4.7 Article

Associations of perfluoroalkyl and polyfluoroalkyl substances with gestational hypertension and blood pressure during pregnancy: A cohort study

期刊

ENVIRONMENTAL RESEARCH
卷 215, 期 -, 页码 -

出版社

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.envres.2022.114284

关键词

Perfluoroalkyl and polyfluoroalkyl substances; Gestational exposure; Mixture; Gestational hypertension; Blood pressure

资金

  1. National Key Research and Development Program of China [2021YFC2701003]
  2. National Natural Scientific Foundation of China [22076123]
  3. Science and Technology Commission of Shanghai Municipality [20ZR1448000]
  4. Shanghai Municipal Health Commission [202040275]
  5. Shanghai Municipal Commission of Health and Family Planning [201840184]
  6. Health Commission of Zhejiang Province [2018KY812, 2020KY320]
  7. NHC Key Lab of Reproduction Regulation [CX2022-04]

向作者/读者索取更多资源

This study aimed to evaluate the effects of perfluoroalkyl and polyfluoroalkyl substances (PFAS) on gestational hypertension and blood pressure during pregnancy. The results showed associations between PFAS and lower risk of gestational hypertension and lower blood pressure. Additionally, fetal sex may modify these effects.
Previous studies have reported inconsistent associations between perfluoroalkyl and polyfluoroalkyl substances (PFAS) and gestational hypertension (GH) and blood pressure (BP) during pregnancy. Herein, we aimed to evaluate individual and overall effects of PFAS on GH and longitudinal BP measures during pregnancy. We included 826 pregnant women from the Jiashan Birth Cohort established between 2016 and 2018. Concentra-tions of thirteen PFAS were quantified using plasma samples collected within 16 weeks of gestation. Longitudinal BP measures were obtained from medical records, and more than nine measurements were available for 85.60% of participants. GH was defined as new-onset hypertension occurring after 20 weeks of gestation. Logistic regression models were used to examine the effect of PFAS on GH, while generalized estimating equation models evaluated the average effect of PFAS on BP in each trimester. The potential effect modification by fetal sex was also examined. Bayesian kernel machine regression (BKMR) and quantile g-computation (QgC) were imple-mented to explore the overall effect of the PFAS mixture. PFOA, PFOS, and PFHxS presented the highest median concentrations of 11.99, 8.81 and 5.43 ng/mL, respectively. Overall, 5.57% of subjects developed GH. PFOS, PFDA, PFUdA, and PFDoA were significantly associated with lower GH odds, and odds ratios ranged between 0.62 and 0.68. We noted associations between PFAS and lower systolic BP and diastolic BP in the third trimester, with PFDA and PFUdA exhibiting the effect on systolic BP only in pregnant women carrying a female fetus. These associations were further confirmed by BKMR and QgC, showing an inverse overall effect of the PFAS mixture. Higher concentrations of PFAS during early pregnancy were associated with lower GH risk and longitudinal BP measures in the third trimester in a population with relatively high exposure levels. Fetal sex might modify the effects of PFDA and PFUdA on systolic BP in the third trimester.

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