Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Massarenti 9, 40138, Bologna, (BO), Italy.
Human Milk Bank "Allattami", Via Cadriano 27/2, 40127, Bologna, (BO), Italy.
Eur J Pediatr. 2021 Sep;180(9):3047-3051. doi: 10.1007/s00431-021-04073-4. Epub 2021 Apr 10.
Perfluoroalkyl substances (PFASs) are environmental contaminants that have been shown to exert toxic effects, which are dependent upon concentration, in animals and humans. No specific data on the exposure of preterm infants to PFASs are available. We aimed to quantify the potential exposure of preterm infants to PFASs through human milk (HM), to be compared to the exposure data recently reported for infants by EFSA. The amount of PFASs in ten preterm (PHM) and ten donor HM (DHM) samples was evaluated, and the expected daily intake (EDI) at full enteral feeding was calculated. This EDI was compared to the mean and the 95 centile dietary exposure ranges at the lower bound for infants issued by EFSA. The calculated median EDI for total PFASs was 20.72 ng/kg/day (range 10.72-107.84) for PHM and 17.92 ng/kg/day (range 6.4-28.96) for DHM, which were both higher than mean exposure ranges reported for infants (2.4-12.2 ng/kg/day). The calculated EDI for DHM was far more similar to the 95 centile (4.5-27.9 ng/kg/day) dietary exposure ranges. For PHM samples, higher EDI values were obtained, with 4 out of 10 samples exceeding the upper limit of the 95 centile range.Conclusion: The exposure of preterm infants to PFASs through HM feeding might exceed reference values reported for older and healthier infants. Given the immunological and developmental vulnerability of preterm infants, the risks related to their exposure to PFASs should be further investigated, also focusing on how maternal exposure and subsequent transfer through HM feeding can be reduced. What is Known: • Perfluoroalkyl substances (PFASs) are environmental contaminants that have been shown to exert toxic effects, which are dependent upon concentration, in animals and humans. The EFSA has recently issued reference values for PFASs exposure for different age groups. • Infants might be exposed to PFASs prenatally, as these substances can cross the placenta, and postnatally, through breastfeeding. No specific data about exposure of preterm infants through human milk (HM) feeding are currently available. What is New: • The exposure of preterm infants to PFASs through HM feeding might exceed reference values reported for older and healthier infants. • Given the immunological and developmental vulnerability of preterm infants, the risks related to their exposure to PFASs deserve further investigation. As HM represents the optimal feeding for preterm infants, it will be fundamental to focus on how maternal exposure and subsequent transfer through HM feeding can be reduced.
全氟烷基物质 (PFAS) 是一种环境污染物，已被证明在动物和人类中具有毒性效应，且其毒性效应取决于浓度。目前尚无关于早产儿接触 PFAS 的具体数据。我们旨在通过人乳 (HM) 量化早产儿接触 PFAS 的潜在暴露情况，并与 EFSA 最近报告的婴儿接触数据进行比较。评估了 10 份早产儿人乳 (PHM) 和 10 份捐赠人乳 (DHM) 样本中的 PFAS 含量，并计算了完全肠内喂养时的预期每日摄入量 (EDI)。将计算得出的总 PFAS EDI 与 EFSA 为婴儿设定的最低下限的 95%置信区间的中位值和第 95 百分位数的膳食暴露范围进行了比较。对于 PHM，计算得出的总 PFAS 的中位 EDI 为 20.72ng/kg/天（范围 10.72-107.84），对于 DHM，为 17.92ng/kg/天（范围 6.4-28.96），均高于 EFSA 报告的婴儿的中位暴露范围（2.4-12.2ng/kg/天）。DHM 的计算 EDI 更接近第 95 百分位数（4.5-27.9ng/kg/天）的膳食暴露范围。对于 PHM 样本，得出了更高的 EDI 值，其中 10 个样本中有 4 个超过了第 95 百分位数范围的上限。结论：通过 HM 喂养，早产儿接触 PFAS 的情况可能超过为年龄较大且健康的婴儿设定的参考值。鉴于早产儿的免疫和发育脆弱性，应进一步调查他们接触 PFAS 相关的风险，同时还应重点关注如何减少母体接触和随后通过 HM 喂养的传递。已知内容：• 全氟烷基物质 (PFAS) 是一种环境污染物，已被证明在动物和人类中具有毒性效应，且其毒性效应取决于浓度。EFSA 最近为不同年龄组的 PFAS 接触发布了参考值。• 婴儿可能会在产前通过胎盘接触 PFAS，也可能在产后通过母乳喂养接触 PFAS。目前尚无关于通过人乳 (HM) 喂养早产儿接触 PFAS 的具体数据。新内容：• 通过 HM 喂养，早产儿接触 PFAS 的情况可能超过为年龄较大且健康的婴儿设定的参考值。• 鉴于早产儿的免疫和发育脆弱性，应进一步调查他们接触 PFAS 相关的风险。由于 HM 是早产儿的最佳喂养方式，因此需要重点关注如何减少母体接触和随后通过 HM 喂养的传递。
