Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; German Center for Diabetes Research München-Neuherberg, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.
Environ Int. 2021 Jun;151:106442. doi: 10.1016/j.envint.2021.106442. Epub 2021 Feb 17.
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.
To study the association between PFAS exposure in early pregnancy and maternal BP trajectories in pregnancy, gestational hypertension and preeclampsia.
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.
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.
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.
先前关于多氟和全氟烷基物质（PFAS）暴露与妊娠高血压（GH）和子痫前期（PE）之间关联的研究结果相互矛盾，但大多数研究将结局二分法处理，并未研究连续血压（BP）变化。
研究妊娠早期 PFAS 暴露与孕妇妊娠期间 BP 轨迹、妊娠高血压和子痫前期之间的关系。
1436 名妇女在妊娠早期参加了奥登塞儿童队列研究，并抽取了血清样本，采用 LC-MS/MS 测定了其中的全氟己烷磺酸（PFHxS）、全氟辛烷磺酸（PFOS）、全氟辛酸（PFOA）、全氟壬酸（PFNA）和全氟癸酸（PFDA）的含量。通过妊娠期间多次 BP 测量和医院病历获得 PE 相关信息。采用调整后的线性混合模型来研究 PFAS 暴露与 BP 轨迹之间的关系。采用 Cox 比例风险模型评估 PFAS 与 PE 和 GH 的关系。
所有女性的 PFAS 浓度均有可测量值。在许多比较中，较高的 PFAS 暴露（PFHxS 除外）与较高的收缩压（SBP）和舒张压（DBP）相关，尽管并非所有结果均具有统计学意义，但这不太可能是由于偶然因素造成的。调整后，PFOS 或 PFOA 暴露每增加一倍，SBP 分别增加 0.47mmHg（95%CI：-0.13；1.08）和 0.36mmHg（-0.19；0.92）；DBP 分别增加 0.58mmHg（0.13；1.04）和 0.37mmHg（-0.05；0.79）。未发现 PFAS 暴露与 PE 或 GH 之间存在明确关联。
PFAS 暴露与 BP 之间的关联幅度可能看起来较小，统计学上无显著性，潜在的临床重要性较低。然而，从人群水平来看，这可能会使 GH 的发病率略升高，BP 分布向更高的方向移动。如果妊娠期间 BP 升高，不仅会对孕妇，还会对其后代的健康产生长期影响。
