Maternal Plasma Perfluoroalkyl Substances and Miscarriage: A Nested Case-Control Study in the Danish National Birth Cohort.

Autor: Liew Z; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA.; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA., Luo J; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA.; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA., Nohr EA; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.; Centre of Women's Family and Child Health, University of South-Eastern Norway, Kongsberg, Norway., Bech BH; Department of Public Health, Research Unit for Epidemiology, University of Aarhus, Aarhus, Denmark., Bossi R; Department of Environmental Science, University of Aarhus, Roskilde, Denmark., Arah OA; Department of Public Health, Research Unit for Epidemiology, University of Aarhus, Aarhus, Denmark.; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.; Department of Statistics, UCLA College of Letters and Science, Los Angeles, California, USA., Olsen J; Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Denmark.
Jazyk: angličtina
Zdroj: Environmental health perspectives [Environ Health Perspect] 2020 Apr; Vol. 128 (4), pp. 47007. Date of Electronic Publication: 2020 Apr 22.
DOI: 10.1289/EHP6202
Abstrakt: Background: Per- and polyfluoroalkyl substances (PFAS) are widespread persistent organic pollutants and endocrine disruptors. High doses of perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) exposure can cause pregnancy loss and infant deaths in animals, but the associations between PFAS exposures and risk of miscarriage in humans are not well studied.
Methods: Using a case-control study nested within the Danish National Birth Cohort (DNBC, 1996-2002), we compared 220 pregnancies ending in miscarriage during weeks 12-22 of gestation, with 218 pregnancies resulting in live births. Levels of seven types of PFAS [PFOS, PFOA, perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonate (PFHpS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluorooctanesulfonic acid (PFOSA)] were measured in maternal plasma collected in early gestation (mean gestational week 8). We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for miscarriage and each PFAS as a continuous variable or in quartiles, controlling for maternal age, parity, socio-occupational status, smoking and alcohol intake, gestational week of blood sampling, and maternal history of miscarriage. Stratification by parity and PFAS mixture analyses using weighted quantile sum (WQS) regression were also conducted.
Results: We observed a monotonic increase in odds for miscarriage associated with increasing PFOA and PFHpS levels. The ORs comparing the highest PFOA or PFHpS quartile to the lowest were 2.2 (95% CI: 1.2, 3.9) and 1.8 (95% CI: 1.0, 3.2). The ORs were also elevated for the second or third quartile of PFHxS or PFOS, but no consistent exposure-outcome pattern emerged. An interquartile range (IQR) increment in the WQS index of seven PFAS was associated with 64% higher odds for miscarriage (95% CI: 1.15, 2.34). The associations were stronger in parous women, while findings were inconsistent among nulliparous women.
Conclusion: Maternal exposures to higher levels of PFOA, PFHpS, and PFAS mixtures were associated with the risk of miscarriage and particularly among parous women. Larger replication studies among nulliparous women are needed to allay concerns about confounding by reproductive history. https://doi.org/10.1289/EHP6202.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje