Perfluoroalkyl Mixture Exposure in Relation to Fetal Growth: Potential Roles of Maternal Characteristics and Associations with Birth Outcomes

Influence of maternal endocrine disrupting chemicals exposure on adverse pregnancy outcomes: A systematic review and meta-analysis

Maternal endocrine disrupting chemicals (EDCs) exposure, the common environmental pollutants, was capable of involving in adverse pregnancy outcomes. However, the evidence of their connection is not consistent. Our goal was to comprehensively explore the risk of EDCs related to adverse pregnancy outcomes. One hundred and one studies were included from two databases before 2023 to explore the association between EDCs and adverse pregnancy outcomes including miscarriage, small for gestational age (SGA), low birth weight (LBW) and preterm birth (PTB). We found that maternal PFASs exposure was positively correlated with PTB (OR:1.13, 95% CI:1.04-1.23), SGA (OR:1.10, 95% CI:1.04-1.16) and miscarriage (OR:1.09, 95% CI:1.00-1.19). The pooled estimates also showed maternal PAEs exposure was linked with PTB (OR:1.16, 95% CI:1.11-1.21), SGA (OR:1.20, 95% CI:1.07-1.35) and miscarriage (OR:1.55, 95% CI:1.33-1.81). In addition, maternal exposure to some specific class of EDCs including PFOS, MBP, MEHP, DEHP, and BPA was associated with PTB. Maternal exposure to PFOS, PFOA, PFHpA was associated with SGA. Maternal exposure to BPA was associated with LBW. Maternal exposure to MMP, MEHP, MEHHP, MEOHP, BPA was associated with miscarriage. Maternal PFASs, PAEs and BPA exposure may increase adverse pregnancy outcomes risk according to our study. However, the limited number of studies on dose-response hampered further explanation for causal association.

Low transplacental transfer of PFASs in the small-for-gestational-age (SGA) new-borns: Evidence from a Chinese birth cohort

Early life in utero exposure to per- and polyfluoroalkyl substances (PFASs) and infiltration through the placenta into cord blood pose significant risk to fetal development. Accumulating knowledge suggests that PFASs pass through the placenta in multiple transportation ways, not limiting to passive transport but also active transport or facilitated diffusion. Therefore, we propose that the transplacental transfer efficiency (TTE) could be re-evaluated as traditional cord to maternal ratio-based method might overlook certain biological or health information from the mother and fetus. In this study, we investigated 30 PFAS chemicals in paired maternal and cord serum from 195 births classified as small-for-gestational-age (SGA) and matched appropriate-for-gestational-age (AGA). PFASs were ubiquitously detected in the maternal and serum samples, with PFOA, PFOS, 6:2 Cl-PFESA and other dominant compounds. We adopted a modified TTE estimation method (TTEm), taking into consideration of the total burden mass of PFASs in the blood from mother to fetus. Using the modified TTEm, a significant (p < 0.05) decrease was observed in the PFAS transplacental transfer potential in SGA (1.6%-11.3%) compared to AGA (2.3%-21.1%), suggesting a reverse association between TTE and SGA birth risk. This is the first study attempted to re-evaluate the TTE of PFAS and indicates that TTEm might be more advantageous to reflect the transplacental transfer potency of chemicals particularly when transportation mechanisms are multi-faceted.