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Tracing PFAS Transfer from Mother to the Fetoplacental Unit: Insights from Trimester-Specific Maternal Serum Profiles

Kyle Campbell¹, Dana Boyd Barr¹, Andrew J Morris^2,3

¹Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA.

Biorxiv : the Preprint Server for Biology

|July 3, 2026

Insights

Early pregnancy exposure to per- and polyfluoroalkyl substances (PFAS) is linked to higher placental and fetal levels. Maternal serum PFAS in early-to-mid gestation best predicts offspring exposure, highlighting the need for early prevention.

Area of Science:

Environmental Health
Toxicology
Reproductive Science

Background:

Per- and polyfluoroalkyl substances (PFAS) are widespread endocrine disruptors with documented placental transfer.
Limited understanding exists regarding the timing and extent of PFAS transfer to placental and fetal tissues.

Purpose of the Study:

To investigate the relationship between trimester-specific maternal serum PFAS levels and concentrations in paired placental and cord plasma.
To identify the most critical windows of prenatal exposure for fetoplacental burden.

Main Methods:

Prospective cohort study (Central Arkansas Glowing, n=151) with trimester-specific maternal serum PFAS measurements.
Liquid chromatography-tandem mass spectrometry used for quantifying four common PFAS.
Regression, elastic net, and parametric g-formula models employed to assess associations.

Main Results:

Maternal PFAS levels in the first (T1) and second (T2) trimesters showed the strongest associations with placental PFAS levels.
T1 and T2 maternal serum PFAS, along with placental PFOA, were significantly associated with cord plasma PFAS levels.
PFOA demonstrated potentially more efficient transfer from placenta to cord plasma.

Conclusions:

Early-to-mid gestation maternal serum PFAS levels are robust indicators of fetoplacental exposure.
Prioritizing early pregnancy exposure prevention is crucial for mitigating potential offspring health risks.
Findings underscore the importance of timing in prenatal exposure assessments for persistent pollutants.

Read full analysis

Abstract:

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous endocrine-disrupting pollutants that cross the placenta and affect offspring health, but the extent and timing of their transfer to placental and fetal compartments remain poorly understood. We characterized the relationship between trimester-specific prenatal maternal serum PFAS levels and paired placental and cord plasma levels at term. Data came from the Central Arkansas Glowing prospective cohort (n=151, 2010-2014). Four well-detected PFAS were measured using liquid chromatography-tandem mass spectrometry. Regression, elastic net, and parametric g-formula models tested the association between maternal levels in each trimester and placental or cord PFAS levels. In g-formula models, trimester one (T1) or trimester two (T2) measures consistently had the largest effect sizes associated with placental levels (p<0.001-0.05). Similarly, T1 (PFHxS, PFNA, PFOS, PFOA), T2 (PFNA, PFOS, PFOA), and placental PFOA were associated with cord plasma levels (p<0.05-p<0.001). Results were robust to time-varying adjustment for estimated glomerular filtration rate, serum albumin, or maternal weight. Predictive models improved with additional timepoint measures. Our findings suggest PFOA may transfer more efficiently from the placenta to cord plasma and early-to-mid gestation maternal serum PFAS measures may serve as the most robust sentinels of fetoplacental exposure burden, suggesting early exposure prevention should be prioritized.

Keywords:

PFAS perinatal placenta prenatal transfer efficiency

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