Association between per- and polyfluoroalkyl exposures and postpartum psychological symptoms: Evidence from two...

Emerging evidence suggests that per- and polyfluoroalkyl substances (PFAS) may be associated with mother's postpartum psychological symptoms. We examined such in two population-based pregnancy cohorts.

Using liquid chromatography-high resolution mass spectrometry, we measured untargeted serum PFAS at 1 month postpartum (PROGRESS cohort) and targeted plasma PFAS at 32 gestation weeks (BiSC cohort). Postpartum depression (PPD) was assessed with the Edinburgh Postnatal Depression Scale (EPDS≥10) from 1 to 24 months postpartum. Poisson regression assessed the association between PFAS and PPD (Yes/No), and negative binomial regression was used for the EPDS subscales (anhedonia, anxiety, and depression) assessed in continuous scale. Weighted Sum Quantile regression estimated the PFAS mixture effect on PPD and subscales.

Each doubling increase in PFNA exposure was associated with 53% increase in incident PPD (RR: 1.53, 95%CI: 1.15-2.06; q-value = 0.033) at 1 month postpartum in PROGRESS. Other individual PFAS showed a weak positive association with PPD and the subscale of anhedonia at 1 month, although adjusted p-values were borderline. The PFAS mixture at 1 month postpartum was associated with increased risk of anhedonia (IRR: 1.20, 95%CI: 1.02-1.42) at 1 month postpartum. The findings in BiSC were null or toward a protective effect.

Inconsistent findings were observed between PFAS exposure and postpartum psychological symptoms across the cohorts, particularly between PFNA and incident PPD, which may be explained by variation in cohort design, exposure profiles, cultural context, and sample size. More evidence is needed on the association between PFAS exposure and postpartum psychological symptoms.