NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, 200032, China.
NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China.
Environ Res. 2022 Dec;215(Pt 2):114284. doi: 10.1016/j.envres.2022.114284. Epub 2022 Sep 8.
Previous studies have reported inconsistent associations between perfluoroalkyl and polyfluoroalkyl substances (PFAS) and gestational hypertension (GH) and blood pressure (BP) during pregnancy. Herein, we aimed to evaluate individual and overall effects of PFAS on GH and longitudinal BP measures during pregnancy. We included 826 pregnant women from the Jiashan Birth Cohort established between 2016 and 2018. Concentrations of thirteen PFAS were quantified using plasma samples collected within 16 weeks of gestation. Longitudinal BP measures were obtained from medical records, and more than nine measurements were available for 85.60% of participants. GH was defined as new-onset hypertension occurring after 20 weeks of gestation. Logistic regression models were used to examine the effect of PFAS on GH, while generalized estimating equation models evaluated the average effect of PFAS on BP in each trimester. The potential effect modification by fetal sex was also examined. Bayesian kernel machine regression (BKMR) and quantile g-computation (QgC) were implemented to explore the overall effect of the PFAS mixture. PFOA, PFOS, and PFHxS presented the highest median concentrations of 11.99, 8.81 and 5.43 ng/mL, respectively. Overall, 5.57% of subjects developed GH. PFOS, PFDA, PFUdA, and PFDoA were significantly associated with lower GH odds, and odds ratios ranged between 0.62 and 0.68. We noted associations between PFAS and lower systolic BP and diastolic BP in the third trimester, with PFDA and PFUdA exhibiting the effect on systolic BP only in pregnant women carrying a female fetus. These associations were further confirmed by BKMR and QgC, showing an inverse overall effect of the PFAS mixture. Higher concentrations of PFAS during early pregnancy were associated with lower GH risk and longitudinal BP measures in the third trimester in a population with relatively high exposure levels. Fetal sex might modify the effects of PFDA and PFUdA on systolic BP in the third trimester.
先前的研究报告称，全氟烷基和多氟烷基物质（PFAS）与妊娠期间的妊娠高血压（GH）和血压（BP）之间的关联并不一致。在此，我们旨在评估 PFAS 对妊娠期间 GH 和纵向 BP 测量的个体和总体影响。我们纳入了 2016 年至 2018 年期间建立的嘉善出生队列中的 826 名孕妇。使用妊娠 16 周内采集的血浆样本定量测定了 13 种 PFAS 的浓度。纵向 BP 测量值从病历中获得，超过 9 次测量值可用于 85.60%的参与者。GH 定义为妊娠 20 周后新发生的高血压。使用逻辑回归模型检查 PFAS 对 GH 的影响，而广义估计方程模型则评估了 PFAS 在每个三个月期间对 BP 的平均影响。还检查了胎儿性别对潜在效应修饰的影响。实施贝叶斯核机器回归（BKMR）和分位数 g 计算（QgC）以探索 PFAS 混合物的总体影响。PFOA、PFOS 和 PFHxS 的中位数浓度最高，分别为 11.99、8.81 和 5.43 ng/mL。总体而言，有 5.57%的受试者发生 GH。PFOS、PFDA、PFUdA 和 PFDoA 与 GH 几率降低显著相关，比值比在 0.62 至 0.68 之间。我们注意到 PFAS 与第三个三个月的收缩压和舒张压较低之间存在关联，PFDA 和 PFUdA 仅在携带女胎的孕妇中对收缩压有影响。BKMR 和 QgC 进一步证实了这些关联，表明 PFAS 混合物具有反向的总体影响。在暴露水平相对较高的人群中，妊娠早期 PFAS 浓度较高与 GH 风险降低和第三个三个月的纵向 BP 测量值降低相关。胎儿性别可能会修饰 PFDA 和 PFUdA 对第三个三个月收缩压的影响。
