Timmermann Amalie, Avenbuan Oyemwenosa N, Romano Megan E, Braun Joseph M, Tolstrup Janne S, Vandenberg Laura N, Fenton Suzanne E
National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark.
Curriculum in Toxicology and Environmental Medicine, University of North Carolina, Chapel Hill, NC 27 599-7325, USA.
Toxics. 2023 Mar 29;11(4):325. doi: 10.3390/toxics11040325.
Milk formation in the breast during breastfeeding is a complex hormonally regulated process, potentially sensitive to the effects of endocrine-disrupting chemical exposures. The environmental chemicals, per- and polyfluoroalkyl substances (PFAS) are known endocrine disruptors. PFAS exposure have been associated with insufficient mammary gland development in mice and reduced breastfeeding duration in humans. The aim of this review was to gather the epidemiological evidence on the association between PFAS exposure and breastfeeding duration. Using PubMed and Embase, we performed a systematic literature search (on 23 January 2023) to identify epidemiological studies examining the association between maternal PFAS exposure and breastfeeding duration. Animal studies, reviews, and non-English studies were excluded. The risk of bias was assessed using the risk of bias in non-randomized studies of exposures tool. Estimates describing the association between PFAS exposure and the duration of breastfeeding were identified, and the data were synthesized separately for each type of PFAS and for the duration of exclusive and total breastfeeding. Six studies with between 336 and 2374 participants each were identified. PFAS exposure was assessed in serum samples (five studies) or based on residential address (one study). Five out of six studies found shorter total duration of breastfeeding with higher PFAS exposure. The most consistent associations were seen for perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA). The finding of a potential causal association between PFAS exposure and breastfeeding duration is in agreement with findings from experimental studies.
母乳喂养期间乳房中的乳汁形成是一个复杂的激素调节过程，可能对内分泌干扰化学物质暴露的影响敏感。环境化学物质全氟和多氟烷基物质（PFAS）是已知的内分泌干扰物。PFAS暴露与小鼠乳腺发育不足以及人类母乳喂养持续时间缩短有关。本综述的目的是收集关于PFAS暴露与母乳喂养持续时间之间关联的流行病学证据。我们使用PubMed和Embase进行了系统的文献检索（于2023年1月23日），以确定研究母亲PFAS暴露与母乳喂养持续时间之间关联的流行病学研究。动物研究、综述和非英文研究被排除。使用暴露的非随机研究中的偏倚风险工具评估偏倚风险。确定了描述PFAS暴露与母乳喂养持续时间之间关联的估计值，并针对每种类型的PFAS以及纯母乳喂养和全母乳喂养的持续时间分别汇总数据。共确定了六项研究，每项研究有336至2374名参与者。通过血清样本（五项研究）或根据居住地址（一项研究）评估PFAS暴露。六项研究中有五项发现，PFAS暴露水平越高，母乳喂养的总持续时间越短。全氟辛烷磺酸（PFOS）、全氟辛酸（PFOA）和全氟壬酸（PFNA）的关联最为一致。PFAS暴露与母乳喂养持续时间之间存在潜在因果关联的这一发现与实验研究的结果一致。
