Abstract
BackgroundPerfluoroalkyl and polyfluoroalkyl substances (PFAS) have been reported to disrupt endocrine system and reproduction. However, epidemiological evidence on the association between PFAS and preeclampsia is inconsistent. We aimed to investigate the association between prenatal PFAS exposure and hypertensive disorders of pregnancy (HDP) in humans.MethodsPFAS were measured by liquid chromatography system coupled with tandem mass spectrometry in 687 umbilical cord plasma samples collected between 2011 and 2012 in Shanghai, China. Information on HDP including gestational hypertension and preeclampsia was abstracted from medical records. Multiple logistic regression was used to examine the association of each PFAS with gestational hypertension, preeclampsia, and overall HDP in separate models. Elastic net regression with logit link was used to identify independent associations between exposures and outcomes. Logistic regression was used to obtain the unpenalized estimates of the selected PFAS components for the associations with outcomes, adjusting for age, education level, pre-pregnancy BMI, parity, and mutual adjustment of selected PFAS.ResultsThe risk of gestational hypertension and preeclampsia was 3.3% and 2.8% in our subjects, respectively. Perfluorobutane sulfonate (PFBS), perfluorohexane sulfonate (PFHxS), perfluoroundecanoic acid (PFUA) were associated with preeclampsia based on elastic net penalty regression. In the fully adjusted statistical model, women with a higher level of standardized ln-transformed PFBS had an increased odds of preeclampsia [adjusted odds ratio (AOR): 1.81, 95% confidence interval (CI): 1.03–3.17], and overall HDP (AOR: 1.64, 95% CI: 1.09–2.47).ConclusionsPrenatal exposure to PFBS was positively associated with the risk of preeclampsia and overall HDP.
Highlights
Hypertensive disorders of pregnancy (HDP) are among the most common complications of pregnancy
Two studies focusing on women who lived in areas with a high perfluorooctanoic acid (PFOA) level but with background perfluorooctane sulfonate (PFOS) level found that PFOA and PFOS were significantly positively associated with preeclampsia with an odds ratio (OR) of 1.1–1.2 across the upper three quintiles for PFOA and OR of 1.13 in relation to a shift from 25th to 75th percentile for PFOS [16, 17], while another study focusing on women with background level of polyfluoroalkyl substances (PFAS) exposure found that PFOA, PFOS and perfluoroheptane sulfonate (PFHpS) were not associated with preeclampsia, but perfluoroundecanoic acid (PFUA) had an inverse significant association with preeclampsia [HR: 0.78 (0.66, 0.92) for per ln-unit] [18]
Chronic hypertension before pregnancy and preeclampsia superimposed on chronic hypertension were excluded in the current analysis because our study focused on the association between PFAS and pregnancy-related hypertension
Summary
Hypertensive disorders of pregnancy (HDP) are among the most common complications of pregnancy. HDP are often classified into four (2019) 18:5 body mass index than women with preeclampsia [8]. Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a large group of manufactured compounds widely used in both industrial and consumer products [9]. Most frequently studied PFAS have a long half-life of 3– 5 years in human body [14]. Our previous study found that eight common PFAS were detected in more than 90% of umbilical cord blood samples [15]. Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been reported to disrupt endocrine system and reproduction. We aimed to investigate the association between prenatal PFAS exposure and hypertensive disorders of pregnancy (HDP) in humans
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