Exposure to perfluoroalkyl substances and neonatal immunoglobulin profiles in the upstate KIDS study (2008–2010)

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Infant exposure to per/polyfluoroalkyl compounds is associated with immune disruption. We examined associations between neonatal concentrations of perflurooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) and immunoglobulin (Ig) isotype profiles in a prospective cohort of infants. We measured Ig isotypes, including IgA, IgE, IgM and the IgG subclasses IgG1, IgG2, IgG3, and IgG4, and PFOA and PFOS in newborn dried bloodspots from N=3175 infants in the Upstate KIDS Study (2008-2010). We examined the association between newborn Ig isotype levels and individual PFOS and PFOA concentrations using mixed effects regression models with a random intercept to account for twins among study participants. We assessed the joint effect PFOA and PFOS with quantile-based g-computation on all singletons and one randomly selected twin (N=2901), with Ig categorized as above or below median value. Models were adjusted for infant sex, and maternal pre-pregnancy body mass index, race, parity, age and infertility treatment. In adjusted models, PFOA was inversely associated with IgE (coefficient=-0.12 per unit increase in PFOA, 95% CI: -0.065, -0.17), whereas IgG2, IgM, and IgA were positively associated with PFOA (coefficient for IgG2=0.22, 95% CI: 0.15, 0.27; coefficient for IgM=0.11, 95% CI: 0.08, 0.15; and coefficient for IgA=0.15, 95% CI: 0.07, 0.18). There was no relation between PFOS and Ig isotypes. Analysis of the joint effect of PFOA and PFOS showed an OR of 1.2 (95% CI: 1.04, 1.36) for IgA and OR of 1.12 (95% CI: 1.00, 1.24) for IgG2 levels above the median for every quartile increase. PFOA levels were significantly associated with elevated IgA, IgM, IgG2, and reduced levels of IgE in single-pollutant models. A small but significant joint effect of PFOA and PFOS was observed. Our results suggest that early exposure to PFOA and PFOS may disrupt neonatal immunoglobulin levels.