Prenatal exposure to per- and poly-fluoroalkyl substances (PFAS) and associations with hypertensive disorders of pregnancy in the Atlanta African American Maternal-Child Cohort Open Access

Abstract

Background/Aims: Per- and polyfluoroalkyl substances (PFAS) are environmental chemicals that are widely detected in the environment and are slow to break down. Epidemiological evidence suggests that prenatal exposure to PFAS leads to adverse birth outcomes. However, the relationship between PFAS, pregnancy complications remain largely unknown, despite biologic plausibility. Here, we examined associations between a mixture of PFAS in relation to hypertensive disorders of pregnancy in a birth cohort of African Americans.

Methods: Participants in the present study were enrolled in the Atlanta African Maternal-Child cohort (N=513). Four PFAS were measured in 1^st trimester serum samples and were detected in >80% of participants. Logistic regression was used to assess associations between individual natural log transformed PFAS and hypertensive disorders of pregnancy (preeclampsia, gestational hypertension), while quantile g-computation was used to estimate mixture effects. Preeclampsia gestational hypertension were treated as separate outcomes in individual models. All models were adjusted for maternal education, maternal age, parity, and any alcohol, tobacco, or drug use.

Results: Individual PFAS were not strongly associated with gestational hypertension or preeclampsia in single pollutant or quantile g-computation models. For example, using quantile g-computation a simultaneous one quartile increase in all PFAS was associated with a non-significant reduction in odds of gestational hypertension (odds ratio= 0.86, 95% confidence interval= 0.60, 1.23).

Conclusions: Our findings suggest that PFAS are not strongly associated with hypertensive disorders of pregnancy.

Table of Contents

Table of Contents

1.0 Introduction

2.0 Material and Methods

2.1. Study population

2.2. Per- and polyfluorinated Substances (PFAS) measurement

2.3. Hypertensive disorders of pregnancy

2.4. Covariates

2.5. Statistical analyses

3.0 Results

4.0 Discussion

5.0 Conclusions

6.0 References

7.0 Tables and figures

Table 1. Description of demographics characteristics of the Atlanta African American Maternal-Child Cohort, 2016-2020 (N=513)

Table 2. Distribution of serum per- and polyfluoroalkyl substances (ng/mL) concentrations in the Atlanta African American Maternal-Child Cohort (N = 513).

Table 3. Unadjusted and adjusted odds ratios and 95% confidence intervals for individual pregnancy complications with an interquartile range increase in serum PFAS (ng/mL) unit increase in the Atlanta African American Maternal-Child Cohort.

Table 4. Odds ratios and 95% confidence intervals for the association between individual pregnancy complications and the PFAS exposure mixture, estimated using quantile g-computation among pregnant persons in the Atlanta African American Maternal-Child Cohort.

Table 5. Weights representing the proportion of the positive and negative effect on hypertensive disorders of pregnancy in relation to a mixture of PFAS, estimated using quantile g-computation in the Atlanta African American Maternal-Child Cohort (N=513).

Figure 1. Spearman correlation coefficients between natural log transformed PFAS concentrations in the Atlanta African American Maternal-Child Cohort (N=513).

Figure 2.  Adjusted odds ratios and 95% confidence intervals for hypertensive disorders of pregnancy with an interquartile range increase in serum PFAS (ng/mL) unit increase in the Atlanta African American Maternal-Child Cohort.

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Environmental Health
Keyword	African Americans Per- and polyfluoroalkyl substances (PFAS) Pregnancy complications Adverse birth outcomes Hypertensive disorders of pregnancy Prenatal exposure
Committee Chair / Thesis Advisor	Dr. Stephanie Eick, Emory University

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