Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Environ Health Perspect. 2021 Oct;129(10):107004. doi: 10.1289/EHP9091. Epub 2021 Oct 12.
Prenatal exposure to perfluoroalkyl substances (PFAS) has been previously associated with preeclampsia, although findings are mixed with respect to the direction and magnitude of effect. To our knowledge, no studies have examined associations between PFAS and preeclampsia subtypes, which may have distinct etiologies.
We examined associations between PFAS, any preeclampsia diagnosis, and early- and late-onset preeclampsia. In addition, we estimated associations between PFAS and the angiogenic biomarkers soluble fms-like tyrosine kinase-1 (sFLT-1) and placental growth factor (PlGF), which provide an estimate of pro- and anti-angiogenic activity within the placenta.
This case-control study ( cases, controls) was sampled from the LIFECODES birth cohort. Nine legacy PFAS were quantified in maternal plasma from early pregnancy ( 10 wk) and angiogenic biomarkers were quantified in maternal plasma from four study visits ( 10, 18, 26, and 35 wk). Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the association between an interquartile range (IQR)-increase in PFAS and preeclampsia outcomes. Linear regression was used to estimate associations between an IQR-increase in PFAS and concentrations of angiogenic biomarkers.
Both perfluorodecanoic acid ( 1.64, 95% CI: 1.08, 2.47) and perfluorooctanesulfonic acid ( 1.60, 95% CI: 1.06, 2.43) were associated with higher odds of late-onset preeclampsia. Associations tended to be below the null for early-onset preeclampsia, although findings were imprecise. Few associations were noted between PFAS and angiogenic biomarkers.
Maternal PFAS concentrations were associated with higher odds of late-onset preeclampsia. Heterogeneity of preeclampsia should be considered in future studies because populations may have different distributions of disease subtypes. https://doi.org/10.1289/EHP9091.
先前的研究表明，产前暴露于全氟烷基物质（PFAS）与子痫前期有关，尽管关于作用方向和程度的研究结果存在差异。据我们所知，尚无研究探讨 PFAS 与子痫前期子类型之间的关系，这些子类型可能具有不同的病因。
我们研究了 PFAS 与子痫前期的任何诊断以及早发型和晚发型子痫前期之间的关系。此外，我们还评估了 PFAS 与血管生成生物标志物可溶性 fms 样酪氨酸激酶-1（sFLT-1）和胎盘生长因子（PlGF）之间的关系，这些生物标志物可以评估胎盘内的促血管生成和抗血管生成活性。
这项病例对照研究（病例组 n=307，对照组 n=286）是从 LIFECODES 出生队列中抽取的样本。在妊娠早期（10 周）测量了母亲血浆中的 9 种 legacy PFAS，并在 4 次研究访问时（10、18、26 和 35 周）测量了血管生成生物标志物。使用逻辑回归估计 PFAS 每四分位间距（IQR）增加与子痫前期结局之间的比值比（OR）及其 95%置信区间（CI）。使用线性回归估计 PFAS 每 IQR 增加与血管生成生物标志物浓度之间的关系。
全氟癸酸（OR=1.64，95%CI：1.08，2.47）和全氟辛烷磺酸（OR=1.60，95%CI：1.06，2.43）与晚发型子痫前期的发病风险较高相关。虽然结果不精确，但早发型子痫前期的相关性倾向于低于零。PFAS 与血管生成生物标志物之间几乎没有关联。
母体 PFAS 浓度与晚发型子痫前期的发病风险较高相关。未来的研究应考虑子痫前期的异质性，因为不同人群可能具有不同的疾病子类型分布。
