Maternal Exposure to Perfluorooctane Sulfonate (PFOS) Is Associated with Maternal Hyperglycaemia and Adverse Neonatal and Childhood Outcomes

Abstract

Perfluorooctane sulfonate (PFOS) belongs to a class of endocrine-disrupting chemicals, perfluoroalkyl chemicals (PFCs), implicated in adiposity. Although supposedly phased out since 2002, its use remains widespread in Asia. We aim to examine the relationship between exposure to PFOS and maternal hyperglycaemia and metabolic outcomes in the offspring. We measured blood PFOS and other PFCs in archived samples taken at 24-32weeks gestation from mothers in the Hong Kong centre of the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) study between 2002-2004. All mothers underwent 75g OGTT and GDM was diagnosed according to the IADPSG/WHO 2013 criteria. Pregnancy outcomes, neonatal anthropometrics and childhood outcomes at 7 years were documented. PFCs were measured using high performance LC-MS-MS. We completed analysis of PFCs in 1,601 maternal samples, a subset of 99 cord blood samples, and 970 offspring at 7 years follow-up. There is strong correlation among PFOS and other PFCs in cord blood (ρ=0.51-0.74, p<0.001), as well as correlation with maternal levels (ρ=0.60, p<0.001). Ratio of cord blood to maternal PFOS was 0.60. Using regression analysis with adjustment for maternal age, BMI, and offspring gender, maternal PFOS showed association with maternal 1 hour glucose, 2 hour glucose, HbA1c, AUC during OGTT and GDM, though only the association with HbA1c remained significant using log-transformed PFOS (beta 0.0746 ± 0.0132, p=1.7x10-8). Log-transformed maternal PFOS was associated with higher birthweight, lower birth length, higher ponderal index and lower neonatal sum of skin fold thickness (beta -0.337 ± 0.085, p=7.1x 10-5), after adjustment for all covariates. Maternal PFOS during pregnancy was associated with lower height in offspring at age 7, but not offspring glycaemic parameters. Exposure to PFOS may be an important contributing factor to the epidemic of hyperglycaemia in pregnancy and childhood metabolic disorders in Asia. Disclosure R.C.W. Ma: Research Support; Self; AstraZeneca, Bayer AG, Merck Sharp & Dohme Corp., Pfizer Inc.. Advisory Panel; Self; Boehringer Ingelheim GmbH, Nippon Boehringer Ingelheim Co. Ltd.. C.H.T. Tam: None. G. Cheung: None. W. Lowe: None. B.E. Metzger: None. W.H. Tam: None. C.K. Wong: None.