PMID- 35696844 OWN - NLM STAT- MEDLINE DCOM- 20220622 LR - 20220805 IS - 1873-6750 (Electronic) IS - 0160-4120 (Print) IS - 0160-4120 (Linking) VI - 165 DP - 2022 Jul TI - Early-pregnancy plasma per- and polyfluoroalkyl substance (PFAS) concentrations and hypertensive disorders of pregnancy in the Project Viva cohort. PG - 107335 LID - S0160-4120(22)00262-8 [pii] LID - 10.1016/j.envint.2022.107335 [doi] AB - BACKGROUND: Hypertensive disorders of pregnancy (HDP), defined here as hypertensive disorders with onset in pregnancy (i.e., gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension), affect up to 10% of pregnancies in the United States and are associated with substantial maternal and neonatal morbidity and mortality. Per- and polyfluoroalkyl substances (PFAS) are associated with adverse cardiometabolic outcomes during pregnancy, but associations between PFAS and HDP are inconsistent and joint effects of PFAS mixtures have not been evaluated. METHODS: We studied 1,558 pregnant individuals from the Project Viva cohort, recruited during 1999-2002. We quantified concentrations of eight PFAS in plasma samples (median 9.7 weeks of gestation). Using clinical records, we calculated trimester-specific mean systolic (SBP) and diastolic (DBP) blood pressure and categorized HDP status [no HDP (normotensive & chronic hypertension), gestational hypertension, preeclampsia]. We estimated associations of individual PFAS with HDP using multinomial logistic regression and estimated associations with blood pressure using linear regression. We used Bayesian kernel machine regression (BKMR) and quantile g-computation to assess joint effects of the PFAS mixture on HDP and blood pressure measures. RESULTS: Four percent of participants developed preeclampsia and 7% developed gestational hypertension. We observed higher odds of gestational hypertension, but not preeclampsia, per doubling of perfluorooctanoate (PFOA) [OR = 1.51 (95% confidence interval: 1.12, 2.03)], perfluorooctane sulfonate (PFOS) [OR = 1.38 (1.04, 1.82)], and perfluorohexane sulfonate [OR = 1.28 (1.06, 1.54)] concentrations. We observed higher mean DBP per doubling of PFOA [2nd trimester (T2): 0.39 mmHg (-0.01, 0.78); 3rd trimester (T3): 0.56 mmHg (0.14, 0.98)] and PFOS [T2: 0.46 mmHg (0.11, 0.82); T3: 0.43 mmHg (0.05, 0.80)]. The PFAS mixture was positively associated with odds of gestational hypertension [75th vs. 50th percentile: OR = 1.14 (95% credible interval:1.03, 1.25), BKMR] and mean DBP [T2 = 0.17 mmHg (-0.06, 0.40); T3 = 0.22 mmHg (-0.03, 0.48), BKMR]. CONCLUSIONS: These findings suggest that exposure to certain PFAS may increase the odds of gestational hypertension during pregnancy, with potential implications for subsequent maternal and child health outcomes. CI - Copyright (c) 2022 The Authors. Published by Elsevier Ltd.. All rights reserved. FAU - Preston, Emma V AU - Preston EV AD - Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: epreston@hsph.harvard.edu. FAU - Hivert, Marie-France AU - Hivert MF AD - Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States; Diabetes Unit, Massachusetts General Hospital, Boston, MA, United States. Electronic address: mhivert@partners.org. FAU - Fleisch, Abby F AU - Fleisch AF AD - Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, United States; Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, United States. Electronic address: abby.fleisch@mainehealth.org. FAU - Calafat, Antonia M AU - Calafat AM AD - National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States. Electronic address: aic7@cdc.gov. FAU - Sagiv, Sharon K AU - Sagiv SK AD - Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States. Electronic address: sagiv@berkeley.edu. FAU - Perng, Wei AU - Perng W AD - Department of Epidemiology and the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States. Electronic address: wei.perng@cuanschutz.edu. FAU - Rifas-Shiman, Sheryl L AU - Rifas-Shiman SL AD - Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States. Electronic address: sheryl_rifas@harvardpilgrim.org. FAU - Chavarro, Jorge E AU - Chavarro JE AD - Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States. Electronic address: jchavarr@hsph.harvard.edu. FAU - Oken, Emily AU - Oken E AD - Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States. Electronic address: emily_oken@harvardpilgrim.org. FAU - Zota, Ami R AU - Zota AR AD - Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States. Electronic address: azota@email.gwu.edu. FAU - James-Todd, Tamarra AU - James-Todd T AD - Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: tjtodd@hsph.harvard.edu. LA - eng GR - UH3 OD023286/OD/NIH HHS/United States GR - KL2 TR002534/TR/NCATS NIH HHS/United States GR - R01 ES030101/ES/NIEHS NIH HHS/United States GR - R01 ES031065/ES/NIEHS NIH HHS/United States GR - T32 ES007069/ES/NIEHS NIH HHS/United States GR - R01 ES021447/ES/NIEHS NIH HHS/United States GR - R01 HD034568/HD/NICHD NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20220606 PL - Netherlands TA - Environ Int JT - Environment international JID - 7807270 RN - 0 (Alkanesulfonic Acids) RN - 0 (Environmental Pollutants) RN - 0 (Fluorocarbons) SB - IM MH - *Alkanesulfonic Acids/adverse effects MH - Bayes Theorem MH - Child MH - *Environmental Pollutants/adverse effects MH - Female MH - *Fluorocarbons/adverse effects MH - Humans MH - *Hypertension, Pregnancy-Induced/epidemiology MH - Infant, Newborn MH - *Pre-Eclampsia/epidemiology MH - Pregnancy PMC - PMC9348856 MID - NIHMS1817482 OTO - NOTNLM OT - Blood pressure OT - Gestational hypertension OT - Hypertensive disorders of pregnancy OT - PFAS OT - Preeclampsia COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2022/06/14 06:00 MHDA- 2022/06/23 06:00 PMCR- 2022/08/03 CRDT- 2022/06/13 18:20 PHST- 2022/02/14 00:00 [received] PHST- 2022/05/25 00:00 [revised] PHST- 2022/06/01 00:00 [accepted] PHST- 2022/06/14 06:00 [pubmed] PHST- 2022/06/23 06:00 [medline] PHST- 2022/06/13 18:20 [entrez] PHST- 2022/08/03 00:00 [pmc-release] AID - S0160-4120(22)00262-8 [pii] AID - 10.1016/j.envint.2022.107335 [doi] PST - ppublish SO - Environ Int. 2022 Jul;165:107335. doi: 10.1016/j.envint.2022.107335. Epub 2022 Jun 6.