Norwegian Institute of Public Health, Division of Infection Control and Environmental Health, Oslo, Norway; National Institute for Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA.
National Institute for Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA.
Environ Int. 2019 Mar;124:462-472. doi: 10.1016/j.envint.2018.12.041. Epub 2019 Jan 23.
Prenatal exposure to perfluoroalkyl substances (PFASs) has been inconsistently associated with asthma and allergic diseases and increased number of infections in early childhood. We examined the association of PFASs measured in pregnancy with childhood asthma, allergies and common infectious diseases in a prospective pregnancy cohort followed to age 7 years.
Six PFASs (out of 19 measured) with at least 80% of measurements above the limit of quantification (LOQ) in maternal plasma during pregnancy in two subcohorts of the Norwegian Mother and Child Cohort Study (MoBa) were analyzed in relation to health outcomes: perfluorooctane sulfonic acid (PFOS), acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluoroundecanoic acid (PFUnDA), and perfluoroheptane sulfonic acid (PFHpS). Follow-up questionnaires were completed at 3 years by 1270 women and at 7 years by 972 women among the 1943 with pregnancy questionnaire and PFAS measures. Health outcomes included parent reports of child's symptoms or doctor diagnosed asthma and allergic conditions at age 7 years and parent-reported frequency of various infections at 3 and 7 years of age. Logistic and Poisson regression were used. The false discovery rate was controlled at 5%. Sensitivity analyses on gender were performed.
Among the allergy and asthma outcomes, a statistically significant inverse association was seen between PFUnDA concentrations and ever having atopic eczema in girls. PFUnDA also tended to be inversely associated with both wheeze and asthma. For infections from 0 to 3 and 6 to 7 years, 11 significant positive associations were seen between PFASs and airways infections (bronchitis/pneumonia, throat infection, pseudocroup), ear infection and gastric flu/diarrhea; whereas 6 inverse associations were seen for pseudocroup, ear infections and urinary tract infections. The majority of the findings with respect to infectious diseases were found in girls only.
With the exception of an inverse association between PFUnDA and eczema, and a tendency of a similar association for wheeze and asthma, maternal PFAS levels during pregnancy showed little association with asthma or allergy related outcomes. Findings from the present study suggest immunosuppressive effects of PFASs on airways infections, such as bronchitis/pneumonia and throat infections, as well as diarrhea/gastric flu. Our results indicate a possible role of gender in the PFAS-health outcome associations.
产前接触全氟烷基物质（PFAS）与儿童哮喘、过敏和早期感染的发生呈不一致的关联。我们在一项前瞻性妊娠队列研究中，对 2 个子队列的孕妇血浆中至少 80%的测量值高于限量（LOQ）的 6 种 PFAS（共 19 种测量）与儿童哮喘、过敏和常见传染病的关系进行了分析。这些子队列均来自挪威母亲和儿童队列研究（MoBa）。在母亲怀孕期间，对 6 种 PFAS（共 19 种测量）进行了分析，其中至少有 80%的测量值高于限量（LOQ）。这 6 种 PFAS 分别为：全氟辛烷磺酸（PFOS）、酸（PFOA）、全氟己烷磺酸（PFHxS）、全氟壬酸（PFNA）、全氟癸酸（PFUnDA）和全氟庚烷磺酸（PFHpS）。在 1943 名完成妊娠问卷和 PFAS 测量的女性中，有 1270 名女性在 3 岁时和 972 名女性在 7 岁时完成了随访问卷。健康结果包括父母报告的 7 岁儿童的症状或医生诊断的哮喘和过敏情况，以及父母报告的 3 岁和 7 岁时各种感染的频率。采用逻辑和泊松回归进行分析。假发现率控制在 5%。进行了性别敏感性分析。
在过敏和哮喘结果中，女孩的 PFUnDA 浓度与特应性皮炎的发生呈统计学上的负相关。PFUnDA 与喘息和哮喘也呈负相关趋势。对于 0 至 3 岁和 6 至 7 岁的感染，在气道感染（支气管炎/肺炎、喉咙感染、假性喉炎）、耳部感染和流感/腹泻之间，有 11 个与 PFAS 呈显著正相关；而在假性喉炎、耳部感染和尿路感染方面，有 6 个与 PFAS 呈负相关。关于传染病的大部分发现仅见于女孩。
除了 PFUnDA 与湿疹之间存在负相关，以及与喘息和哮喘也存在类似的关联趋势外，孕妇在怀孕期间的 PFAS 水平与哮喘或过敏相关结果几乎没有关联。本研究的结果表明，PFAS 对气道感染具有免疫抑制作用，如支气管炎/肺炎和喉咙感染，以及腹泻/流感。我们的研究结果表明，性别可能在 PFAS 与健康结果的关联中起作用。
