Academic journal article Environmental Health Perspectives

Perfluoroalkyl Substances during Pregnancy and Offspring Weight and Adiposity at Birth: Examining Mediation by Maternal Fasting Glucose in the Healthy Start Study

Academic journal article Environmental Health Perspectives

Perfluoroalkyl Substances during Pregnancy and Offspring Weight and Adiposity at Birth: Examining Mediation by Maternal Fasting Glucose in the Healthy Start Study

Article excerpt

Introduction

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are widespread and persistent environmental contaminants detected in many populations worldwide, including among pregnant women and infants (Cariou et al. 2015; Jiang et al. 2014; Kato et al. 2014; Manzano-Salgado et al. 2015; Okada et al. 2013). PFAS have been used for decades in industrial and commercial applications, including surface treatments for fabrics, food packaging, and aqueous film-forming foams for extinguishing fires (Buck et al. 2011; Prevedouros et al. 2006). The serum concentrations of certain PFAS have declined in the United States over the past decade (CDC 2015) following the phase out of perfluorooctane sulfonate (PFOS) production by 3M in 2000-2002 (U.S. EPA 2000) and the listing of PFOS in Annex B of the Stockholm Convention on Persistent Organic Pollutants in 2009 (Secretariat of the Stockholm Convention 2010). However, other PFAS concentrations have remained relatively constant over the same time period (CDC 2015), suggesting that human exposure is ongoing.

The ubiquitous presence of certain PFAS in humans is of concern because animal studies have demonstrated hepatotoxicity, immunotoxicity, and developmental toxicity resulting from high dose exposure (Lau et al. 2007). Epidemiologic studies in a population highly exposed to one PFAS, perfluorooctanoate (PFOA), have shown associations between PFAS exposure and chronic diseases, including kidney and testicular cancers (Barry et al. 2013), ulcerative colitis (Steenland et al. 2013), high cholesterol (Steenland et al. 2009), and pregnancy-induced hypertension (Darrow et al. 2013). Strong correlations between maternal and cord blood PFAS concentrations suggest transfer to the fetus from maternal circulation (Aylward et al. 2014). Maternal concentrations of PFOA during pregnancy have been previously associated with lower offspring birth weight in systematic reviews of the human evidence (Bach et al. 2015a; Johnson et al. 2014), as well an integrative assessment of human and nonhuman animal evidence (Lam et al. 2014), but the factors responsible for this association, if causal, have not been established. Moreover, some recent studies have reported positive associations between maternal PFAS concentrations during pregnancy and offspring body weight, waist circumference, and other indicators of adiposity in childhood and early adulthood (Braun et al. 2016; Halldorsson et al. 2012; H0yer et al. 2015; Mora et al. 2017), while another study reported null associations (Andersen et al. 2013).

Fetal growth depends on the transfer of nutrients, including glucose, amino acids, and free fatty acids, from the mother to the fetus (Jansson and Powell 2013). Excess maternal circulating nutrients, as in maternal obesity and gestational diabetes, have been associated with fetal overgrowth (macrosomia) and greater adiposity at birth (Catalano et al. 2003; Freinkel 1980). Overnutrition and undernutrition in utero have both been associated with greater risk of obesity and metabolic disease in adulthood (Baird et al. 2005; Claris et al. 2010). Adiposity at birth may be a stronger predictor of future obesity risk than birth weight alone (Catalano et al. 2009). Therefore, it is important to examine whether environmental exposures influence fetal growth, and, in particular, fat mass accretion, with the goal of preventing long-term chronic disease. To our knowledge, no previous studies have examined the association between maternal PFAS concentrations during pregnancy and offspring adiposity at birth.

The primary objective of this study was to estimate associations between maternal serum concentrations of PFAS and offspring birth weight and adiposity (percent fat mass) at birth. The secondary objectives were to estimate cross-sectional associations between maternal PFAS concentrations and fasting glucose and lipids at mid-pregnancy. Because the pathway by which prenatal PFAS exposure may lead to reduced body mass at birth has not been elucidated, we then investigated whether concentrations of certain maternal circulating nutrients mediate associations between PFAS concentrations and offspring weight and adiposity at birth. …

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