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Per- and Polyfluoroalkyl Substances in Umbilical Cord Serum and Key Intermediate Metabolites in Relation to Preterm

Nuo Chen1, Shui-Yue Lu1, Jing-Lin Zhang1

  • 1Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.

Environmental Science & Technology
|March 23, 2026
PubMed

Insights

Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) is linked to increased preterm birth (PTB) risk in Chinese populations. Specific PFAS, like PFTrDA, and their mixtures show significant associations, potentially through metabolic disruptions.

Area of Science:

  • Environmental Health
  • Reproductive Toxicology
  • Metabolomics

Background:

  • Limited data exists on prenatal per- and polyfluoroalkyl substance (PFAS) exposure and preterm birth (PTB) in Chinese populations.
  • Understanding the metabolic mechanisms linking PFAS exposure to PTB is crucial for public health.

Purpose of the Study:

  • To investigate the association between umbilical cord serum PFAS levels and PTB risk in a multicenter Chinese cohort.
  • To explore the role of metabolic pathways, particularly bile acid and lipid metabolism, in mediating the effects of PFAS on PTB.

Main Methods:

  • A multicenter case-control study involving 1990 mother-infant pairs in China (2015-2021).
  • Umbilical cord serum PFAS levels were measured.
  • Untargeted metabolomics analysis was performed on maternal venous blood from a subcohort (n=134).

Main Results:

  • Higher levels of most PFAS were associated with increased PTB risk.
  • Pentacosafluorotridecanoic acid (PFTrDA) demonstrated the strongest association with PTB (OR=1.51).
  • PFAS mixtures showed a positive joint effect on PTB risk (OR=1.03).
  • PFTrDA exposure was linked to four metabolic perturbations, and Glycodeoxycholic acid (GDCA) mediated 21-44% of the PFAS-PTB associations, indicating disrupted bile acid and lipid metabolism.

Conclusions:

  • Prenatal PFAS exposure is associated with an elevated risk of preterm birth in Chinese populations.
  • Specific PFAS, such as PFTrDA, and their combined exposure contribute to PTB risk.
  • Metabolic dysregulation, particularly in bile acid and lipid pathways, plays a significant role in the relationship between PFAS exposure and PTB.

Keywords:
intermediate metabolitesper- and polyfluoroalkyl substancespregnancypreterm birth

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