Concentrations of per- and polyfluoroalkyl substances (PFAS) in human placental tissues and associations with birth outcomes
Open accessAbstract
Per- and polyfluoroalkyl substances (PFAS) are ubiquitous environmental contaminants commonly detected in human serum. Previous studies have observed associations between maternal serum PFAS and adverse pregnancy and birth outcomes such as lower birth weight or pre-eclampsia; however, few studies have explored these associations with birth outcomes and placental tissue PFAS concentration. The placenta is a vital contributor to a healthy pregnancy and may be involved in the mechanism of PFAS reproductive toxicity. Our goal was to measure placental PFAS concentrations and examine associations with birth outcomes (e.g., birth weight, gestational duration). Placenta samples (n=120) were collected during delivery from women enrolled in the Healthy Pregnancy, Healthy Baby cohort (HPHB) in Durham, North Carolina. All placenta samples contained detectable PFAS, with perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) being the most abundant and most frequently detected (all >96% detection frequency). While placental PFAS concentrations did not differ by infant sex, higher PFAS levels were observed in placenta from nulliparous women, suggesting that parity influences the accumulation of PFAS in the placenta. We used linear regression models to examine associations between placental PFAS and birth outcomes. After adjustment for parity, tobacco use, maternal age, and maternal race, we found that placental PFOS was associated with lower birth weight for gestational age in male infants and higher birth weight for gestational age in female infants. Similar findings were seen for PFNA for birth weight for gestational age. These differences in birth outcomes based on infant sex highlight a need to explore mechanistic differences in PFAS toxicity during gestation for male and female infants.
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PFAS can cross the placental barrier, as shown by their detection in cord blood samples from newborns.
“Alarmingly, PFAS can cross the placental barrier, as revealed by their ubiquitous detection in cord blood samples from newborns (Cao et al., 2018; Hall et al., 2022; Li et al., 2017; Mahfouz et al., 2023; Manea et al., 2020).”
From Associations between in utero exposure of per- and polyfluoroalkyl substances (PFAS) mixture and anthropometry measures at birth (2025) · cites this paper as Hall et al., 2022
The Introduction reports PFAS in umbilical cord blood and says transplacental transfer has been observed in humans, supporting the claim that PFAS can cross the placental barrier. The paper does not establish ubiquitous detection in newborn cord blood; its finding that every sample contained PFAS concerns placental tissue, not cord blood. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe effects of PFAS exposure on anthropometry measures at birth might vary depending on fetal sex.
“It is noteworthy that the effects of PFAS exposure on anthropometry measures at birth might vary depending on fetal sex (Hall et al., 2022; Li et al., 2017; Chen et al., 2021; Shen et al., 2022a; Valvi et al., 2017; Wang et al., 2019).”
From Associations between in utero exposure of per- and polyfluoroalkyl substances (PFAS) mixture and anthropometry measures at birth (2025) · cites this paper as Hall et al., 2022
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References 78 · Cited by 144
Research works printed but not linked: 3
- ATSDR, 2021. Toxicological Profile for Perfluoroalkyls. pp. 1– 852. DOI: 10.15620/cdc:59198 37220203 · DOI
- NTP, 2016. NTP Monograph on Immunotoxicity Associated with Exposure to Perfluorooctanoic Acid (PFOA) or Perfluorooctane Sulfonate (PFOS). in: Services, U.S.D.o.H.a.H. (Ed.), Research Triangle Park, NC: National Toxicology Program, pp. 1– 147
- NIST, 2017. Standard Reference Material® 1947 Certificate of Analysis: Lake Michigan Fish Tissue. National Institute of Standards & Technology., pp. 1– 17
- Authors
- Hall, S. M., Zhang, S., Hoffman, K., Miranda, M. L., & Stapleton, H. M.
- Affiliations
- Duke University (US)
- University of Notre Dame (US)
- Corresponding author
- Stapleton, Heather M.
- Venue
- Chemosphere
- Publisher
- Elsevier BV
- Published
- 2022-05
- Volume
- 295
- Pages
- 133873
- ISSN
- 0045-6535 (ISSN-L)
- PMC
- PMC8923299
- OpenAlex
- W4210864530
- Semantic Scholar
- 03943b75c2931af5e1ff4cbcd5f1e658d045d24c
- Cited by
- 144
- References
- 78
- Citations by year
- 2026: 25 · 2025: 37 · 2024: 41 · 2023: 34 · 2022: 6
- FWCI
- 13.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 285 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Chemosphere (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- U.S. Environmental Protection Agency (RD-83329301-0)
- National Institutes of Health
- National Institute of Environmental Health Sciences (R01 ES031419, T32-ES021432)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Keywords
- per- and polyfluoroalkyl substances, PFAS, placental tissue, birth weight, gestation length, sex differences, parity, PFOS, perfluorooctanoic acid, perfluorononanoic acid, perfluorodecanoic acid, reproductive toxicity, environmental pollutants
- MeSH terms
- Birth Weight, Environmental Pollutants, Female, Fluorocarbons, Humans, Male, Parity, Placenta, Pregnancy, Alkanesulfonic Acids
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