Association between exposure to per- and polyfluoroalkyl substances and missed miscarriage: A hospital-based case-control study in Shanghai, China.

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental pollutants linked to reproductive disruptions. This study investigated the relationship between PFAS exposure and missed miscarriage in a hospital-based, case-control study in Shanghai, China. There were 393 women in our research, including 198 cases and 195 controls. Concentrations of 30 PFAS in plasma were quantified using HPLC-MS/MS, and 15 PFAS were detected at a rate greater than 90 percent. PFOA, L-PFOS, and PFOS isomers were significantly higher in the cases than those in the controls. 13 PFAS showed significant positive associations with miscarriage risk after adjustment for confounders, particularly PFOA (OR: 2.99, 95 % CI: 1.96-4.68) and various PFOS isomers. BKMR analysis confirmed higher overall PFAS levels were associated with increased miscarriage risk. These findings highlight the potential reproductive toxicity of PFAS and underscore the need for further investigations and regulatory actions to mitigate PFAS exposure in pregnant women.