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.

中文翻译：

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来自欧登塞儿童队列的 1436 名妇女在怀孕期间接触全氟烷基物质和血压

 背景

先前关于接触多氟烷基物质和全氟烷基物质 (PFAS) 与妊娠高血压 (GH) 和先兆子痫 (PE) 之间关系的研究显示了相互矛盾的结果，但大多数结果都是二分法，并且没有研究连续血压 (BP) 变化。

 目标

研究妊娠早期 PFAS 暴露与孕期母亲血压轨迹、妊娠期高血压和先兆子痫之间的关联。

 方法

1436 名妊娠早期妇女被纳入欧登塞儿童队列，并抽取了血清样本，其中全氟己烷磺酸 (PFHxS)、全氟辛烷磺酸 (PFOS)、全氟辛酸 (PFOA)、全氟壬酸 (PFNA) 和全氟癸酸 (PFNA)。 PFDA）使用 LC-MS/MS 进行测量。整个怀孕期间的重复血压测量和 PE 信息均从医院档案中获得。使用调整后的线性混合模型来研究 PFAS 暴露与血压轨迹之间的关联。通过 Cox 比例风险模型评估 PFAS 与 PE 和 GH 之间的关联。

 结果

所有女性的 PFAS 浓度均可测量。在所有许多比较中，较高的 PFAS 暴露（PFHxS 除外）与较高的收缩压 (SBP) 和舒张压 (DBP) 相关，尽管并非全部都很显着，这不太可能是偶然的。调整后，PFOS 或 PFOA 暴露量每增加一倍，SBP 就会升高 0.47 mmHg（95% CI：-0.13；1.08）和 0.36 mmHg（-0.19；0.92）； DBP 升高 0.58 mmHg (0.13; 1.04) 和 0.37 mmHg (-0.05; 0.79)。未发现 PFAS 暴露与 PE 或 GH 之间存在明显关联。

 讨论

PFAS 暴露与血压之间的关联程度可能很小，在统计上不显着，而且可能的临床重要性也很低。然而，在人口水平上，这可能会稍微改变 BP 的分布，导致 GH 发病率增加。如果怀孕期间血压升高，不仅可能对孕妇及其后代的健康产生长期影响。