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Prenatal Per- and Polyfluoroalkyl Substance Exposures and Longitudinal Blood Pressure Measurements in Children Aged 3
Zeyu Li1, Guoying Wang1, Xiumei Hong1
1Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA.
Insights
Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) is linked to higher blood pressure in children, especially in adolescents, males, and Black children. These effects may be long-term and intergenerational.
Area of Science:
- Environmental Health
- Pediatric Health
- Toxicology
Background:
- Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may impact offspring blood pressure (BP).
- Long-term studies on PFAS and childhood BP in diverse populations are limited.
Purpose of the Study:
- To investigate the association between prenatal PFAS exposure and offspring blood pressure (BP) trajectories.
- To examine how these associations vary by child's age, sex, and race/ethnicity.
Main Methods:
- Utilized data from the Boston Birth Cohort, measuring PFAS in maternal plasma post-delivery.
- Extracted children's BP from medical records, calculating age-, sex-, and height-specific BP percentiles.
- Employed statistical models to assess PFAS associations with BP percentiles and elevated BP, and predict BP trajectories.
Main Results:
- Higher levels of specific PFAS (PFDeA, PFNA, PFUnA) were linked to elevated systolic BP percentiles.
- Associations varied significantly by life stage, sex, and race/ethnicity, with stronger effects observed in older, male, and Black children.
- Perfluoroheptanesulfonic acid (PFHpS) exposure showed a dose-dependent increase in elevated BP risk in male children from age 6 onwards, with diverging BP trajectories starting at adolescence.
Conclusions:
- Prenatal PFAS exposure is associated with increased offspring blood pressure, particularly in adolescents, males, and Black children.
- These findings suggest potential intergenerational, long-term, and latent hypertensive effects of prenatal PFAS exposure.
Background:
Prenatal per- and polyfluoroalkyl substance (PFAS) exposures may influence offspring blood pressure (BP), but long-term studies in diverse populations remain limited.
Methods:
Participants were from the Boston Birth Cohort. We measured PFAS in maternal plasma collected 24 to 72 hours after delivery and extracted children's BP from medical records. We calculated age-, sex-, and height-specific BP percentiles and defined elevated BP as systolic/diastolic BP ≥90th percentile (ages 3 to <13 years) or ≥120/80 mm Hg (ages 13 to <18 years). We used adjusted mixed-effects linear and modified Poisson models to examine associations of PFAS with BP percentiles and elevated BP. We used linear spline mixed-effects models to predict BP trajectories at ages 3 to 18 years by PFAS levels.
Results:
We included 13 404 BP measurements from 1094 children (median follow-up: 12 years [interquartile range, 9-15 years]; 61% Black and 22% Hispanic). Overall, higher perfluorodecanoic acid (PFDeA), perfluorononanoic acid (PFNA), and perfluoroundecanoic acid (PFUnA) were associated with higher systolic BP percentile. The associations differed by child life stage, sex, race and ethnicity. For example, associations of PFDeA with systolic BP percentile were stronger in older (β3-5y=0.40; β6-12y=1.06; β13-18y=2.55), male (βmale=1.51; βfemale=0.52), and Black (βBlack=1.75; βHispanic=0.45) children. In male children, each doubling of perfluoroheptanesulfonic acid (PFHpS) was associated with a 9% higher risk of elevated BP at ages 6 to 12 years and a 17% higher risk at 13 to 18 years, with no increased risk at 3 to 5 years. PFHpS was associated with a dose-dependent divergence in BP trajectories beginning at age 13 years.
Conclusions:
Prenatal exposures to certain PFAS were associated with offspring BP, with stronger associations in adolescents, male children, and Black children. Prenatal PFAS exposures may have intergenerational, long-term, and latent hypertensive effects.
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