TY - JOUR
T1 - Exposure to perfluoroalkyl substances and blood pressure in pregnancy among 1436 women from the Odense Child Cohort
AU - Birukov, Anna
AU - Andersen, Louise Bjørkholt
AU - Andersen, Marianne Skovsager
AU - Nielsen, Julie H.
AU - Nielsen, Flemming
AU - Kyhl, Henriette Boye
AU - Jørgensen, Jan Stener
AU - Grandjean, Philippe
AU - Dechend, Ralf
AU - Jensen, Tina Kold
N1 - Funding Information:
The families in OCC are acknowledged for their participation and commitment to the study. The midwives at the Department of Obstetrics and Gynecology, technicians at Hans Christian Andersen's Children's Hospital and at the Department of Environmental Medicine are acknowledged for their careful examination of the participants and analysis of PFAS in serum samples. This work was supported by the Danish Foundation for Scientific Innovation and Technology (09-067180), Innovation Fund Denmark, Odense University Hospital, the Region of Southern Denmark, the Municipality of Odense, the Mental Health Service of the Region of Southern Denmark, The European Union, Human Biomonitorying for EU (HBM4EU), Odense University Hospital Research Foundation, Odense Patient data Exploratory Network (OPEN), Novo Nordisk Foundation (grant nr. NNF19OC0058266 and NNF17OC0029404), the Danish Council for Independent Research (4004-00352B_FSS), The Foundation for research collaboration between Rigshospitalet and Odense University Hospital, and the Health Foundation (Helsefonden). PG is supported by the National Institute of Environmental Health Sciences, NIH (P42ES027706).
Publisher Copyright:
© 2021 The Authors
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - Background: Previous studies of association between exposure to poly- and perfluoroalkyl substances (PFAS) and gestational hypertension (GH) and preeclampsia (PE) have shown conflicting results, but most dichotomized outcome and did not study continuous blood pressure (BP) changes. Objectives: To study the association between PFAS exposure in early pregnancy and maternal BP trajectories in pregnancy, gestational hypertension and preeclampsia. Methods: 1436 women were enrolled in the Odense Child Cohort in early pregnancy and had a serum sample drawn, from which perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) were measured using LC–MS/MS. Repeated BP measurements through pregnancy and information on PE were obtained from hospital files. Adjusted linear mixed models were used to investigate association between PFAS exposure and BP trajectory. Associations between PFAS and PE and GH were assessed by Cox proportional hazards model. Results: All women had measurable concentrations of PFAS. In all of many comparisons higher PFAS exposure (apart from PFHxS) was associated with higher systolic (SBP) and diastolic (DBP) blood pressures, although not all were significant, which is unlikely to be due to chance. After adjustment, each doubling in PFOS or PFOA exposure was associated with 0.47 mmHg (95% CI: −0.13; 1.08) and 0.36 mmHg (−0.19; 0.92) higher SBP; and 0.58 mmHg (0.13; 1.04) and 0.37 mmHg (−0.05; 0.79) higher DBP. No clear associations between PFAS exposure and PE or GH were found. Discussion: The magnitude of the association between PFAS exposure and BP might appear small, statistically non-significant and the possible clinical importance low. However, at a population level this may slightly shift the distribution of BP towards an increased incidence of GH. If BP increases in pregnancy, it may have long-term impact on health not only of the pregnant woman but also of her offspring.
AB - Background: Previous studies of association between exposure to poly- and perfluoroalkyl substances (PFAS) and gestational hypertension (GH) and preeclampsia (PE) have shown conflicting results, but most dichotomized outcome and did not study continuous blood pressure (BP) changes. Objectives: To study the association between PFAS exposure in early pregnancy and maternal BP trajectories in pregnancy, gestational hypertension and preeclampsia. Methods: 1436 women were enrolled in the Odense Child Cohort in early pregnancy and had a serum sample drawn, from which perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) were measured using LC–MS/MS. Repeated BP measurements through pregnancy and information on PE were obtained from hospital files. Adjusted linear mixed models were used to investigate association between PFAS exposure and BP trajectory. Associations between PFAS and PE and GH were assessed by Cox proportional hazards model. Results: All women had measurable concentrations of PFAS. In all of many comparisons higher PFAS exposure (apart from PFHxS) was associated with higher systolic (SBP) and diastolic (DBP) blood pressures, although not all were significant, which is unlikely to be due to chance. After adjustment, each doubling in PFOS or PFOA exposure was associated with 0.47 mmHg (95% CI: −0.13; 1.08) and 0.36 mmHg (−0.19; 0.92) higher SBP; and 0.58 mmHg (0.13; 1.04) and 0.37 mmHg (−0.05; 0.79) higher DBP. No clear associations between PFAS exposure and PE or GH were found. Discussion: The magnitude of the association between PFAS exposure and BP might appear small, statistically non-significant and the possible clinical importance low. However, at a population level this may slightly shift the distribution of BP towards an increased incidence of GH. If BP increases in pregnancy, it may have long-term impact on health not only of the pregnant woman but also of her offspring.
KW - Blood pressure
KW - Environmental chemicals
KW - Perfluoroalkyl substances (PFAS)
KW - Preeclampsia
KW - Pregnancy
U2 - 10.1016/j.envint.2021.106442
DO - 10.1016/j.envint.2021.106442
M3 - Journal article
C2 - 33610053
AN - SCOPUS:85101356923
SN - 0160-4120
VL - 151
JO - Environment International
JF - Environment International
M1 - 106442
ER -