Birth Outcomes in Relation to Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Stress in the Environmental Influences on Child Health Outcomes (ECHO) Program

Overview

Journal Environ Health Perspect

Date 2023 Mar 15

PMID 36920051

Authors

Amy M Padula

Xuejuan Ning

Shivani Bakre

Emily S Barrett

Tracy Bastain

Deborah H Bennett

Michael S Bloom

Carrie V Breton

Anne L Dunlop

Stephanie M Eick

Assiamira Ferrara

Abby Fleisch

Sarah Geiger

Dana E Goin

Kurunthachalam Kannan

Margaret R Karagas

Susan Korrick

John D Meeker

Rachel Morello-Frosch

Thomas G OConnor

Emily Oken

Morgan Robinson

Megan E Romano

Susan L Schantz

Rebecca J Schmidt

Anne P Starling

Yeyi Zhu

Ghassan B Hamra

Tracey J Woodruff

Affiliations

Soon will be listed here.

Abstract

Background: Per- and polyfluoroalkyl substances (PFAS) are persistent and ubiquitous chemicals associated with risk of adverse birth outcomes. Results of previous studies have been inconsistent. Associations between PFAS and birth outcomes may be affected by psychosocial stress.

Objectives: We estimated risk of adverse birth outcomes in relation to prenatal PFAS concentrations and evaluate whether maternal stress modifies those relationships.

Methods: We included 3,339 participants from 11 prospective prenatal cohorts in the Environmental influences on the Child Health Outcomes (ECHO) program to estimate the associations of five PFAS and birth outcomes. We stratified by perceived stress scale scores to examine effect modification and used Bayesian Weighted Sums to estimate mixtures of PFAS.

Results: We observed reduced birth size with increased concentrations of all PFAS. For a 1-unit higher log-normalized exposure to perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS), we observed lower birthweight-for-gestational-age z-scores of [95% confidence interval (CI): , ], (95% CI: , ), (95% CI: , ), (95% CI: , 0.06), and (95% CI: , ), respectively. We observed a lower odds ratio (OR) for large-for-gestational-age: (95% CI: 0.38, 0.83), (95% CI: 0.35, 0.77). For a 1-unit increase in log-normalized concentration of summed PFAS, we observed a lower birthweight-for-gestational-age z-score [; 95% highest posterior density (HPD): , ] and decreased odds of large-for-gestational-age (; 95% HPD: 0.29, 0.82). Perfluorodecanoic acid (PFDA) explained the highest percentage (40%) of the summed effect in both models. Associations were not modified by maternal perceived stress.

Discussion: Our large, multi-cohort study of PFAS and adverse birth outcomes found a negative association between prenatal PFAS and birthweight-for-gestational-age, and the associations were not different in groups with high vs. low perceived stress. This study can help inform policy to reduce exposures in the environment and humans. https://doi.org/10.1289/EHP10723.

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