Association study of umbilical cord serum per- and polyfluoroalkyl substances (PFAS) exposure with birth outcomes: A
Zhenting Xu1, Anhui Ning1, Huanqiang Wang2
1Department of Epidemiology, Institute for Applied Research in Public Health, School of Public Health, Nantong University, Nantong 226019, China.
Insights
Per- and polyfluoroalkyl substances (PFAS) in cord serum are linked to birth outcomes. This meta-analysis found associations between specific PFAS, like PFOA and PFNA, and gestational age, birth length, and head circumference.
Area of Science:
- Environmental Health
- Reproductive Toxicology
- Per- and Polyfluoroalkyl Substances (PFAS) Research
Background:
- Per- and polyfluoroalkyl substances (PFAS) are environmental contaminants found in cord serum.
- Previous studies show inconsistent associations between cord serum PFAS and birth outcomes.
- A comprehensive meta-analysis is needed to clarify these relationships.
Purpose of the Study:
- To systematically evaluate and summarize the existing evidence on the association between cord serum PFAS concentrations and various birth outcomes.
- To identify specific PFAS compounds and their consistent links to neonatal development indicators.
Main Methods:
- A meta-analysis was conducted on 22 eligible studies.
- Data extraction included study characteristics, beta values, and confidence intervals.
- Random or fixed effects models were used, with subgroup analyses to address heterogeneity.
Main Results:
- Perfluorooctanoic acid (PFOA) was positively associated with gestational age.
- Perfluorononanoic acid (PFNA) showed positive associations with birth length and head circumference.
- Perfluoroundecanoic acid (PFDA) was significantly associated with increased birth length. High-dose exposures amplified certain associations.
Conclusions:
- Cord serum PFAS levels are significantly associated with gestational age, neonatal head circumference, and birth length.
- Further research is required to determine if these associations translate to an elevated risk of abnormal birth outcomes.
- The findings highlight the potential impact of prenatal PFAS exposure on infant development.
Background:
It has been reported that per- and polyfluoroalkyl substances (PFAS) in cord serum are closely associated with birth outcomes. However, the associations vary inconsistently across different studies. To summarize the relationships between cord serum PFAS and birth outcomes, a meta-analysis was performed.
Methods:
The characteristics of the studies, β values and 95 % confidence intervals were extracted. A random effects model or a fixed effects model was selected for analysis based on the I2 value. Subgroup analyses were applied to explore the sources of heterogeneity.
Results:
We included 22 eligible studies in this meta-analysis. Perfluorooctanoic acid (PFOA) in cord serum was positively related to gestational age (β = 0.10; 95 % CI: 0.00, 0.19; P < 0.05). Cord serum perfluorononanoic acid (PFNA) was positively associated with birth length and head circumference, with corresponding values of 0.18 (95 % CI: 0.10, 0.26; P < 0.05) and 0.07 (95 %CI: 0.01, 0.14; P < 0.05), respectively. Cord serum perfluoroundecanoic acid (PFDA) was significantly associated with birth length (β = 0.15; 95 % CI: 0.04, 0.27; P < 0.05). Based on the subgroup analysis, it was found that the associations between PFOA exposure and birth weight, between PFNA and birth length, and between PFOS and head circumference were more pronounced at high dose levels.
Conclusions:
This meta-analysis demonstrates that PFAS concentrations in cord serum are significantly associated with gestational age, as well as neonatal head circumference and birth length. However, whether these findings might translate into an elevated risk of abnormal birth outcomes associated with PFAS concentration in cord serum warrants further investigation.
