Association of exposure to per- and polyfluoroalkyl substances with hemoglobin and hematocrit during pregnancy

Fengzhen Cui; Hongxiu Liu; Yuanyuan Li; Tong-Zhang Zheng; Shunqing Xu; Wei Xia; Xia Sheng

doi:10.1016/j.ecoenv.2022.114319

Association of exposure to per- and polyfluoroalkyl substances with hemoglobin and hematocrit during pregnancy

Ecotoxicol Environ Saf. 2022 Dec 15:248:114319. doi: 10.1016/j.ecoenv.2022.114319. Epub 2022 Nov 21.

Authors

Fengzhen Cui¹, Hongxiu Liu¹, Yuanyuan Li¹, Tong-Zhang Zheng², Shunqing Xu¹, Wei Xia³, Xia Sheng⁴

Affiliations

¹ Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
² Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
³ Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China. Electronic address: xiawei@hust.edu.cn.
⁴ Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China. Electronic address: xiasheng@hust.edu.cn.

PMID: 36423372
DOI: 10.1016/j.ecoenv.2022.114319

Abstract

Background: Per- and polyfluoroalkyl substances (PFASs) are common environmental contaminants and are widely detected in humans. Previous studies have linked PFASs exposure to adverse birth outcomes. However, the association between maternal exposure to PFASs and hemoglobin (Hb) and hematocrit (HCT) remains unclear.

Objectives: We aimed to explore the relationship between PFASs exposure with Hb and HCT during pregnancy.

Methods: The present birth cohort study included 1044 pregnant women from Wuhan, China. Maternal HCT and Hb were measured in the first, second and third trimesters, and 13 PFASs were detected in the cord sera. Mixed linear models and general linear regression were applied to analyze the association between each single PFASs and Hb and HCT. Weighted quantile sum (WQS) regressions were used to investigate the association between PFASs mixture and Hb and HCT during pregnancy.

Results: In single-PFAS models, 10 PFASs were positively associated with HCT and Hb across pregnancy (a 10-fold increase in PFASs was associated with 1.47-3.54 % change in HCT and 1.46-3.20 % change in Hb (All P-FDR < 0.05). In addition, Hb and HCT were more positively related to PFASs in the second and third trimesters rather than the first trimester. The association between PFASs exposure and maternal HCT and Hb was not significant in the iron supplementation group, whereas significant in the non-iron supplementation group. A significant interaction between iron supplementation and non-iron supplementation was also detected. WQS regressions showed that perfluorononanoic acid (PFNA) and perfluorohexane sulfonate (PFHxS) contributed most to the association between PFASs and HCT and Hb in the second and third trimesters, respectively.

Conclusion: Maternal PFASs exposure was positive with serum Hb and HCT. Moreover, maternal iron supplementation may play a modifying effect in influencing the relationship between PFASs and HCT and Hb.

Keywords: Hematocrit; Hemoglobin; Iron supplementation; Per-and polyfluoroalkyl substances; Pregnant women.

MeSH terms

Alkanesulfonates
Cohort Studies
Female
Fluorocarbons*
Hematocrit
Hemoglobins
Humans
Pregnancy

Substances

Fluorocarbons
Hemoglobins
Alkanesulfonates