Prior studies suggest that prenatal per- and polyfluoroalkyl substances (PFAS) exposures are associated with shorter breastfeeding duration. Studies assessing PFAS mixtures and populations in North America are sparse. We quantified PFAS concentrations in maternal plasma collected during pregnancy in the New Hampshire Birth Cohort Study (2010–2017). Participants completed standardized breastfeeding surveys at regular intervals until weaning (n = 813). We estimated associations between mixtures of 5 PFAS and risk of stopping exclusive breastfeeding before 6 months or any breastfeeding before 12 months using probit Bayesian kernel machine regression. For individual PFAS, we calculated the relative risk and hazard ratio (HR) of stopping breastfeeding using modified Poisson regression and accelerated failure time models respectively. PFAS mixtures were associated with stopping exclusive breastfeeding before 6 months, primarily driven by perfluorooctanoate (PFOA). We observed statistically significant trends in the association of perfluorohexane sulfonate (PFHxS), PFOA, and perfluorononanoate (PFNA) (p-trends≤0.02) with stopping exclusive breastfeeding. Participants in the highest PFOA quartile had a 28% higher risk of stopping exclusive breastfeeding before 6 months compared to those in the lowest quartile (95% Confidence Interval: 1.04, 1.56). Similar trends were observed for PFHxS and PFNA with exclusive breastfeeding (p-trends≤0.05). PFAS were not associated with stopping any breastfeeding before 12 months. In this cohort, we observed that participants with greater overall plasma PFAS concentrations had greater risk of stopping exclusive breastfeeding before 6 months and associations were driven largely by PFOA. These findings further support the growing literature indicating that PFAS may be associated with shorter duration of breastfeeding.

中文翻译：

---

新罕布什尔州出生队列研究中怀孕期间和母乳喂养期间的血浆全氟烷基物质混合物和多氟烷基物质混合物

先前的研究表明，产前的全氟烷基物质和多氟烷基物质 (PFAS) 暴露与较短的母乳喂养时间有关。评估北美 PFAS 混合物和人群的研究很少。我们在新罕布什尔州出生队列研究（2010-2017）中量化了怀孕期间收集的母体血浆中的 PFAS 浓度。参与者定期完成标准化母乳喂养调查，直至断奶 (n = 813)。我们使用概率贝叶斯核机回归估计了 5 种 PFAS 混合物与 6 个月前停止纯母乳喂养或 12 个月前停止任何母乳喂养的风险之间的关联。对于个体 PFAS，我们分别使用修正的泊松回归和加速失效时间模型计算了停止母乳喂养的相对风险和风险比 (HR)。 PFAS 混合物与 6 个月前停止纯母乳喂养有关，主要由全氟辛酸 (PFOA) 驱动。我们观察到全氟己烷磺酸盐 (PFHxS)、PFOA 和全氟壬酸盐 (PFNA)（p 趋势≤0.02）与停止纯母乳喂养之间的关联具有统计学上显着的趋势。与最低四分位数的参与者相比，最高 PFOA 四分位数的参与者在 6 个月前停止纯母乳喂养的风险高出 28%（95% 置信区间：1.04、1.56）。纯母乳喂养的 PFHxS 和 PFNA 也观察到类似的趋势（p 趋势≤0.05）。 PFAS 与 12 个月前停止母乳喂养无关。在该队列中，我们观察到，总体血浆 PFAS 浓度较高的参与者在 6 个月前停止纯母乳喂养的风险较大，并且这种关联主要是由 PFOA 驱动的。这些发现进一步支持了越来越多的文献表明 PFAS 可能与较短的母乳喂养时间有关。