Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China.
The Third Affiliated Hospital of Guangxi Medical University, Nanning, 530031, Guangxi, China.
Chemosphere. 2022 Nov;307(Pt 1):135741. doi: 10.1016/j.chemosphere.2022.135741. Epub 2022 Jul 18.
Perfluoroalkyl substances (PFASs) are persistent organic pollutants that may lead the adverse birth outcomes, including preterm birth (PTB). However, previous studies have reported inconsistent results on the association between PFASs and PTB, and lack of the epidemiological evidence regarding the effect of PFASs mixture on PTB. This study aimed to explore association of individual and multiple exposure to PFASs with PTB.
The study subjects were consisted of 1341 pregnant women from Guangxi Zhuang Birth Cohort in Guangxi, China, from June 2015 to April 2019. Nine PFASs concentrations in the maternal serum were examined by ultrahigh liquid performance chromatography-tandem mass spectrometry, and the gestational weeks were obtained from medical records. We applied binary logistics regression model to explore correlation between individual PFAS and PTB and inspected the combined effect of PFASs mixture on PTB by applying Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) regression models.
In adjusted logistics regression model, perfluorooctane sulfonate (PFOS), perfluoroheptanoic acid (PFHpA), perfluorobutanesulfonic acid (PFBS), ∑perfluorinated sulfonic acids (PFSA), and ∑PFASs were positively associated with the risk of PTB. In contrast, perfluoroundecanoic acid (PFUnA), perfluorohexane sulfonate (PFHxS), and perfluorooctanoic acid (PFOA) were negatively associated with the risk of PTB. These associations of n PFOS and PFHpA with PTB were found to be more pronounced in male infants. Restricted cubic splines (RCSs) showed an inverse U-shaped relationship between PFBS and PTB. Analysis from BKMR model showed a positive association between PFASs mixture and PTB, and no evidence of interactions among the nine PFASs were detected. Additionally, PFHpA, PFOS, and PFBS were identified as the main contributors for the effect of PFASs mixture on increasing the risk of PTB by BKMR and WQS models.
Prenatal exposure to higher levels of PFASs mixture was associated with higher risk of PTB.
全氟烷基物质（PFASs）是持久性有机污染物，可能导致不良的出生结局，包括早产（PTB）。然而，先前的研究报告了 PFASs 与 PTB 之间关联的不一致结果，并且缺乏关于 PFASs 混合物对 PTB 影响的流行病学证据。本研究旨在探讨个体和多种 PFASs 暴露与 PTB 的关系。
研究对象包括 2015 年 6 月至 2019 年 4 月来自中国广西壮族出生队列的 1341 名孕妇。采用超高效液相色谱-串联质谱法检测母体血清中 9 种 PFASs 浓度，并从病历中获取孕周。我们应用二元逻辑回归模型探讨个体 PFAS 与 PTB 的相关性，并应用贝叶斯核机器回归（BKMR）和加权分位数总和（WQS）回归模型检查 PFASs 混合物对 PTB 的联合作用。
在调整后的逻辑回归模型中，全氟辛烷磺酸（PFOS）、全氟庚酸（PFHpA）、全氟丁烷磺酸（PFBS）、全氟磺酸总和（PFSA）和全氟化合物总和（∑PFASs）与 PTB 风险呈正相关。相反，全氟癸酸（PFUnA）、全氟己烷磺酸（PFHxS）和全氟辛酸（PFOA）与 PTB 风险呈负相关。PFOS 和 PFHpA 与男婴 PTB 的相关性更为显著。限制性立方样条（RCSs）显示 PFBS 与 PTB 之间呈反 U 型关系。BKMR 模型分析表明，PFASs 混合物与 PTB 呈正相关，并且未检测到 9 种 PFASs 之间存在相互作用的证据。此外，BKMR 和 WQS 模型表明，PFHpA、PFOS 和 PFBS 是 PFASs 混合物增加 PTB 风险的主要因素。
产前暴露于高水平的 PFASs 混合物与较高的 PTB 风险相关。
