PMID- 36252672 OWN - NLM STAT- MEDLINE DCOM- 20221124 LR - 20240121 IS - 1879-1026 (Electronic) IS - 0048-9697 (Print) IS - 0048-9697 (Linking) VI - 857 IP - Pt 2 DP - 2023 Jan 20 TI - Per- and polyfluoroalkyl substances and psychosocial stressors have a joint effect on adverse pregnancy outcomes in the Atlanta African American Maternal-Child cohort. PG - 159450 LID - S0048-9697(22)06549-4 [pii] LID - 10.1016/j.scitotenv.2022.159450 [doi] AB - BACKGROUND: African Americans (AAs) experience high rates of adverse pregnancy outcomes relative to Whites. Differential in utero exposure to environmental chemicals and psychosocial stressors may explain some of the observed health disparities, as exposures to per- and polyfluoroalkyl substances (PFAS) and experiences of discrimination have been linked to adverse birth outcomes. Few studies have examined chemicals and non-chemical stressors together as an exposure mixture, which may better reflect real-life exposure patterns. Here, we adapted methods designed for the analysis of exposure mixtures to examine joint effects of PFAS and psychosocial stress on birth outcomes among AAs. METHODS: 348 participants from the Atlanta African American Maternal-Child cohort were included in this study. Four PFAS were measured in first trimester serum samples. Self-report questionnaires were administered during the first trimester and were used to assess psychosocial stress (perceived stress, depression, anxiety, gendered racial stress). Quantile g-computation and Bayesian kernel machine regression (BKMR) were used to estimate the joint effects between PFAS and psychosocial stressors on gestational age at delivery and birthweight for gestational age z-scores. All models were adjusted for maternal education, maternal age, parity, and any alcohol, tobacco and marijuana use. RESULTS: Our analytic sample included a socioeconomically diverse group of pregnant women, with 79 % receiving public health insurance. In quantile g-computation models, a simultaneous one-quartile increase in all PFAS, perceived stress, depression, anxiety, and gendered racial stress was associated with a reduction in birthweight z-scores (mean %change per quartile increase = -0.24, 95 % confidence interval = -0.43, -0.06). BKMR similarly showed that increasing all exposures in the mixture was associated with a modest decrease in birthweight z-scores, but not a reduced length of gestation. DISCUSSION: Using methods designed for analyzing exposure mixtures, we found that a simultaneous increase in in utero PFAS and psychosocial stressors was associated with reduced birthweight for gestational age z-scores. CI - Copyright (c) 2022 Elsevier B.V. All rights reserved. FAU - Eick, Stephanie M AU - Eick SM AD - Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: stephanie.marie.eick@emory.edu. FAU - Barr, Dana Boyd AU - Barr DB AD - Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. FAU - Brennan, Patricia A AU - Brennan PA AD - Department of Psychology, Emory University, Atlanta, GA, USA. FAU - Taibl, Kaitlin R AU - Taibl KR AD - Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. FAU - Tan, Youran AU - Tan Y AD - Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. FAU - Robinson, Morgan AU - Robinson M AD - Department of Pediatrics, New York University School of Medicine, New York, NY, USA. FAU - Kannan, Kurunthachalam AU - Kannan K AD - Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA. FAU - Panuwet, Parinya AU - Panuwet P AD - Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. FAU - Yakimavets, Volha AU - Yakimavets V AD - Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. FAU - Ryan, P Barry AU - Ryan PB AD - Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. FAU - Liang, Donghai AU - Liang D AD - Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. FAU - Dunlop, Anne L AU - Dunlop AL AD - Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA, USA. LA - eng GR - R01 NR014800/NR/NINR NIH HHS/United States GR - U2C ES026542/ES/NIEHS NIH HHS/United States GR - U2C OD023375/OD/NIH HHS/United States GR - R01 MD009064/MD/NIMHD NIH HHS/United States GR - UH3 OD023318/OD/NIH HHS/United States GR - R01 MD009746/MD/NIMHD NIH HHS/United States GR - U2C ES026560/ES/NIEHS NIH HHS/United States GR - P30 ES019776/ES/NIEHS NIH HHS/United States GR - R24 ES029490/ES/NIEHS NIH HHS/United States GR - UG3 OD023318/OD/NIH HHS/United States PT - Journal Article DEP - 20221014 PL - Netherlands TA - Sci Total Environ JT - The Science of the total environment JID - 0330500 RN - 0 (Fluorocarbons) RN - 0 (Environmental Pollutants) RN - 0 (Alkanesulfonic Acids) SB - IM MH - Humans MH - Pregnancy MH - Female MH - *Fluorocarbons MH - Black or African American MH - Birth Weight MH - Pregnancy Outcome/epidemiology MH - Bayes Theorem MH - *Environmental Pollutants/toxicity MH - *Alkanesulfonic Acids PMC - PMC9884463 MID - NIHMS1864169 OTO - NOTNLM OT - Joint effects OT - Mixtures OT - PFAS OT - Pregnancy OT - Stress COIS- Declaration of competing interest The authors report no conflicts of interest. EDAT- 2022/10/18 06:00 MHDA- 2022/11/25 06:00 PMCR- 2024/01/20 CRDT- 2022/10/17 19:23 PHST- 2022/08/19 00:00 [received] PHST- 2022/10/11 00:00 [revised] PHST- 2022/10/11 00:00 [accepted] PHST- 2022/10/18 06:00 [pubmed] PHST- 2022/11/25 06:00 [medline] PHST- 2022/10/17 19:23 [entrez] PHST- 2024/01/20 00:00 [pmc-release] AID - S0048-9697(22)06549-4 [pii] AID - 10.1016/j.scitotenv.2022.159450 [doi] PST - ppublish SO - Sci Total Environ. 2023 Jan 20;857(Pt 2):159450. doi: 10.1016/j.scitotenv.2022.159450. Epub 2022 Oct 14.