts, E., & Main, K. M. (2001). Testicular dysgenesis syndrome: An increasingly common developmental disorder with environmental aspects. Human Reproduction, 16(5), 972–978. https://doi.org/10.1093/humrep/16.5.972 Stefanidou, M., Maravelias, C., & Spiliopoulou, C. (2009). Human exposure to endocrine disruptors and breast milk. Endocrine, Metabolic & Immune Disorders Drug Targets, 9(3), 269–276. https://doi.org/10.2174/187153009789044374 Street, M. E., & Bernasconi, S. (2020). Endocrine-disrupting chemicals in human fetal growth. International Journal of Molecular Sciences, 21(4). https://doi.org/10.3390/ijms21041430 Swan, S. H., Elkin, E. P., & Fenster, L. (1997). Have sperm densities declined? A reanalysis of global trend data. Environmental Health Perspectives, 105(11), 1228–1232. https://doi.org/10.1289/ehp.971051228 Swan, S. H., Brazil, C., Drobnis, E. Z., Liu, F., Kruse, R. L., Hatch, M., Redmon, J. B., Wang, C., & Overstreet, J. W. (2003). Geographic differences in semen quality of fertile U.S. males. Environmental Health Perspectives, 111(4), 414–420. https://doi.org/10.1289/ehp.5927 Toppari, J., Kaleva, M., & Virtanen, H. E. (2001). Trends in the incidence of cryptorchidism and hypospadias, and methodological limitations of registry-based data. Human Reproduction Update, 7(3), 282–286. https://doi.org/10.1093/humupd/7.3.282 Vafeiadi, M., Roumeliotaki, T., Myridakis, A., Chalkiadaki, G., Fthenou, E., Dermitzaki, E., Karachaliou, M., Sarri, K., Vassilaki, M., Stephanou, E. G., Kogevinas, M., & Chatzi, L. (2016). Association of early life exposure to bisphenol A with obesity and cardiometabolic traits in childhood. Environmental Research, 146, 379–387. https://doi.org/10.1016/j.envres.2016.01.017 Vandenberg, L. N., Colborn, T., Hayes, T. B., Heindel, J. J., Jacobs, D. R., Lee, D. H., Shioda, T., Soto, A. M., vom Saal, F. S., Welshons, W. V., Zoeller, R. T., & Myers, J. P. (2012). Hormones and endocrine-disrupting chemicals: Low-dose effects and nonmonotonic dose responses. Endocrine Reviews, 33(3), 378–455. https://doi.org/10.1210/er.2011-1050 Vo. (EG) 10/2011, Pub. L. No. Verordening (EU) Nr. 10/2011 van de commissie van 14 januari 2011 betreffende materialen en voorwerpen van kunststof, bestemd om met levensmiddelen in contact te komen (2011). https://eur-lex.europa.eu/legal-content/NL/ALL/?uri=celex%3A32011R0010 Vo. (EG) 1107/2009, Pub. L. No. Verordening (EG) nr. 1107/2009 van het Europees Parlement en de Raad van 21 oktober 2009 betreffende het op de markt brengen van gewasbeschermingsmiddelen en tot intrekking van de Richtlijnen 79/117/EEG en 91/414/EEG van de Raad (2009). https://eur-lex.europa.eu/legal-content/NL/TXT/?uri=celex%3A32009R1107 Vo. (EG) 1123/2009, Pub. L. No. Verordening (EG) nr. 1223/2009 van het Europees Parlement en de Raad van 30 november 2009 betreffende cosmetische producten (2009). https://eur-lex.europa.eu/legal-content/NL/ALL/?uri=CELEX%3A32009R1223 Vo. (EG) 1907/2006, Pub. L. No. Verordening (EG) nr. 1907/2006 van het Europees Parlement en de Raad van 18 december 2006 inzake de registratie en beoordeling van en de autorisatie en beperkingen ten aanzien van chemische stoffen (REACH), tot oprichting van een Europees Agentschap voor (2006). https://eur-lex.europa.eu/legal-content/NL/TXT/PDF/?uri=CELEX:32006R1907 Völkel, W., Colnot, T., Csanády, G. A., Filser, J. G., & Dekant, W. (2002). Metabolism and kinetics of bisphenol a in humans at low doses following oral administration. Chemical Research in Toxicology, 15(10), 1281–1287. https://doi.org/10.1021/tx025548t Weatherly, L. M., & Gosse, J. A. (2017). Triclosan exposure, transformation, and human health effects. Journal of Toxicology and Environmental Health. Part B, Critical Reviews, 20(8), 447–469. https://doi.org/10.1080/10937404.2017.1399306 Windham, G., & Fenster, L. (2008). Environmental contaminants and pregnancy outcomes. Fertility and Sterility, 89(2 SUPPL.), 111–116. https://doi.org/10.1016/j.fertnstert.2007.12.041 Witorsch, R. J., & Thomas, J. A. (2010). Personal care products and endocrine disruption: A critical review of the literature. Critical Reviews in Toxicology, 40(SUPPL. 3), 1–30. https://doi.org/10.3109/10408444.2010.515563 World Health Organization. (2012). State of the Science of Endocrine Disrupting Chemicals 2012 (Å. Bergman, J. J. Heindel, S. Jobling, K. A. Kidd, & R. Thomas Zoeller, Eds.). World Health Organization. (2023). Infertility prevalence estimates, 1990-2021. Yang, C., Song, G., & Lim, W. (2019). A mechanism for the effect of endocrine disrupting chemicals on placentation. Chemosphere, 231, 326–336. https://doi.org/10.1016/j.chemosphere.2019.05.133 Yesildemir, O., & Akdevelioglu, Y. (2021). Endocrine Disruptors in Baby Formulas: A Literature Review. Selcuk Journal of Agricultural and Food Sciences, 35(3), 272–279. https://doi.org/10.15316/sjafs.2021.257 Yilmaz, B., Terekeci, H., Sandal, S., & Kelestimur, F. (2020). Endocrine disrupting chemicals: exposure, effects on human health, mechanism of action, models for testing and strategies for prevention. In Reviews in Endocrine and Metabolic Disorders (Vol. 21, Issue 1, pp. 127–147). Springer. https://doi.org/10.1007/s11154-019-09521-z Zhao, Y., Song, Q., Cao, Z., Su, X., Hua, J., Zhang, Y., & He, X. (2018). Umbilical cord blood PBDEs concentrations in relation to placental size at birth. Chemosphere, 201, 20–24. https://doi.org/10.1016/j.chemosphere.2018.02.121 Zhu, Y.-D., Gao, H., Huang, K., Zhang, Y.-W., Cai, X.-X., Yao, H.-Y., Mao, L.-J., Ge, X., Zhou, S.-S., Xu, Y.-Y., Jin, Z.-X., Sheng, J., Yan, S.-Q., Pan, W.-J., Hao, J.-H., Zhu, P., & Tao, F.-B. (2018). Prenatal phthalate exposure and placental size and shape at birth: A birth cohort study. Environmental Research, 160, 239–246. https://doi.org/10.1016/j.envres.2017.09.012