First trimester plasma PER- AND Polyfluoroalkyl Substances (PFAS) and blood pressure trajectories across the second and third trimesters of pregnanacy

Jordan A Burdeau; Briana J K Stephenson; Izzuddin M Aris; Emma V Preston; Marie-France Hivert; Emily Oken; Shruthi Mahalingaiah; Jorge E Chavarro; Antonia M Calafat; Sheryl L Rifas-Shiman; Ami R Zota; Tamarra James-Todd

doi:10.1016/j.envint.2024.108628

First trimester plasma PER- AND Polyfluoroalkyl Substances (PFAS) and blood pressure trajectories across the second and third trimesters of pregnanacy

Environ Int. 2024 Apr:186:108628. doi: 10.1016/j.envint.2024.108628. Epub 2024 Apr 3.

Authors

Affiliations

¹ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: jarvayo@hsph.harvard.edu.
² Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: bstephenson@hsph.harvard.edu.
³ Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. Electronic address: izzuddin_aris@hphci.harvard.edu.
⁴ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: epreston@hsph.harvard.edu.
⁵ Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA. Electronic address: mhivert@partners.org.
⁶ Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. Electronic address: emily_oken@hphci.harvard.edu.
⁷ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital, Boston, MA, USA. Electronic address: shruthi@hsph.harvard.edu.
⁸ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: jchavarr@hsph.harvard.edu.
⁹ Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: aic7@cdc.gov.
¹⁰ Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. Electronic address: sheryl_rifas@hphci.harvard.edu.
¹¹ Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA. Electronic address: arz2124@cumc.columbia.edu.
¹² Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. Electronic address: tjtodd@hsph.harvard.edu.

PMID: 38583297
DOI: 10.1016/j.envint.2024.108628

Abstract

Background: Evidence suggests that exposure to per- and polyfluoroalkyl substances (PFAS) increases risk of high blood pressure (BP) during pregnancy. Prior studies did not examine associations with BP trajectory parameters (i.e., overall magnitude and velocity) during pregnancy, which is linked to adverse pregnancy outcomes.

Objectives: To estimate associations of multiple plasma PFAS in early pregnancy with BP trajectory parameters across the second and third trimesters. To assess potential effect modification by maternal age and parity.

Methods: In 1297 individuals, we quantified six PFAS in plasma collected during early pregnancy (median gestational age: 9.4 weeks). We abstracted from medical records systolic BP (SBP) and diastolic BP (DBP) measurements, recorded from 12 weeks gestation until delivery. BP trajectory parameters were estimated via Super Imposition by Translation and Rotation modeling. Subsequently, Bayesian Kernel Machine Regression (BKMR) was employed to estimate individual and joint associations of PFAS concentrations with trajectory parameters - adjusting for maternal age, race/ethnicity, pre-pregnancy body mass index, income, parity, smoking status, and seafood intake. We evaluated effect modification by age at enrollment and parity.

Results: We collected a median of 13 BP measurements per participant. In BKMR, higher concentration of perfluorooctane sulfonate (PFOS) was independently associated with higher magnitude of overall SBP and DBP trajectories (i.e., upward shift of trajectories) and faster SBP trajectory velocity, holding all other PFAS at their medians. In stratified BKMR analyses, participants with ≥ 1 live birth had more pronounced positive associations between PFOS and SBP velocity, DBP magnitude, and DBP velocity - compared to nulliparous participants. We did not observe significant associations between concentrations of the overall PFAS mixture and either magnitude or velocity of the BP trajectories.

Conclusion: Early pregnancy plasma PFOS concentrations were associated with altered BP trajectory in pregnancy, which may impact future cardiovascular health of the mother.

Keywords: BKMR; Blood pressure; Hypertensive disorders of pregnancy; Per- and polyfluoroalkyl substances (PFAS); Pregnancy.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Alkanesulfonic Acids / blood
Blood Pressure*
Environmental Pollutants* / blood
Female
Fluorocarbons* / blood
Humans
Maternal Exposure / statistics & numerical data
Pregnancy
Pregnancy Trimester, First / blood
Pregnancy Trimester, Second / blood
Pregnancy Trimester, Third / blood
Young Adult

Substances

Fluorocarbons
Environmental Pollutants
Alkanesulfonic Acids