Associations of a Per- and Polyfluoroalkyl Substance Mixture with Perinatal Outcomes Among Participants from the Study of Environment, Lifestyle, and Fibroids

Document Type

Conference Proceeding

Publication Date

3-10-2025

Publication Title

Reprod Sci

Keywords

Obstetrics & Gynecology, Reproductive Biology

Abstract

Introduction: Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals that can dysregulate reproductive hormones that support healthy pregnancy. Exposure to PFAS has been associated with adverse perinatal outcomes, but less is known about the cumulative effects of PFAS mixtures, or the role of psychosocial factors as effect measure modifiers of PFAS perinatal toxicity, particularly among Black individuals. Methods: We leveraged prospective data from the Study of Environment, Lifestyle, and Fibroids, a cohort of 1,693 reproductive-aged Black participants recruited in 2010-2012, to investigate associations between a PFAS mixture and perinatal outcomes reported by 321 participants with live births during ~60 months of follow-up. We quantified concentrations of six PFAS in plasma samples collected at baseline using online solid-phase extraction-liquid chromatography-isotope dilution tandem mass spectrometry. Participants reported social support (via questionnaire) and perceived stress (on the Perceived Stress Scale-4) at baseline. We used Bayesian Kernel Machine Regression (BKMR) to estimate associations of the PFAS mixture and assess modification of the mixture by social support and perceived stress by including these variables in the BKMR kernel function, adjusting for hypothesized confounders. We estimated mean differences (β) in birthweight (grams) and gestational age at birth (weeks), with 95% credible intervals (CrIs). Results: The overall PFAS mixture was not materially associated with perinatal outcomes: the 75th percentile of the mixture (versus the 50th percentile), for example, was not associated with birthweight (β=-8.8; 95% CrI=-95.3, 77.8) or gestational age (β=-0.1; 95% CrI=-0.2, 0.1). Several individual PFAS were weakly associated with perinatal outcomes in BKMR univariate exposure response profiles, but directions of association varied by PFAS. There was no evidence of effect measure modification by social support or perceived stress. Conclusion: The PFAS mixture was not associated with perinatal outcomes, and associations were not modified by social support or perceived stress.

Volume

32

First Page

237A

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