Pregnancy Exposure to Perfluoroalkyl Substances and Associations With Prolactin Concentrations and Breastfeeding in the Odense Child Cohort

Abstract

Context Human exposure to perfluoroalkyl substances (PFAS) has been associated with reduced duration of breastfeeding, though not consistently so, and mechanisms by which PFAS might affect breastfeeding are unknown. Objective To examine the association between early pregnancy serum-PFAS concentrations and breastfeeding termination and elucidate the potential role of serum-prolactin concentrations in pregnancy. Materials and methods Pregnant women from the Odense Child Cohort provided blood samples for analysis of five major PFAS (n=1300) and prolactin concentrations (n=924). They subsequently provided information about the duration of breastfeeding in questionnaires at three and eighteen months postpartum, and a subgroup also provided breastfeeding information via weekly cell phone text messages. Associations between serum-PFAS concentrations and breastfeeding termination were analyzed using Cox regressions, while linear regression was used to assess associations between serum-PFAS and prolactin concentrations. Results Increased serum concentrations of PFOS, PFOA, PFNA and ∑PFAS were associated with a 16% (95% CI: 4-30%), 14% (95% CI: 2-26%), 14% (95% CI: 3-27%), and 20% (95% CI: 6-36%), respectively, increased risk of terminating breastfeeding at any given time after childbirth. Serum-PFAS concentrations were not associated with serum-prolactin concentrations. Conclusions These findings are of public health importance due to the global exposures to PFAS. Because breastfeeding is crucial to promote both child health and maternal health, adverse PFAS effects on the ability to breastfeed may have long-term health consequences.

Per- and Polyfluoroalkyl Substances and Breastfeeding as a Vulnerable Function: A Systematic Review of Epidemiological Studies

“…The included studies were published between 2010 and 2022, and were based on data from women giving birth between 1996 and 2012 (Table 3). Five of the studies focused on women living in northern Europe [40][41][42][43][44] and one was from women in the United States [45]. The study size ranged from 336 [45] to 2374 participants [41].…”

“…The study size ranged from 336 [45] to 2374 participants [41]. Five studies were prospective cohort studies [40,[42][43][44][45], and one was based on data from a natural experiment, in which contaminated drinking water caused serum PFHxS, PFOS, and PFOA concentrations to be 135, 35, and 5 times higher, respectively, in one Swedish municipality, Ronneby, compared to a nearby municipality [41]. The median duration of total breastfeeding ranged from 6 [45] to 9 months [44].…”

“…However, the definition of exclusive breastfeeding was not uniform across the studies. For example, one study relied on the American Academy of Pediatrics guidelines and equaled the duration of exclusive breastfeeding to the infant's age at the first ever use of formula, water, juice or solid foods [45], while another study defined the duration of exclusive breastfeeding in accordance with the Danish health and food authorities, as the infant's age when receiving more than one non-breastmilk meal per week [43]. NA: not assessed.…”

Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities

“…Developmental delays were apparent at puberty (PND22) and persisted into adulthood at PND63. At [7][8][9]51], PFOS [7,8,51], PFNA [7,8]), b DDT/ DDE [54][55][56], Smoking [46][47][48][49][50],…”

“…This continual dynamic development-with monthly cycles of proliferation and regression, full differentiation at the first full-term pregnancy, and more extensive regression after menopause-makes the organ vulnerable to disruption, with the potential for persistent effects for both a woman and her offspring [3]. Indeed, in recent decades, there have been increased reports of premature breast development [4][5][6], shortened duration of breastfeeding [7][8][9], and premenopausal breast cancer [10][11][12][13]. Despite these concerning trends, chemically induced alterations to MG development and function remain under-studied, while the need for research into the causes of these adverse outcomes is urgent to protect women and subsequent generations.…”