Maternal serum levels of perfluoroalkyl substances in early pregnancy and offspring birth weight

Wikström, Sverre; Lin, Ping; Lindh, Christian; Shu, Huan; Bornehag, Carl‐Gustaf

doi:10.1038/s41390-019-0720-1

Cited by 110 publications

(67 citation statements)

References 42 publications

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“…Serum concentrations of PFNA, PFOA and PFOS in early pregnancy corresponded well with those of other pregnant Swedish populations at the time, i.e. the SELMA study where samplings were performed 2007-2010 and PFAS were analysed at the same laboratory [47]. Thus, the generalisability of our findings to the general population of pregnant women should be high but they might not be applicable to preeclamptic pregnancies where cystatin C retention in blood is more pronounced [27].…”

Section: Discussionsupporting

confidence: 59%

Pregnancy-induced changes in serum concentrations of perfluoroalkyl substances and the influence of kidney function

et al. 2020

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Background: Epidemiological associations between maternal concentrations of perfluoroalkyl substances (PFAS) and birth weight are inconsistent. There is concern that studies based on samples collected in late pregnancy may be confounded by kidney function but studies of the relation between pregnancy-induced changes in PFAS and kidney function are lacking. Our aims were to investigate changes in serum concentrations of perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) from early to late pregnancy and to explore relations to changes in glomerular filtration rate (GFR) and glomerular pore size. Methods: We conducted the study in a cohort of 73 pregnancies of normal-weight Swedish women without gestational diabetes and preeclampsia, enrolled 2009-2014. Blood was collected in median weeks 11 and 36, respectively, and analysed PFAS using liquid chromatography-tandem-mass-spectrometry. We estimated GFR based on creatinine and cystatin C and used the ratio eGFR cystatin C /eGFR creatinine to indicate glomerular pore size. We used Wilcoxon signed-rank test to compare early and late measures and partial Spearman rank correlations to explore relations between changes in PFAS and kidney function. Results: Median concentrations of PFNA, PFOA and PFOS decreased by 15-21% but changes were uncorrelated to changes in kidney function (partial R = − 0.06-0.11). The observed increase in median PFHxS concentration of 69% was likely an artefact of systematic measurement error caused by coeluting endogenous inferences. Conclusions: Serum concentrations of PFNA, PFOA and PFOS decrease during pregnancy but the magnitudes of change are unrelated to parallel changes in eGFR and glomerular pore size, suggesting that changes in these indicators of kidney function are not important confounders in studies of PFAS and birth weight in pregnancies without gestational diabetes and preeclampsia.

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Section: Discussionsupporting

confidence: 59%

Pregnancy-induced changes in serum concentrations of perfluoroalkyl substances and the influence of kidney function

et al. 2020

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“…Linear models were parameterised to include covariates, MNI and concentrations of an endocrine disrupting chemical (log transformed) previously shown to be associated with the outcome variable; that is, PFOS with birth weight and BPF with WISC IQ. 8 17 We addressed the issue of the balance between good nutrition and dietary sources of toxicant exposures, as is the case for PFOS, in three steps: (1) We created a score for fish consumption using FFQ data. (2) We constructed an indicator variable for low and high fish consumption at varying cuts.…”

Section: Methodsmentioning

confidence: 99%

“…A more complex scenario is that a good diet may be a source for chemical exposure, as is the case with perfluoroalkyl acids (PFAAs), (eg, fish consumption is a source of perfluoro-octanesulfonic acid (PFOS) uptake) where prenatal exposure for several single PFAAs has been shown to be associated with a lower birth weight. 8 9 An interesting line of inquiry is measuring the balance between a healthy prenatal diet which may also be a source of environmental toxicants.…”

Section: Introductionmentioning

confidence: 99%

Contrasting prenatal nutrition and environmental exposures in association with birth weight and cognitive function in children at 7 years

Gennings

Wolk

Håkansson

et al. 2020

BMJNPH

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BackgroundGood nutrition is essential for individual health, a notion that is particularly true during pregnancy. We have used a nutrition index that measures the adequacy of one’s diet relative to the unique nutritional needs of individuals due to, for example, their activity level, dietary restrictions, lifestyle and body size. The use of this personalised metric of dietary nutritiousness in the analysis of prenatal environmental exposures and developmental outcomes permits testing for potential mitigating effects of good nutrition. We also provide an analysis strategy for investigating the balance in beneficial food sources which are also the source of environmental toxicants.MethodsA holistic measure of nutrition, My Nutrition Index (MNI), measures the nutrient quality (ie, ‘nutritiousness’) of a specified daily diet. MNI is calculated based on quantification of dozens of macronutrients and micronutrients that are specific to an individual’s nutritional needs by incorporating dietary restrictions, subject characteristics, activity level and health behaviours. The Swedish Environmental, Longitudinal, Mother and child, Asthma and allergy Study is a Swedish pregnancy cohort, with prenatal endocrine disrupting chemicals (EDCs) exposure and dietary data available. This makes it possible to test for the potential mitigating effects of good nutrition on health and development effects in offspring from EDCs.ResultsUsing prenatal Food Frequency Questionnaire data to construct an individual’s MNI, the index was significantly and positively associated with important metabolic outcome (as measured by birth weight) and cognitive function at age 7 years (as measured by WISC IQ) in children when adjusted for covariates and prenatal concentrations of an EDC. In a stratified analysis of ‘low’ and ‘high’ fish consumption, a potential source of perfluoro-octanesulfonic acid (PFOS), the association between PFOS and birth weight was diminished in the high consumption group compared with the low consumption group.ConclusionsThus, MNI is evidently a metric of the general nutritiousness of daily diets and is useful in environmental health studies in representing the impact of good nutrition, even during pregnancy.

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“…In the SELMA-study we have previously shown associations between early pregnancy PFAS exposures, including PFOS, PFOA and PFNA, and preeclampsia as well as lower birth weight 9,14 . Within the same cohort we now add the novel finding of a positive association between first trimester PFOA exposure and increased risk for sporadic miscarriage during the second half of the first trimester.…”

Section: Discussionmentioning

confidence: 99%

“…In human, a continuously increasing number of publications reports associations between higher serum levels of several PFASs during pregnancy, especially perfluorooctane sulfonate (PFOS) together with perfluorooctanoic acid (PFOA), and preeclampsia [8][9][10] as well as reduced fetal growth [11][12][13][14] . Causation for such associations has however been questioned 13 .…”

mentioning

confidence: 99%

Exposure to perfluoroalkyl substances in early pregnancy and risk of sporadic first trimester miscarriage

Wikström

Hussein

Karlsson

et al. 2021

Sci Rep

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Many first trimester sporadic miscarriages are unexplained and the role of environmental exposures is unknown. The present aim was to study if levels of Perfluoroalkyl substances (PFASs) in early pregnancy are associated with unexplained, sporadic first trimester miscarriage. The study was performed within the Swedish SELMA pregnancy cohort. Seventy-eight women with non-recurrent first trimester miscarriage were included and 1449 women were available as live birth controls. Eight PFASs were measured in first trimester serum. A doubling of perfluorooctanoic acid (PFOA) exposure, corresponding to an inter-quartile increase, was associated with an odds ratio (95%CI) for miscarriage of 1.48 (1.09–2.01) when adjusting for parity, age and smoking. Analyses per quartiles of PFOA exposure indicated a monotonic dose response association with miscarriage. A similar, but not significant, pattern was observed for perfluorononanoic acid (PFNA). For other PFAS, there were no associations with miscarriage. We have previously shown associations between early pregnancy PFAS exposures and preeclampsia, as well as lower birth weight. Now we report an association between PFOA and miscarriage within the same cohort, which may suggest shared but unknown mechanisms. The study can only represent a period of early placentation and clinical pregnancy loss during the second half of the first trimester.

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Maternal serum levels of perfluoroalkyl substances in early pregnancy and offspring birth weight

Cited by 110 publications

References 42 publications

Pregnancy-induced changes in serum concentrations of perfluoroalkyl substances and the influence of kidney function

Pregnancy-induced changes in serum concentrations of perfluoroalkyl substances and the influence of kidney function

Contrasting prenatal nutrition and environmental exposures in association with birth weight and cognitive function in children at 7 years

Exposure to perfluoroalkyl substances in early pregnancy and risk of sporadic first trimester miscarriage

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