Birth Outcomes in Relation to Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Stress in the Environmental Influences on Child Health Outcomes (ECHO) Program
Year: 2024
Type: article
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 formula presented [95% confidence interval (CI): formula presented ], formula presented (95% CI: formula presented ), formula presented (95% CI: formula presented ), formula presented (95% CI: formula presented , 0.06), and formula presented (95% CI: formula presented ), respectively. We observed a lower odds ratio (OR) for large-for-gestational-age: formula presented (95% CI: 0.38, 0.83), formula presented (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 [formula presented ; 95% highest posterior density (HPD): formula presented ] and decreased odds of large-for-gestational-age (formula presented ; 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.
Authors: Bastain, T, Starling, A.P, Bakre, S, Bennett, D.H, Woodruff, T.J, Hamra, G.B, O'Connor, T.G, Oken, E, Meeker, J.D, Bloom, M.S, Padula, A.M, Zhu, Y, Romano, M.E, Breton, C.V, Karagas, M.R, Goin, D.E, Barrett, E.S, Korrick, S, Environmental influences on Child Health Outcomes, Kannan, K, Ning, X, Schmidt, R.J, Schantz, S.L, Eick, S.M, Fleisch, A, Robinson, M, Morello-Frosch, R, Ferrara, A, Dunlop, A.L, Geiger, S
Institution: University of North Carolina at Chapel Hill
Language: English
Subfield: Environmental Chemistry
Field: Environmental Science
Domain: Physical Sciences
Open Access status: green
Funders: Northwestern University, Johns Hopkins University, National Institutes of Health, Johns Hopkins Bloomberg School of Public Health, National Institute of General Medical Sciences, Duke Clinical Research Institute, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1654048961, Center for Molecular Epidemiology, G5340521262, Understanding Prenatal Signals and Infant Development (UPSIDE), G9000010689, G9000027636, G9000030369, G9000031755, G9000035545, G9000049131, G9000061677, G9000095024, G9000097450, G9000124005, G9000205763, G9000255038, G9000256436, G9000311504, Atlanta ECHO Pediatric Cohort, A prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort Study, Environmental influences on Child Health Outcomes (ECHO) Coordinating Center, ECHO DAC (Environmental Influences on Child Health Outcomes Data Analysis Center)
OpenAlex ID: W4400026003