Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China.
Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai 200052, China.
Sci Total Environ. 2022 Oct 10;842:156869. doi: 10.1016/j.scitotenv.2022.156869. Epub 2022 Jun 22.
Previous studies on the association between exposure to per- and polyfluoroalkyl substances (PFAS) and sleep patterns in pregnant women are limited. This cohort study aims to assess the associations between PFAS and sleep quality in pregnant women. Of the 4127 women who participated in the Shanghai Birth Cohort, 3174, 3070, and 2887 women in their first, second, and third trimesters of gestation, respectively, were included in our analysis. Sleep measures were taken using the Pittsburgh Sleep Quality Index questionnaire. Ten PFAS were measured in blood samples collected in early pregnancy. We first evaluate the associations between individual PFAS and sleep quality in the three trimesters. Weighted quantile sum (WQS) regression models were performed to test the overall effect of the PFAS mixture on sleep quality during the three trimesters. Longitudinal analyses throughout pregnancy were performed with generalized estimating equation models. Furthermore, the effect of the PFAS mixture on longitudinal sleep patterns was examined using longitudinal latent class analyses combined with WQS models. The single pollutant analysis suggested that most PFAS were associated with increased sleep disturbance risk, lower sleep efficiency, and shorter sleep duration in the three trimesters. Similarly, the WQS models revealed a significant association between the PFAS mixtures and elevated sleep disturbance risk in pregnant women, with perfluorobutane sulfonate acting as the predominant risk factor. Additionally, the longitudinal analysis confirmed the effects of PFAS exposure on increased sleep disturbance over time. The PFAS mixture was positively associated with higher risks of poor sleep quality and sleep medicine use [adjusted odds ratio (aOR) = 1.10; 95 % confidence interval (95%CI): 1.01, 1.20; and aOR = 1.25 (95%CI: 1.04, 1.50) respectively] throughout the three trimesters. Our study suggests that PFAS may increase the risk of sleep disturbance in pregnant women. Further studies are needed to confirm our results and elucidate potential mechanisms.
先前关于孕期妇女暴露于全氟和多氟烷基物质（PFAS）与睡眠模式之间关联的研究较为有限。本队列研究旨在评估 PFAS 与孕妇睡眠质量之间的关系。在参加上海出生队列的 4127 名女性中，分别有 3174、3070 和 2887 名处于妊娠第一、第二和第三 trimester 的女性纳入了我们的分析。使用匹兹堡睡眠质量指数问卷来评估睡眠情况。在妊娠早期采集的血样中检测了十种 PFAS。我们首先评估了个体 PFAS 与三个 trimester 期间睡眠质量之间的关联。使用加权分位数总和（WQS）回归模型检验 PFAS 混合物对三个 trimester 期间睡眠质量的总体影响。通过广义估计方程模型对整个孕期进行纵向分析。此外，使用纵向潜类别分析结合 WQS 模型来检验 PFAS 混合物对纵向睡眠模式的影响。单污染物分析表明，在三个 trimester 中，大多数 PFAS 与睡眠障碍风险增加、睡眠效率降低和睡眠时间缩短有关。同样，WQS 模型显示 PFAS 混合物与孕妇睡眠障碍风险增加之间存在显著关联，其中全氟丁烷磺酸是主要的危险因素。此外，纵向分析证实了 PFAS 暴露随时间推移对睡眠障碍风险的影响。PFAS 混合物与较差的睡眠质量和使用睡眠医学的风险增加呈正相关[调整后的比值比（aOR）=1.10；95%置信区间（95%CI）：1.01，1.20；和 aOR=1.25（95%CI：1.04，1.50）]。我们的研究表明，PFAS 可能会增加孕妇睡眠障碍的风险。需要进一步的研究来证实我们的结果并阐明潜在的机制。
