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Wise LA, Coleman CM, Schildroth S, Geller RJ, Lovett SM, Claus Henn B, Calafat AM, Botelho JC, Marsh EE, Noel N, Wegienka GR, Bethea TN, Harmon QE, Baird DD, Wesselink AK. Associations of per- and polyfluoroalkyl substances with uterine leiomyomata incidence and growth: a prospective ultrasound study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00698-3. [PMID: 38914782 DOI: 10.1038/s41370-024-00698-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals used in commercial and consumer products. OBJECTIVE We evaluated PFAS exposure in relation to incidence and growth of uterine leiomyomata (UL), hormone-dependent neoplasms that are associated with severe gynecologic morbidity. METHODS We studied 1158 participants in the Study of Environment, Lifestyle, and Fibroids, a Detroit-based prospective cohort study of Black females aged 23-35 years at enrollment (2010-2012). At enrollment and four subsequent visits during 10 years of follow-up, participants attended in-person clinic visits, completed questionnaires, provided non-fasting blood samples, and underwent ultrasound for UL detection. We quantified 7 PFAS in baseline plasma samples using mass spectrometry. We used Cox regression and probit Bayesian kernel machine regression to estimate individual and joint effects of PFAS on UL incidence. We fit linear mixed models to estimate effects of individual PFAS on UL growth. We stratified by parity, an important route of PFAS elimination and determinant of UL. RESULTS In individual PFAS analyses, we observed inverse associations for perfluorodecanoate (PFDA; ≥0.3 vs. <0.2 ng/ml: hazard ratio [HR] = 0.74; 95% confidence interval [CI]: 0.54-1.00) and perfluoroundecanoate (detected vs. non-detected: HR = 0.78; 95% CI: 0.61-1.01) and a weak positive association for perfluorohexane sulfonate (≥1 vs. <0.6 ng/ml: HR = 1.17; 95% CI: 0.85-1.61), while perfluorooctane sulfonate, perfluorooctanoate, perfluorononanoate (PFNA), and 2-N-methyl-perfluorooctane sulfonamido acetate (MeFOSAA) showed little association with UL incidence. The PFAS mixture was inversely associated with UL incidence, a finding driven by MeFOSAA and PFDA; however, PFNA was positively associated with UL incidence. The inverse association for PFDA and positive association for PFNA were stronger among nulliparous participants. Most PFAS showed slight inverse associations with UL growth. IMPACT STATEMENT In this prospective ultrasound study of 1158 Black females aged 23-35 years at enrollment, we conducted a mixtures analysis to account for co-pollutant confounding and interaction. MeFOSAA and PFDA concentrations were inversely associated with UL incidence, while PFNA concentrations were positively associated with UL incidence. Concentrations of most PFAS were associated with decreased UL growth. This study contributes data to the sparse literature on PFAS exposure and UL development.
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Affiliation(s)
- Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Chad M Coleman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Samantha Schildroth
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Ruth J Geller
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Sharonda M Lovett
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julianne Cook Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erica E Marsh
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Nyia Noel
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA
| | | | - Traci N Bethea
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Chapel Hill, NC, USA
| | - Quaker E Harmon
- Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Center, Washington DC, WA, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Chapel Hill, NC, USA
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Rokoff LB, Wallenborn JT, Harris MH, Rifas-Shiman SL, Criswell R, Romano ME, Young JG, Calafat AM, Oken E, Sagiv SK, Fleisch AF. Plasma concentrations of per- and polyfluoroalkyl substances in pregnancy and breastfeeding duration in Project Viva. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 891:164724. [PMID: 37290653 PMCID: PMC10327962 DOI: 10.1016/j.scitotenv.2023.164724] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) may disrupt mammary gland development and function; thereby inhibiting milk supply and breastfeeding duration. However, conclusions on the potential effects of PFAS and breastfeeding duration are limited by prior epidemiologic studies that inconsistently adjusted for past cumulative breastfeeding duration and by a lack of examination of the joint effects of PFAS mixtures. METHODS In Project Viva, a longitudinal cohort that enrolled pregnant participants from 1999 to 2002 in the greater Boston, MA area, we studied 1079 women who ever attempted to lactate. We investigated associations of plasma concentrations of select PFAS in early pregnancy (mean: 10.1 weeks gestation) with breastfeeding termination by 9 months, after which women typically cite self-weaning as the reason for terminating breastfeeding. We used Cox regression for single-PFAS models and quantile g-computation for mixture models, adjusting for sociodemographics, prior breastfeeding duration, and weeks of gestation at the time of blood draw. RESULTS We detected 6 PFAS [perfluorooctane sulfonate; perfluorooctanoate (PFOA); perfluorohexane sulfonate; perfluorononanoate; 2-(N-ethyl-perfluorooctane sulfonamido) acetate (EtFOSAA); 2-(N-methyl-perfluorooctane sulfonamide) acetate (MeFOSAA)] in >98 % of samples. Sixty percent of lactating women terminated breastfeeding by 9 months postpartum. Women with higher plasma concentrations of PFOA, EtFOSAA, and MeFOSAA had a greater hazard of terminating breastfeeding in the first 9 months postpartum [HR (95 % CI) per doubling concentration: 1.20 (1.04, 1.38) for PFOA; 1.10 (1.01, 1.20) for EtFOSAA; 1.18 (1.08, 1.30) for MeFOSAA]. In the quantile g-computation model, simultaneously increasing all PFAS in the mixture by one quartile was associated with 1.17 (95 % CI: 1.05, 1.31) greater hazard of terminating breastfeeding in the first 9 months. CONCLUSION Our findings suggest that exposure to PFAS may be associated with reduced breastfeeding duration and draw further attention to environmental chemicals that may dysregulate human lactation.
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Affiliation(s)
- Lisa B Rokoff
- Center for Interdisciplinary Population & Health Research, MaineHealth Institute for Research, Portland, ME, USA.
| | - Jordyn T Wallenborn
- Center of Excellence in Maternal, Child, and Adolescent Health, School of Public Health, University of California at Berkeley, Berkeley, CA, USA; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Maria H Harris
- Center for Environmental Research and Children's Health, School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Sheryl L Rifas-Shiman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Rachel Criswell
- Skowhegan Family Medicine, Redington-Fairview General Hospital, Skowhegan, ME, USA
| | - Megan E Romano
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Jessica G Young
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sharon K Sagiv
- Center for Environmental Research and Children's Health, School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Abby F Fleisch
- Center for Interdisciplinary Population & Health Research, MaineHealth Institute for Research, Portland, ME, USA; Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, USA
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Friedman C, Dabelea D, Keil AP, Adgate JL, Glueck DH, Calafat AM, Starling AP. Maternal serum per- and polyfluoroalkyl substances during pregnancy and breastfeeding duration. Environ Epidemiol 2023; 7:e260. [PMID: 37545807 PMCID: PMC10402953 DOI: 10.1097/ee9.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/01/2023] [Indexed: 08/08/2023] Open
Abstract
Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals that may affect breastfeeding duration. We examined associations between maternal PFAS concentrations during pregnancy and breastfeeding cessation. We investigated potential effect modification by parity status. Methods Among 555 women enrolled in the Healthy Start study (2009-2014), we quantified maternal serum concentrations of 5 PFAS during mid- to late-pregnancy (mean 27 weeks of gestation). Participants self-reported their breastfeeding practices through 18-24 months postnatally. Among all participants and stratified by parity, we estimated associations between maternal PFAS concentrations and breastfeeding discontinuation by 3 and 6 months, using Poisson regression, and breastfeeding duration, using Cox regression. Results Median PFAS concentrations were similar to those in the general US population. Associations between PFAS and breastfeeding duration differed by parity status. After adjusting for covariates, among primiparous women, associations between PFAS and breastfeeding cessation by 3 and 6 months were generally null, with some inverse associations. Among multiparous women, there were positive associations between perfluorohexane sulfonate, perfluorooctane sulfonate, perfluorooctanoate (PFOA), and perfluorononanoate and breastfeeding cessation by 3 and 6 months. For example, per ln-ng/mL increase in PFOA, the risk ratio for breastfeeding discontinuation by 6 months was 1.45 (95% confidence interval, 1.18, 1.78). Hazard ratios reflected similar patterns between PFAS and breastfeeding duration. Conclusions Among primiparous women, we did not find evidence for associations between PFAS concentrations and breastfeeding duration. In contrast, among multiparous women, PFAS serum concentrations were generally inversely associated with breastfeeding duration, though estimates may be biased due to confounding by unmeasured previous breastfeeding.
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Affiliation(s)
- Chloe Friedman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Alexander P. Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John L. Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Deborah H. Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Antonia M. Calafat
- Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, Georgia
| | - Anne P. Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Timmermann A, Avenbuan ON, Romano ME, Braun JM, Tolstrup JS, Vandenberg LN, Fenton SE. Per- and Polyfluoroalkyl Substances and Breastfeeding as a Vulnerable Function: A Systematic Review of Epidemiological Studies. TOXICS 2023; 11:325. [PMID: 37112552 PMCID: PMC10145877 DOI: 10.3390/toxics11040325] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 05/25/2023]
Abstract
Milk formation in the breast during breastfeeding is a complex hormonally regulated process, potentially sensitive to the effects of endocrine-disrupting chemical exposures. The environmental chemicals, per- and polyfluoroalkyl substances (PFAS) are known endocrine disruptors. PFAS exposure have been associated with insufficient mammary gland development in mice and reduced breastfeeding duration in humans. The aim of this review was to gather the epidemiological evidence on the association between PFAS exposure and breastfeeding duration. Using PubMed and Embase, we performed a systematic literature search (on 23 January 2023) to identify epidemiological studies examining the association between maternal PFAS exposure and breastfeeding duration. Animal studies, reviews, and non-English studies were excluded. The risk of bias was assessed using the risk of bias in non-randomized studies of exposures tool. Estimates describing the association between PFAS exposure and the duration of breastfeeding were identified, and the data were synthesized separately for each type of PFAS and for the duration of exclusive and total breastfeeding. Six studies with between 336 and 2374 participants each were identified. PFAS exposure was assessed in serum samples (five studies) or based on residential address (one study). Five out of six studies found shorter total duration of breastfeeding with higher PFAS exposure. The most consistent associations were seen for perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA). The finding of a potential causal association between PFAS exposure and breastfeeding duration is in agreement with findings from experimental studies.
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Affiliation(s)
- Amalie Timmermann
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
| | - Oyemwenosa N. Avenbuan
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina, Chapel Hill, NC 27 599-7325, USA
| | - Megan E. Romano
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, NH 03 755, USA
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, RI 02 903, USA
| | - Janne S. Tolstrup
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
| | - Laura N. Vandenberg
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01 003, USA
| | - Suzanne E. Fenton
- Mechanistic Toxicology Branch, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Durham, NC 27 709, USA
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5
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Nielsen C, Li Y, Lewandowski M, Fletcher T, Jakobsson K. Breastfeeding initiation and duration after high exposure to perfluoroalkyl substances through contaminated drinking water: A cohort study from Ronneby, Sweden. ENVIRONMENTAL RESEARCH 2022; 207:112206. [PMID: 34653413 DOI: 10.1016/j.envres.2021.112206] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/29/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The drinking water in parts of Ronneby was heavily contaminated with perfluoroalkyl substances (PFAS) for decades. Although PFAS has endocrine-disrupting properties and may interfere with breastfeeding, the effects in populations with a point source of high exposure are unknown. OBJECTIVES To investigate associations between high PFAS exposure and 1) initiation and 2) duration of breastfeeding. METHODS We retrieved data on infant feeding practices for 2374 children born between 1999 and 2009 from Child Health Care centers in Ronneby and a reference municipality. Residential address before delivery was used as a proxy for exposure, and confounders were obtained from charts and registers. We used modified Poisson regressions to estimate the relative risks (RR) of not initiating breastfeeding, not breastfeeding exclusively after 3 months, and not breastfeeding at all at 6 months. We also estimated hazard ratios (HR) of cessation of exclusive breastfeeding before 6 months and any breastfeeding before 12 months. RESULTS Mothers who had received contaminated water seemed to have a higher risk of not initiating breastfeeding (RR = 2.4; 95% CI: 0.8, 6.7). Primiparous mothers from the exposed area were at a 1.2 times increased risk (95% CI: 0.9, 1.6) of not exclusively breastfeeding at 3 months and a 1.6 times increased risk (95% CI: 1.2, 2.1) of not breastfeeding at 6 months. The results were confirmed by the Cox regressions, which further showed that the HR for cessation of any breastfeeding was time dependent and higher in early lactation, thereafter decreasing as lactation progressed. We observed no overall associations in multiparous mothers. DISCUSSION Exposure to high levels of PFAS seemed to be associated with increased risks of not initiating breastfeeding and shorter breastfeeding duration in primiparous mothers. The findings imply that the ability of first-time mothers to establish breastfeeding is a sensitive outcome after high exposure to PFAS.
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Affiliation(s)
- Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Magdalena Lewandowski
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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6
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Criswell R, Romano ME. Unpacking the Relationship Between Perfluoroalkyl Substances and Placental Hormones in Lactation. J Clin Endocrinol Metab 2022; 107:e1312-e1314. [PMID: 34562075 PMCID: PMC8852160 DOI: 10.1210/clinem/dgab702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Indexed: 11/19/2022]
Affiliation(s)
| | - Megan E Romano
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Correspondence: Megan E. Romano, Department of Epidemiology, The Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hinman Box 7927, Lebanon, NH 03756, USA.
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Timmermann CAG, Andersen MS, Budtz-Jørgensen E, Boye H, Nielsen F, Jensen RC, Bruun S, Husby S, Grandjean P, Jensen TK. Pregnancy Exposure to Perfluoroalkyl Substances and Associations With Prolactin Concentrations and Breastfeeding in the Odense Child Cohort. J Clin Endocrinol Metab 2022; 107:e631-e642. [PMID: 34529060 PMCID: PMC8764222 DOI: 10.1210/clinem/dgab638] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/14/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Human exposure to perfluoroalkyl substances (PFAS) has been associated with reduced duration of breastfeeding, although not consistently so, and mechanisms by which PFAS might affect breastfeeding are unknown. OBJECTIVE To examine the association between early pregnancy serum-PFAS concentrations and breastfeeding termination and to elucidate the potential role of serum-prolactin concentrations in pregnancy. MATERIALS AND METHODS Pregnant women from the Odense Child Cohort provided blood samples for analysis of 5 major PFAS (n = 1300) and prolactin concentrations (n = 924). They subsequently provided information about the duration of breastfeeding in questionnaires at 3 and 18 months postpartum, and a subgroup also provided breastfeeding information via weekly cell phone text messages. Associations between serum-PFAS concentrations and breastfeeding termination were analyzed using Cox regressions, while linear regression was used to assess associations between serum-PFAS and prolactin concentrations. RESULTS Increased serum concentrations of perfluorooctane sulfonic acid, perfluorooctanoic acid, perfluorononanoic acid, and ∑PFAS were associated with a 16% (95% CI: 4%-30%), 14% (95% CI: 2%-26%), 14% (95% CI: 3%-27%), and 20% (95% CI: 6%-36%), respectively, increased risk of terminating breastfeeding at any given time after childbirth. Serum-PFAS concentrations were not associated with serum-prolactin concentrations. CONCLUSIONS These findings are of public health importance due to the global exposures to PFAS. Because breastfeeding is crucial to promote both child health and maternal health, adverse PFAS effects on the ability to breastfeed may have long-term health consequences.
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Affiliation(s)
- Clara Amalie Gade Timmermann
- Research Unit of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Correspondence: Clara Amalie Gade Timmermann, MSc, PhD, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen, Denmark.
| | | | | | - Henriette Boye
- Odense Child Cohort, Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
| | - Flemming Nielsen
- Research Unit of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Richard Christian Jensen
- Research Unit of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Signe Bruun
- Hans Christian Andersen Children’s Hospital, Odense University Hospital and University of Southern Denmark, Odense, Denmark
- Strategic Business Unit Pediatric, Arla Foods Ingredients Group P/S, Viby J, Denmark
| | - Steffen Husby
- Hans Christian Andersen Children’s Hospital, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Philippe Grandjean
- Research Unit of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, United States
| | - Tina Kold Jensen
- Research Unit of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Odense Child Cohort, Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
- Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
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8
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Wise LA, Wesselink AK, Schildroth S, Calafat AM, Bethea TN, Geller RJ, Coleman CM, Fruh V, Claus Henn B, Botelho JC, Harmon QE, Thirkill M, Wegienka GR, Baird DD. Correlates of plasma concentrations of per- and poly-fluoroalkyl substances among reproductive-aged Black women. ENVIRONMENTAL RESEARCH 2022; 203:111860. [PMID: 34403666 PMCID: PMC8616815 DOI: 10.1016/j.envres.2021.111860] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals used in commercial and consumer goods. Black women are underrepresented in studies of PFAS exposure. METHODS We performed a cross-sectional analysis of correlates of plasma PFAS concentrations among 1499 Black women aged 23-35 participating in the Study of Environment, Lifestyle, and Fibroids (SELF), a Detroit-based cohort study. At baseline (2010-2012), participants provided questionnaire data on socio-demographics; behaviors; diet; and menstrual, contraceptive, and reproductive histories. Using mass spectrometry in non-fasting plasma samples collected at enrollment, we quantified several PFAS, including perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), perfluorodecanoate (PFDA), perfluoroundecanoate (PFUnDA), and 2-N-methyl-perfluorooctane sulfonamido acetate (MeFOSAA). We used linear regression to calculate percentage differences (%D) and 95 % confidence intervals (CIs) for associations between selected correlates and PFAS concentrations, adjusting for all other correlates. RESULTS PFHxS, PFOS, PFOA, and PFNA were detected in ≥97 % of women; PFDA in 86 %; MeFOSAA in 70 %; and PFUnDA in 52 %. Age, income, education, and intakes of water, alcohol, and seafood were positively associated with several PFAS. Current smoking was positively associated with MeFOSAA. Body mass index was inversely associated with most PFAS, except PFHxS. Strong inverse associations (%D; 95 % CI) were observed between parity (≥3 vs. 0 births) and PFHxS (-34.7; -43.0, -25.1) and PFOA (-33.1; -39.2, -26.3); breastfeeding duration (≥6 months vs. nulliparous) and PFOA (-31.1; -37.8, -23.7), PFHxS (-24.2; -34.5, -12.3), and PFOS (-18.4; -28.3, -7.1); recent birth (<2 years ago vs. nulliparous) and PFOA (-33.1; -39.6, -25.8), PFHxS (-29.3; -39.0, -18.1), PFNA (-25.2; -32.7, -16.8), and PFOS (-18.3; -28.3, -6.9); and intensity of menstrual bleed (heavy vs. light) and PFHxS (-18.8; -28.3, -8.2), PFOS (-16.4; -24.9, -7.1), PFNA (-10.5; -17.8, -2.6), and PFOA (-10.0; -17.2, -2.1). Current use of depot medroxyprogesterone acetate (DMPA) was positively associated with PFOS (20.2; 1.4, 42.5), PFOA (16.2; 1.5, 33.0), and PFNA (15.3; 0.4, 32.4). CONCLUSIONS Reproductive factors that influence PFAS elimination showed strong associations with several PFAS (reduced concentrations with parity, recent birth, lactation, heavy menstrual bleeding; increased concentrations with DMPA use).
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Affiliation(s)
- Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Samantha Schildroth
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Traci N Bethea
- Office of Minority Health & Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Ruth J Geller
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Chad M Coleman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Victoria Fruh
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Julianne C Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Quaker E Harmon
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Maya Thirkill
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | | | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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9
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Jacobson MH, Ghassabian A, Gore AC, Trasande L. Exposure to environmental chemicals and perinatal psychopathology. Biochem Pharmacol 2022; 195:114835. [PMID: 34774531 PMCID: PMC8712457 DOI: 10.1016/j.bcp.2021.114835] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 01/03/2023]
Abstract
Women are nearly twice as likely to develop mood disorders compared with men, and incidence is greatest during reproductive transitions, including pregnancy and postpartum. Because these periods are characterized by dramatic hormonal and physiologic changes, there is heightened susceptibility to external factors, such as exposure to environmental toxicants, which may play a role in maternal psychopathology. The purpose of this scoping review was to provide an overview of studies conducted in humans and animal models on the effects of nonoccupational exposure to environmental chemicals on maternal psychopathology during the perinatal period. The largest number of studies examined exposure to environmental tobacco smoke and antenatal depression and showed consistently positive findings, although more prospective studies using biomarkers for exposure assessment are needed. The few studies examining persistent organic pollutants such as polybrominated diphenyl ethers and perinatal depression were consistent in showing associations with increased depressive symptoms. Results were mixed for exposure to heavy metals and non-persistent chemicals, but a strong literature in animal models supported an association between bisphenols and phthalates and reduced maternal behavior and care of pups after parturition. Biological mechanisms may include endocrine disruption, neurotransmitter system impairment, alterations in gene expression, and immune activation and inflammation. Additional longitudinal studies that include biospecimen collection are essential to furthering the understanding of how environmental toxicants during pregnancy may affect perinatal psychopathology and the underlying mechanisms of action. Future work should also leverage the parallels between animal and human maternal behavior, thereby highlighting the opportunity for multidisciplinary work in this avenue.
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Affiliation(s)
- Melanie H Jacobson
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Andrea C Gore
- Institute for Neuroscience, The University of Texas at Austin, Austin, TX 78712, USA; Division of Pharmacology & Toxicology, The University of Texas at Austin, Austin, TX 78712, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; New York University Wagner School of Public Service, New York, NY, USA; New York University College of Global Public Health, New York, NY, USA
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10
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Cope HA, Blake BE, Love C, McCord J, Elmore SA, Harvey JB, Chappell VA, Fenton SE. Latent, sex-specific metabolic health effects in CD-1 mouse offspring exposed to PFOA or HFPO-DA (GenX) during gestation. EMERGING CONTAMINANTS 2021; 7:219-235. [PMID: 35097227 PMCID: PMC8794304 DOI: 10.1016/j.emcon.2021.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Perfluorooctanoic acid (PFOA) is an environmental contaminant associated with adverse metabolic outcomes in developmentally exposed human populations and mouse models. Hexafluoropropylene oxide-dimer acid (HFPO-DA, commonly called GenX) has replaced PFOA in many industrial applications in the U.S. and Europe and has been measured in global water systems from <1 to 9350 ng/L HFPO-DA. Health effects data for GenX are lacking. OBJECTIVE Determine the effects of gestational exposure to GenX on offspring weight gain trajectory, adult metabolic health, liver pathology and key adipose gene pathways in male and female CD-1 mice. METHODS Daily oral doses of GenX (0.2, 1.0, 2.0 mg/kg), PFOA (0.1, 1.0 mg/kg), or vehicle control were administered to pregnant mice (gestation days 1.5-17.5). Offspring were fed a high- or low-fat diet (HFD or LFD) at weaning until necropsy at 6 or 18 weeks, and metabolic endpoints were measured over time. PFOA and GenX serum and urine concentrations, weight gain, serum lipid parameters, body mass composition, glucose tolerance, white adipose tissue gene expression, and liver histopathology were evaluated. RESULTS Prenatal exposure to GenX led to its accumulation in the serum and urine of 5-day old pups (P = 0.007, P < 0.001), which was undetectable by weaning. By 18 weeks of age, male mice fed LFD in the 2.0 mg/kg GenX group displayed increased weight gain (P < 0.05), fat mass (P = 0.016), hepatocellular microvesicular fatty change (P = 0.015), and insulin sensitivity (P = 0.014) in comparison to control males fed LFD. Female mice fed HFD had a significant increase in hepatocyte single cell necrosis in 1.0 mg/kg GenX group (P = 0.022) and 1.0 mg/kg PFOA group (P = 0.003) compared to control HFD females. Both sexes were affected by gestational GenX exposure; however, the observed phenotype varied between sex with males displaying more characteristics of metabolic disease and females exhibiting liver damage in response to the gestational exposure. CONCLUSIONS Prenatal exposure to 1 mg/kg GenX and 1 mg/kg PFOA induces adverse metabolic outcomes in adult mice that are diet- and sex-dependent. GenX also accumulated in pup serum, suggesting that placental and potentially lactational transfer are important exposure routes for GenX.
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Affiliation(s)
- Harlie A. Cope
- National Toxicology Program Laboratory, Division of the National Toxicology Program (DNTP), National Institutes of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, USA
| | - Bevin E. Blake
- National Toxicology Program Laboratory, Division of the National Toxicology Program (DNTP), National Institutes of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, USA
| | - Charlotte Love
- National Toxicology Program Laboratory, Division of the National Toxicology Program (DNTP), National Institutes of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, USA
| | - James McCord
- Multimedia Methods Branch, Center for Environmental Measurement and Modeling, Office of Research and Development, U.S. Environmental Protection Agency, RTP, NC, USA
| | - Susan A. Elmore
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, NIH, RTP, NC, USA
| | - Janice B. Harvey
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, NIH, RTP, NC, USA
| | - Vesna A. Chappell
- National Toxicology Program Laboratory, Division of the National Toxicology Program (DNTP), National Institutes of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, USA
| | - Suzanne E. Fenton
- National Toxicology Program Laboratory, Division of the National Toxicology Program (DNTP), National Institutes of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, USA
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11
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Fenton SE, Ducatman A, Boobis A, DeWitt JC, Lau C, Ng C, Smith JS, Roberts SM. Per- and Polyfluoroalkyl Substance Toxicity and Human Health Review: Current State of Knowledge and Strategies for Informing Future Research. ENVIRONMENTAL TOXICOLOGY AND CHEMISTRY 2021; 40:606-630. [PMID: 33017053 PMCID: PMC7906952 DOI: 10.1002/etc.4890] [Citation(s) in RCA: 604] [Impact Index Per Article: 201.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/29/2020] [Accepted: 09/20/2020] [Indexed: 01/09/2023]
Abstract
Reports of environmental and human health impacts of per- and polyfluoroalkyl substances (PFAS) have greatly increased in the peer-reviewed literature. The goals of the present review are to assess the state of the science regarding toxicological effects of PFAS and to develop strategies for advancing knowledge on the health effects of this large family of chemicals. Currently, much of the toxicity data available for PFAS are for a handful of chemicals, primarily legacy PFAS such as perfluorooctanoic acid and perfluorooctane sulfonate. Epidemiological studies have revealed associations between exposure to specific PFAS and a variety of health effects, including altered immune and thyroid function, liver disease, lipid and insulin dysregulation, kidney disease, adverse reproductive and developmental outcomes, and cancer. Concordance with experimental animal data exists for many of these effects. However, information on modes of action and adverse outcome pathways must be expanded, and profound differences in PFAS toxicokinetic properties must be considered in understanding differences in responses between the sexes and among species and life stages. With many health effects noted for a relatively few example compounds and hundreds of other PFAS in commerce lacking toxicity data, more contemporary and high-throughput approaches such as read-across, molecular dynamics, and protein modeling are proposed to accelerate the development of toxicity information on emerging and legacy PFAS, individually and as mixtures. In addition, an appropriate degree of precaution, given what is already known from the PFAS examples noted, may be needed to protect human health. Environ Toxicol Chem 2021;40:606-630. © 2020 SETAC.
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Affiliation(s)
- Suzanne E. Fenton
- National Toxicology Program Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Alan Ducatman
- West Virginia University School of Public Health, Morgantown, West Virginia, USA
| | - Alan Boobis
- Imperial College London, London, United Kingdom
| | - Jamie C. DeWitt
- Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Christopher Lau
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Carla Ng
- Departments of Civil and Environmental Engineering and Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James S. Smith
- Navy and Marine Corps Public Health Center, Portsmouth, Virginia, USA
| | - Stephen M. Roberts
- Center for Environmental & Human Toxicology, University of Florida, Gainesville, Florida, USA
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12
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Criswell R, Crawford KA, Bucinca H, Romano ME. Endocrine-disrupting chemicals and breastfeeding duration: a review. Curr Opin Endocrinol Diabetes Obes 2020; 27:388-395. [PMID: 33027070 PMCID: PMC7968861 DOI: 10.1097/med.0000000000000577] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to describe epidemiologic and toxicological literature investigating how endocrine-disrupting chemicals (EDCs) affect mammary gland development and function, thereby impacting lactation duration. RECENT FINDINGS Perfluoroalkyl and polyfluoroalkyl substances appear to reduce breastfeeding duration through impaired mammary gland development, lactogenesis, and suppressed endocrine signaling. Halogenated aromatic hydrocarbons have differing associations with lactation duration, likely because of the variety of signaling pathways that they affect, pointing to the importance of complex mixtures in epidemiologic studies. Although epidemiologic literature suggests that pesticides and fungicides decrease or have no effect on lactation duration, toxicology literature suggests enhanced mammary gland development through estrogenic and/or antiandrogenic pathways. Toxicological studies suggest that phthalates may affect mammary gland development via estrogenic pathways but no association with lactation duration has been observed. Bisphenol A was associated with decreased duration of breastfeeding, likely through direct and indirect action on estrogenic pathways. SUMMARY EDCs play a role in mammary gland development, function, and lactogenesis, which can affect breastfeeding duration. Further research should explore direct mechanisms of EDCs on lactation, the significance of toxicant mixtures, and transgenerational effects of EDCs on lactation.
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Affiliation(s)
| | - Kathryn A. Crawford
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, NH
- Environmental Studies Program, Middlebury College, Middlebury, VT
| | - Hana Bucinca
- Research and Quality Improvement Program, Action for Mothers and Children, Prishtina, Kosovo
- Department of Pharmacy, Rezonanca College of Medical Sciences, Prishtina, Kosovo
| | - Megan E. Romano
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, NH
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13
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Starling AP, Adgate JL, Hamman RF, Kechris K, Calafat AM, Dabelea D. Prenatal exposure to per- and polyfluoroalkyl substances and infant growth and adiposity: the Healthy Start Study. ENVIRONMENT INTERNATIONAL 2019; 131:104983. [PMID: 31284113 PMCID: PMC6728170 DOI: 10.1016/j.envint.2019.104983] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Prenatal exposures to certain per- and polyfluoroalkyl substances (PFAS) have been linked to lower weight and adiposity at birth but greater weight and adiposity in childhood. We hypothesized that faster growth in early infancy may be associated with maternal PFAS concentrations. METHODS Among 415 mother-infant pairs in a longitudinal cohort study, we estimated associations between maternal pregnancy serum concentrations of six PFAS and offspring weight and adiposity at ~5 months of age, and growth in early infancy. Linear and logistic regression models were adjusted for potential confounders including maternal pre-pregnancy body mass index. Effect modification by infant sex was evaluated. We evaluated potential confounding by correlated exposures via multipollutant linear regression and elastic net penalized regression. RESULTS Associations between maternal PFAS concentrations and infant weight and adiposity differed by offspring sex. In male infants, maternal perfluorooctanoate and perfluorononanoate were positively associated with adiposity, with percent fat mass increases of 1.5-1.7% per ln-ng/mL increase in PFAS (median adiposity at ~5 months: 24.6%). Maternal perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were associated with lower weight-for-age z-score among female infants only (-0.26 SD per ln-ng/mL PFOS, 95% CI -0.43, -0.10; -0.17 SD per ln-ng/mL PFHxS, 95% CI -0.33, -0.01). In analyses pooled by sex, 2-(N-methyl-perfluorooctane sulfonamido) acetate above vs. below the limit of detection was associated with greater odds of rapid growth in weight-for-age (odds ratio [OR] 2.2, 95% CI 1.1, 4.3) and weight-for-length (OR 3.3, 95% CI 1.8, 6.2). Multipollutant models generally confirmed the results and strengthened some associations. DISCUSSION We observed sex- and chemical-specific associations between maternal serum PFAS concentrations and infant weight and adiposity. Multipollutant models suggested confounding by correlated PFAS with opposing effects. Although maternal PFAS concentrations are inversely associated with infant weight and adiposity at birth, rapid gain may occur in infancy, particularly in fat mass.
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Affiliation(s)
- Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, CO, USA
| | - Richard F Hamman
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katerina Kechris
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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