PMID- 34624345 OWN - NLM STAT- MEDLINE DCOM- 20211206 LR - 20211214 IS - 1879-1298 (Electronic) IS - 0045-6535 (Linking) VI - 288 IP - Pt 1 DP - 2022 Feb TI - Exposure to perfluoroalkyl substances in early pregnancy and the risk of hypertensive disorders of pregnancy: A nested case-control study in Guangxi, China. PG - 132468 LID - S0045-6535(21)02940-4 [pii] LID - 10.1016/j.chemosphere.2021.132468 [doi] AB - BACKGROUND: Previous epidemiological studies have examined the associations between exposure to perfluoroalkyl substances (PFASs) and the risk of hypertensive disorders of pregnancy (HDP). However, these studies have drawn discrepant conclusions and have some limitations. METHODS: A nested case-control study was conducted with the Guangxi Zhuang Birth Cohort (GZBC), a prospective, ongoing birth cohort that was implemented in Guangxi, China, in June 2015. Maternal serum concentrations of nine PFASs were measured using ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS). The associations between PFAS exposure and the risk of HDP were assessed using logistic regression (single-exposure), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models. RESULTS: A total of 136 HDP cases and 408 controls were enrolled in this study. In logistic regression models, perfluoroundecanoic acid (PFUnA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA) and perfluorobutanesulfonic acid (PFBS) were positively associated with HDP, while perfluorohexane sulfonate (PFHxS) was inversely associated with HDP. In the BKMR analysis, the joint effect of PFASs was positively associated with HDP. PFOS and PFBS showed positive trends, while PFHxS and PFHpA showed inverse trends. In WQS regression analysis, we calculated two WQS indices that were estimated using constraints in both the positive and negative directions of effects. Both WQS indices were significantly associated with HDP (OR: 2.663, 95% CI: 1.795-3.951; OR: 0.338, 95% CI: 0.229-0.499, respectively). PFBS, PFOS and PFUnA had significant weights in the positive effect direction; PFHxS, perfluoroheptanoic acid (PFHpA) and perfluorododecanoic acid (PFDoA) had significant weights in the negative effect direction. CONCLUSION: Considering all model results, we found that combined exposure to nine PFASs had a positive effect on the development of HDP. Moreover, PFOS and PFBS were positively associated with the HDP risk, while PFHxS and PFHpA were negatively associated with the HDP risk in women in Guangxi, China. CI - Copyright (c) 2021 Elsevier Ltd. All rights reserved. FAU - Liu, Bihu AU - Liu B AD - Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China. FAU - Wei, Bincai AU - Wei B AD - Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China. FAU - Mo, Meile AU - Mo M AD - Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China. FAU - Song, Yanye AU - Song Y AD - The Third Affiliated Hospital of Guangxi Medical University, Nanning, 530031, Guangxi, China. FAU - Tang, Chuanqiao AU - Tang C AD - Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China. FAU - Tang, Peng AU - Tang P AD - Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China. FAU - Guo, Xiaojing AU - Guo X AD - Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China. FAU - Tan, Chao AU - Tan C AD - Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China; Department of Epidemiology and Statistics, School of Public Health, Guilin Medical University, Guilin, 541004, Guangxi, China. FAU - Liu, Shun AU - Liu S AD - Department of Maternal, Child and Adolescent Health, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China. Electronic address: liushun@gxmu.edu.cn. FAU - Huang, Dongping AU - Huang D AD - Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China. Electronic address: dongpinghuang@gxmu.edu.cn. FAU - Qiu, Xiaoqiang AU - Qiu X AD - Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China. Electronic address: xqqiu9999@163.com. LA - eng PT - Journal Article DEP - 20211005 PL - England TA - Chemosphere JT - Chemosphere JID - 0320657 RN - 0 (Alkanesulfonic Acids) RN - 0 (Environmental Pollutants) RN - 0 (Fluorocarbons) SB - IM MH - *Alkanesulfonic Acids MH - Bayes Theorem MH - Birth Cohort MH - Case-Control Studies MH - China/epidemiology MH - Chromatography, Liquid MH - *Environmental Pollutants MH - Female MH - *Fluorocarbons MH - Humans MH - *Hypertension, Pregnancy-Induced MH - Pregnancy MH - Prospective Studies MH - Tandem Mass Spectrometry OTO - NOTNLM OT - Hypertensive disorders of pregnancy OT - Joint effect models OT - Nested case-control study OT - Perfluoroalkyl substances EDAT- 2021/10/09 06:00 MHDA- 2021/12/15 06:00 CRDT- 2021/10/08 20:13 PHST- 2021/07/16 00:00 [received] PHST- 2021/09/24 00:00 [revised] PHST- 2021/10/03 00:00 [accepted] PHST- 2021/10/09 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/10/08 20:13 [entrez] AID - S0045-6535(21)02940-4 [pii] AID - 10.1016/j.chemosphere.2021.132468 [doi] PST - ppublish SO - Chemosphere. 2022 Feb;288(Pt 1):132468. doi: 10.1016/j.chemosphere.2021.132468. Epub 2021 Oct 5.