Perfluoroalkyl Substance Mixtures and Gestational Weight Gain among Mothers in the Health Outcomes and Measures of the Environment Study

摘要

Perfluoroalkyl substances (PFAS) are persistent chemicals often used in the production of consumer goods. Exposure to PFAS are associated with greater adiposity in children and adults, but the association of PFAS with gestational weight gain (GWG) has not been well studied. We quantified perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) concentrations in serum at 18+5 weeks' gestation for 279 women enrolled in a prospective pregnancy cohort (2003-2006, Cincinnati, Ohio) using mass spectrometry. We abstracted weight from medical records to calculate GWG from early pregnancy to delivery and rate of weight gain (GWR) in the 2nd and 3rd trimesters. We used multivariable linear regression to assess associations of GWG and GWR with individual PFAS, adjusted for relevant confounders and weeks' gestation at blood draw. We investigated effect measure modification (EMM) by pre-pregnancy BMI<25 kg/m2 vs. ≥25 kg/m2, and used weighted-quantile-sum (WQS) regression to create a PFAS index to examine the combined effect of the four PFAS. Each 2-fold increase in serum PFOA, PFOS, and PFNA was associated with small and statistically non-significant increases in GWG (range 0.3-0.8 lbs) and GWR (range 0.03-0.06 lbs/week). The association of PFNA with GWG was stronger among women with BMI≥25 kg/m2 (β=2 lbs; 95% CI:-2-6) than among those with BMI<25 kg/m2 (β=-0.5 lbs; 95% CI:-3-2; p-EMM=0.06). Among all women, the PFAS index was positively associated with GWG (WQS β=0.3 lbs; 95% CI: -1.0-1.5) and GWR (WQS β=0.02 lbs/week; 95% CI:-0.03-0.08), though 95% CIs included the null. We did not observe strong evidence of associations between PFAS and GWG in this cohort. Our findings are consistent with one prior study suggesting that PFOA and PFOS are associated with modest increases in GWG. Additional investigation of the association of PFAS with GWG in larger cohorts would be informative to the field.