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. 2022 Oct 28;10(11):650.
doi: 10.3390/toxics10110650.

Perfluoroalkyl Mixture Exposure in Relation to Fetal Growth: Potential Roles of Maternal Characteristics and Associations with Birth Outcomes

Chensi Shen  1   2 , Jiaxin Ding  1 , Chenye Xu  1   2 , Long Zhang  3 , Shuren Liu  4 , Yonghong Tian  3
Affiliations

Perfluoroalkyl Mixture Exposure in Relation to Fetal Growth: Potential Roles of Maternal Characteristics and Associations with Birth Outcomes

Chensi Shen et al. Toxics. .

Abstract

Perfluoroalkyl substances (PFASs) exposure is suggested to interfere with fetal growth. However, limited investigations considered the roles of parity and delivery on PFASs distributions and the joint effects of PFASs mixture on birth outcomes. In this study, 506 birth cohorts were investigated in Hangzhou, China with 14 PFASs measured in maternal serum. Mothers with higher maternal ages who underwent cesarean section were associated with elevated PFASs burden, while parity showed a significant but diverse influence. A logarithmic unit increment in perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), and perfluorononane sulfonate (PFNS) was significantly associated with a reduced birth weight of 0.153 kg (95% confidence interval (CI): -0.274, -0.031, p = 0.014), 0.217 kg (95% CI: -0.385, -0.049, p = 0.012), and 0.137 kg (95% CI: -0.270, -0.003, p = 0.044), respectively. Higher perfluoroheptanoic acid (PFHpA) and perfluoroheptane sulphonate (PFHpS) were associated with increased Apgar-1 scores. PFOA (Odds ratio (OR): 2.17, 95% CI: 1.27, 3.71, p = 0.004) and PFNS (OR:1.59, 95% CI: 1.01, 2.50, p = 0.043) were also risk factors to preterm birth. In addition, the quantile-based g-computation showed that PFASs mixture exposure was significantly associated with Apgar-1 (OR: 0.324, 95%CI: 0.068, 0.579, p = 0.013) and preterm birth (OR: 0.356, 95% CI: 0.149, 0.845, p = 0.019). In conclusion, PFASs were widely distributed in the maternal serum, which was influenced by maternal characteristics and significantly associated with several birth outcomes. Further investigation should focus on the placenta transfer and toxicities of PFASs.

Keywords: apgar scores; birth weight; maternal determinants; mixture effects; perfluoroalkyl substances; prenatal exposure; preterm birth.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Levels of PFAS (ng/mL) in maternal serum, * means the maximum concentration.
Figure 2
Figure 2
Spearman correlation coefficients for PFASs in serum.
Figure 3
Figure 3
Quantile-based g-computation approach of PFAS on birth outcomes. (a) birth weight, (b) Apgar-1, (c) Apgar-5, (d) preterm birth. Note: PFAS were log-transformed and missing data imputed. The model was adjusted for maternal age, prenatal BMI, education, occupation, smoking, alcohol drinking, ethnicity, delivery mode and parity.
Figure 4
Figure 4
Odds ratios (ORs) [95% confidence interval (CI)] for preterm birth by serum concentrations of PFASs in logistic regression analyses. Notes: preterm birth risk was estimated for continuous log-transformed PFASs concentrations in serum; The model was adjusted for maternal age, prenatal BMI, education, occupation, smoking, alcohol drinking, ethnicity, delivery mode and parity.
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