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. 2021 Jun:151:106442.
doi: 10.1016/j.envint.2021.106442. Epub 2021 Feb 17.

Exposure to perfluoroalkyl substances and blood pressure in pregnancy among 1436 women from the Odense Child Cohort

Anna Birukov  1 , Louise Bjørkholt Andersen  2 , Marianne Skovsager Andersen  3 , Julie H Nielsen  4 , Flemming Nielsen  5 , Henriette Boye Kyhl  6 , Jan Stener Jørgensen  2 , Philippe Grandjean  7 , Ralf Dechend  8 , Tina Kold Jensen  9
Affiliations

Exposure to perfluoroalkyl substances and blood pressure in pregnancy among 1436 women from the Odense Child Cohort

Anna Birukov et al. Environ Int. 2021 Jun.

Abstract

Background: Previous studies of association between exposure to poly- and perfluoroalkyl substances (PFAS) and gestational hypertension (GH) and preeclampsia (PE) have shown conflicting results, but most dichotomized outcome and did not study continuous blood pressure (BP) changes.

Objectives: To study the association between PFAS exposure in early pregnancy and maternal BP trajectories in pregnancy, gestational hypertension and preeclampsia.

Methods: 1436 women were enrolled in the Odense Child Cohort in early pregnancy and had a serum sample drawn, from which perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) were measured using LC-MS/MS. Repeated BP measurements through pregnancy and information on PE were obtained from hospital files. Adjusted linear mixed models were used to investigate association between PFAS exposure and BP trajectory. Associations between PFAS and PE and GH were assessed by Cox proportional hazards model.

Results: All women had measurable concentrations of PFAS. In all of many comparisons higher PFAS exposure (apart from PFHxS) was associated with higher systolic (SBP) and diastolic (DBP) blood pressures, although not all were significant, which is unlikely to be due to chance. After adjustment, each doubling in PFOS or PFOA exposure was associated with 0.47 mmHg (95% CI: -0.13; 1.08) and 0.36 mmHg (-0.19; 0.92) higher SBP; and 0.58 mmHg (0.13; 1.04) and 0.37 mmHg (-0.05; 0.79) higher DBP. No clear associations between PFAS exposure and PE or GH were found.

Discussion: The magnitude of the association between PFAS exposure and BP might appear small, statistically non-significant and the possible clinical importance low. However, at a population level this may slightly shift the distribution of BP towards an increased incidence of GH. If BP increases in pregnancy, it may have long-term impact on health not only of the pregnant woman but also of her offspring.

Keywords: Blood pressure; Environmental chemicals; Perfluoroalkyl substances (PFAS); Preeclampsia; Pregnancy.

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Conflict of interest statement

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.
Flow chart for the included 1436 women from the Odense Child Cohort.
Fig. 2.
Fig. 2.
Restricted cubic splines assessing potential non-linearity in the relationships between preeclampsia and PFAS.
See this image and copyright information in PMC

References

    1. Avanasi R, Shin HM, Vieira VM, Bartell SM, 2016. Impacts of geocoding uncertainty on reconstructed pfoa exposures and their epidemiological association with preeclampsia. Environ. Res 151, 505–512. - PMC - PubMed
    1. Bach CC, Bech BH, Brix N, Nohr EA, Bonde JP, Henriksen TB, 2015. Perfluoroalkyl and polyfluoroalkyl substances and human fetal growth: a systematic review. Crit. Rev. Toxicol 45, 53–67. - PubMed
    1. Bartsch E, Medcalf KE, Park AL, Ray JG, 2016. High Risk of Pre-eclampsia Identification G. 2016 Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ 353, i1753. - PMC - PubMed
    1. Beck IH, Timmermann CAG, Nielsen F, Schoeters G, Johnk C, Kyhl HB, et al. , 2019. Association between prenatal exposure to perfluoroalkyl substances and asthma in 5-year-old children in the odense child cohort. Environ. Health: Glob. Access Sci. Source 18, 97. - PMC - PubMed
    1. Birukov A, Herse F, Nielsen JH, Kyhl HB, Golic M, Kraker K, et al. , 2020. Blood pressure and angiogenic markers in pregnancy: contributors to pregnancy-induced hypertension and offspring cardiovascular risk. Hypertension 76, 901–909. - PubMed

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