Individual and mixtures of PFAS during pregnancy are associated with maternal cardiometabolic outcomes during pregnancy

Abstract Introduction Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals and widespread environmental contaminants. PFAS cross the placental barrier and reach the developing fetus with potential impacts on many organ systems. There are no studies of PFAS in residents of ce...

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Main Authors: Clark R. Sims, Neha Sehgal, Donald Turner, Lauren A. Havens, Andrew J. Morris, Kartik Shankar, Kevin J. Pearson, Todd M. Everson, Aline Andres
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Environmental Health
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Online Access:https://doi.org/10.1186/s12940-025-01181-8
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author Clark R. Sims
Neha Sehgal
Donald Turner
Lauren A. Havens
Andrew J. Morris
Kartik Shankar
Kevin J. Pearson
Todd M. Everson
Aline Andres
author_facet Clark R. Sims
Neha Sehgal
Donald Turner
Lauren A. Havens
Andrew J. Morris
Kartik Shankar
Kevin J. Pearson
Todd M. Everson
Aline Andres
author_sort Clark R. Sims
collection DOAJ
description Abstract Introduction Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals and widespread environmental contaminants. PFAS cross the placental barrier and reach the developing fetus with potential impacts on many organ systems. There are no studies of PFAS in residents of central Arkansas despite reports of environmental contamination in the region. We aimed to quantify PFAS concentrations in repeated serum samples from participants living in central Arkansas and to investigate relationships with maternal cardiometabolic health during pregnancy. Methods Participants were enrolled during early pregnancy in a longitudinal study (NCT01131117) from 2010 to 2014. PFAS concentrations were measured in serum from each trimester (first trimester n = 282, second trimester n = 217, and third trimester n = 195). PFAS were compared across pregnancy. Linear and linear-mixed effects models were used to investigate relationships between trimester-specific PFAS levels, as single exposures, and maternal outcomes. Effects of PFAS as an exposure mixture were estimated using quantile g-computation. Results Six PFAS were detected in more than 70% of the maternal serum samples: PFOS, PFOA, PFBS, PFHxS, PFNA, and PFHxA. In adjusted linear-mixed models and quantile g-computation models, maternal serum PFAS levels were significantly negatively associated with triglycerides [effect estimates (β)= -16.29; 95% confidence interval (CI)= -24.95, -7.63], total cholesterol (β= -12.77; 95%CI= -19.80, -5.74), low-density lipoproteins (β= -10.83; 95%CI = -16.72, -4.93), high-density lipoproteins (β= -4.10; 95%CI= -6.23, -1.96), and pulse (β= -1.60; 95%CI= -2.85, -0.35). Maternal serum PFAS, as a mixture, was not associated with maternal diastolic blood pressure, but separately, PFASsum, PFOS, PFOA and PFNA had significant positive associations. Conclusion This study evaluated PFAS exposures during pregnancy in central Arkansas. We show that PFAS exposure during pregnancy influences maternal cardiometabolic outcomes and a case in point that future studies are needed to determine the impact on maternal health and to investigate potential interventions to limit the effects of PFAS exposure during pregnancy.
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spelling doaj-art-1a3a0797e528411485adf2f43818ea0f2025-08-20T03:52:24ZengBMCEnvironmental Health1476-069X2025-04-0124111010.1186/s12940-025-01181-8Individual and mixtures of PFAS during pregnancy are associated with maternal cardiometabolic outcomes during pregnancyClark R. Sims0Neha Sehgal1Donald Turner2Lauren A. Havens3Andrew J. Morris4Kartik Shankar5Kevin J. Pearson6Todd M. Everson7Aline Andres8Department of Pediatrics, University of Arkansas for Medical SciencesGangarosa Department of Environmental Health, Rollins School of Public Health at Emory UniversityArkansas Children’s Nutrition CenterCentral Arkansas Veterans Affairs Healthcare System and University of Arkansas for Medical SciencesCentral Arkansas Veterans Affairs Healthcare System and University of Arkansas for Medical SciencesResponsive Agricultural Food Systems Research Unit, Plains Area, USDA Agricultural Research ServiceDepartment of Pharmacology & Nutritional Sciences, University of Kentucky College of MedicineGangarosa Department of Environmental Health, Rollins School of Public Health at Emory UniversityDepartment of Pediatrics, University of Arkansas for Medical SciencesAbstract Introduction Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals and widespread environmental contaminants. PFAS cross the placental barrier and reach the developing fetus with potential impacts on many organ systems. There are no studies of PFAS in residents of central Arkansas despite reports of environmental contamination in the region. We aimed to quantify PFAS concentrations in repeated serum samples from participants living in central Arkansas and to investigate relationships with maternal cardiometabolic health during pregnancy. Methods Participants were enrolled during early pregnancy in a longitudinal study (NCT01131117) from 2010 to 2014. PFAS concentrations were measured in serum from each trimester (first trimester n = 282, second trimester n = 217, and third trimester n = 195). PFAS were compared across pregnancy. Linear and linear-mixed effects models were used to investigate relationships between trimester-specific PFAS levels, as single exposures, and maternal outcomes. Effects of PFAS as an exposure mixture were estimated using quantile g-computation. Results Six PFAS were detected in more than 70% of the maternal serum samples: PFOS, PFOA, PFBS, PFHxS, PFNA, and PFHxA. In adjusted linear-mixed models and quantile g-computation models, maternal serum PFAS levels were significantly negatively associated with triglycerides [effect estimates (β)= -16.29; 95% confidence interval (CI)= -24.95, -7.63], total cholesterol (β= -12.77; 95%CI= -19.80, -5.74), low-density lipoproteins (β= -10.83; 95%CI = -16.72, -4.93), high-density lipoproteins (β= -4.10; 95%CI= -6.23, -1.96), and pulse (β= -1.60; 95%CI= -2.85, -0.35). Maternal serum PFAS, as a mixture, was not associated with maternal diastolic blood pressure, but separately, PFASsum, PFOS, PFOA and PFNA had significant positive associations. Conclusion This study evaluated PFAS exposures during pregnancy in central Arkansas. We show that PFAS exposure during pregnancy influences maternal cardiometabolic outcomes and a case in point that future studies are needed to determine the impact on maternal health and to investigate potential interventions to limit the effects of PFAS exposure during pregnancy.https://doi.org/10.1186/s12940-025-01181-8Per- and polyfluoroalkyl substancesPFASPregnancyMaternal healthCardiometabolic
spellingShingle Clark R. Sims
Neha Sehgal
Donald Turner
Lauren A. Havens
Andrew J. Morris
Kartik Shankar
Kevin J. Pearson
Todd M. Everson
Aline Andres
Individual and mixtures of PFAS during pregnancy are associated with maternal cardiometabolic outcomes during pregnancy
Environmental Health
Per- and polyfluoroalkyl substances
PFAS
Pregnancy
Maternal health
Cardiometabolic
title Individual and mixtures of PFAS during pregnancy are associated with maternal cardiometabolic outcomes during pregnancy
title_full Individual and mixtures of PFAS during pregnancy are associated with maternal cardiometabolic outcomes during pregnancy
title_fullStr Individual and mixtures of PFAS during pregnancy are associated with maternal cardiometabolic outcomes during pregnancy
title_full_unstemmed Individual and mixtures of PFAS during pregnancy are associated with maternal cardiometabolic outcomes during pregnancy
title_short Individual and mixtures of PFAS during pregnancy are associated with maternal cardiometabolic outcomes during pregnancy
title_sort individual and mixtures of pfas during pregnancy are associated with maternal cardiometabolic outcomes during pregnancy
topic Per- and polyfluoroalkyl substances
PFAS
Pregnancy
Maternal health
Cardiometabolic
url https://doi.org/10.1186/s12940-025-01181-8
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