Prenatal exposure to perfluoroalkyl substances and birth outcomes in a Spanish birth cohort. (November 2017)

• Record Type: Journal Article
• Authors: Manzano-Salgado, Cyntia B.; Casas, Maribel; Lopez-Espinosa, Maria-Jose; Ballester, Ferran; Iñiguez, Carmen; Martinez, David; Costa, Olga; Santa-Marina, Loreto; Pereda-Pereda, Eva; Schettgen, Thomas; Sunyer, Jordi; Vrijheid, Martine
• Is Part Of: Environment international. Volume 108(2017)
• Page Start: 278
• Page End: 284
• Publication Date: 2017-11
• Subjects: BMI Body mass index -- CI Confidence interval -- CRL Crown-rump-length -- GAM Generalized additive model -- GFR Glomerular filtration rate -- GM Geometric mean -- HPLC-MS/MS High performance liquid chromatography–tandem mass spectrometry -- INMA Environment and Childhood Project (INfancia y Medio Ambiente) -- LBW Low birth weight -- LOQ Limit of quantification -- OR Odds ratio -- PBPK Physiologically-based pharmacokinetic -- PFAS Perfluoroalkyl substances -- PFHxS Perfluorohexane sulfonate -- PFOS Perfluorooctane sulfonate -- PFOA Perfluorooctanoate -- PFNA Perfluorononanoate -- SD Standard deviation -- SGA Small-for-gestational-age; INMA birth cohort -- Perfluoroalkyl substances -- Perfluorooctanoate (PFOA) -- Perfluorooctane sulfonate (PFOS) -- Fetal growth -- Glomerular filtration rate -- Mother-child pairs; Environmental protection -- Periodicals; Environmental health -- Periodicals; Environmental monitoring -- Periodicals; Environmental Monitoring -- Periodicals; Environnement -- Protection -- Périodiques; Hygiène du milieu -- Périodiques; Environnement -- Surveillance -- Périodiques; Environmental health; Environmental monitoring; Environmental protection; Periodicals; 333.705
• DOI: 10.1016/j.envint.2017.09.006
• Languages: English
• ISSNs: 0160-4120

Abstract

Abstract: Background: Prenatal perfluorooctanoate (PFOA) exposure has been associated with reduced birth weight but maternal glomerular filtration rate (GFR) may attenuate this association. Further, this association remains unclear for other perfluoroalkyl substances (PFAS), such as perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoate (PFNA). We estimated associations between prenatal PFAS exposure and birth outcomes, and the influence of GFR, in a Spanish birth cohort. Methods: We measured PFHxS, PFOS, PFOA, and PFNA in 1st-trimester maternal plasma (years: 2003–2008) in 1202 mother-child pairs. Continuous birth outcomes included standardized weight, length, head circumference, and gestational age. Binary outcomes included low birth weight (LBW), small-for-gestational-age, and preterm birth. We calculated maternal GFR from plasma-creatinine measurements in the 1st-trimester of pregnancy ( n = 765) using the Cockcroft-Gault formula. We used mixed-effects linear and logistic models with region of residence as random effect and adjustment for maternal age, parity, pre-pregnancy BMI, and fish intake during pregnancy. Results: Newborns in this study weighted on average 3263 g and had a median gestational age of 39.8 weeks. The most abundant PFAS were PFOS and PFOA (median: 6.05 and 2.35 ng/mL, respectively). Overall, PFAS concentrations were not significantly associated to birth outcomes. PFOA, PFHxS, and PFNA showed weak, non-statistically significant associations with reduced birth weights ranging from 8.6 g to 10.3 g per doubling of exposure. Higher PFOS exposure was associated with an OR of 1.90 (95% CI: 0.98, 3.68) for LBW (similar in births-at-term) in boys. Maternal GFR did not confound the associations. Conclusions: In this study, PFAS showed little association with birth outcomes. Higher PFHxS, PFOA, and PFNA concentrations were non-significantly associated with reduced birth weight. The association between PFOS and LBW seemed to be sex-specific. Finally, maternal GFR measured early during pregnancy had little influence on the estimated associations. Highlights: The association between prenatal PFAS exposure and birth outcomes was assessed Overall, PFAS concentrations were not significantly associated to birth outcomes PFHxS, PFOA, and PFNA showed patterns of inverse associations with birth weight PFOS was associated with low birth weight (< 2500 g) in a sex-specific manner Maternal glomerular filtration rate in pregnancy did not confound the associations