Department of Epidemiology, Brown University, Providence, Rhode Island 02912, USA. david_savitz@ brown.edu
Environ Health Perspect. 2012 Aug;120(8):1201-7. doi: 10.1289/ehp.1104752. Epub 2012 Mar 26.
Perfluorooctanoic acid (PFOA) is a potential cause of adverse pregnancy outcomes, but previous studies have been limited by low exposures and small study size.
Using birth certificate information, we examined the relation between estimated PFOA exposure and birth outcomes in an area of West Virginia and Ohio whose drinking water was contaminated by a chemical plant.
Births in the study area from 1990 through 2004 were examined to generate case groups of stillbirth (n = 106), pregnancy-induced hypertension (n = 224), preterm birth (n = 3,613), term low birth weight (n = 918), term small-for-gestational-age (SGA) (n = 353), and a continuous measure of birth weight among a sample of term births (n = 4,534). A 10% sample of term births ≥ 2,500 g were selected as a source of controls (n = 3,616). Historical estimates of serum PFOA were derived from a previously developed fate and transport model. In a second study, we examined 4,547 area births linked to a survey with residential history data.
In the analysis based only on birth records, we found no consistent evidence of an association between estimated PFOA exposure and stillbirth, pregnancy-induced hypertension, preterm birth, or indices of fetal growth. In the analysis of birth records linked to the survey, PFOA was unrelated to pregnancy-induced hypertension or preterm birth but showed some suggestion of an association with early preterm birth. Measures of growth restriction showed weak and inconsistent associations with PFOA.
Based on the analysis using the health survey, these results provide little support for an effect of PFOA exposure on most pregnancy outcomes, except for early preterm birth and possibly fetal growth restriction.
全氟辛酸（PFOA）是一种可能导致不良妊娠结局的物质，但之前的研究由于暴露水平低和研究规模小而受到限制。
利用出生证明信息，我们在西弗吉尼亚州和俄亥俄州的一个地区进行了研究，该地区的饮用水受到化工厂的污染，研究了 PFOA 暴露与出生结局之间的关系。
研究了该地区 1990 年至 2004 年的出生情况，以产生死胎（n=106）、妊娠高血压（n=224）、早产（n=3613）、足月低体重儿（n=918）、足月小于胎龄儿（n=353）以及足月出生体重连续测量的病例组（n=4534）。从≥2500g 的足月出生中选择 10%的样本作为对照组（n=3616）。血清 PFOA 的历史估计值来自以前开发的命运和运输模型。在第二项研究中，我们研究了与包含居住史数据的调查相关的 4547 个地区出生情况。
仅基于出生记录的分析中，我们没有发现 PFOA 暴露与死胎、妊娠高血压、早产或胎儿生长指数之间存在一致的关联证据。在与调查相关的出生记录分析中，PFOA 与妊娠高血压或早产无关，但与早期早产有一定的关联。生长受限的指标与 PFOA 呈弱且不一致的关联。
基于使用健康调查的分析结果，这些结果几乎没有支持 PFOA 暴露对大多数妊娠结局（除了早期早产和可能的胎儿生长受限）的影响。
