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Cited by 117Per- and polyfluoroalkyl substances researchToxic Organic Pollutants ImpactEffects and risks of endocrine disrupting chemicals

Are perfluorooctane sulfonate alternatives safer? New insights from a birth cohort study

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Chu, Chu, Zhou, Yang, Li, Qing-Qing, Bloom, Michael S., Lin, Shao, Yu, Yun-Jiang, Chen, Da, Yu, Hong-Yao +4 more·2020·Environment International
DOI 10.1016/j.envint.2019.105365
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Abstract

BACKGROUND: Experimental studies show that chlorinated polyfluorinated ether sulfonic acids (Cl-PFESA 6:2 and 8:2), one of perfluoroalkyl substances (PFAS) used as perfluorooctane sulfonate (PFOS) alternatives, are reproductive toxicants in vivo and in vitro. However, the associations between gestational exposure to Cl-PFESAs and birth outcomes are unknown. OBJECTIVES: We investigated associations between 6:2 Cl-PFESA and 8:2 Cl-PFESA in maternal serum and birth outcomes. METHODS: We measured four PFAS, including 6:2 Cl-PFESA, 8:2 Cl-PFESA, PFOS, and perfluorooctanoic acid (PFOA) in third-trimester maternal serum collected from 372 mother-child dyads participating in the Guangzhou Birth Cohort Study. Characteristics of mothers and infants were gathered from medical records and by interviewer-administered questionnaires. RESULTS: PFOS was the most abundant PFAS in maternal serum (median: 7.15 ng/mL), followed by 6:2 Cl-PFESA (median: 2.41 ng/mL). Greater maternal serum levels of all PFAS alternatives were significantly associated with lower birth weight, adjusted for confounding variables. For example, each ln-ng/mL greater concentration of 6:2 Cl-PFESA and 8:2 Cl-PFESA was associated with a 54.44 g [95% confidence interval (CI): -95.66, -13.22] and 21.15 g (95% CI: -41.44, -0.86) lower birth weight, respectively. Greater continuous maternal serum 6:2 Cl-PFESA (OR: 2.67, 95% CI: 1.73, 4.15) and PFOS (OR: 2.03, 95% CI: 1.24, 3.32) were also associated with higher risks for preterm birth, adjusted for confounders, with a possible threshold effect at the highest quartile of 6:2 Cl-PFESA. CONCLUSIONS: For the first time, we report associations between maternal serum 6:2 Cl-PFESA and 8:2 Cl-PFESA concentrations and adverse birth outcomes. Our findings suggest that PFOS alternatives may be reproductive toxicants in human populations and should be considered with caution before widespread use. Given the preliminary nature of our results, additional epidemiological and toxicological investigations are needed to more definitively assess the risks.

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  • Epidemiological studies indicate that prenatal and/or in utero exposure to PFAS is associated with reductions in birth weight, birth length, and head circumference.

    “A mounting body of epidemiological investigations underscored that prenatal and/or in utero exposure to PFAS was associated with the reduction of BW, BL and HC (Chu et al., 2020; Cao et al., 2018; Li et al., 2017; Chang et al., 2022; Chen et al., 2021; Ji et al., 2023; Kashino et al., 2020; Ku et al., 2022; Lee et al., 2016; Marks et al., 2021; Marks et al., 2019; Padula et al., 2023; Sagiv et al.”

    From Associations between in utero exposure of per- and polyfluoroalkyl substances (PFAS) mixture and anthropometry measures at birth (2025) · cites this paper as Chu et al., 2020

    The Introduction and Results report associations between prenatal PFAS exposure and lower birth weight. The Birth outcomes section lists birth weight and gestational age as the measured outcomes; the paper does not report reductions in birth length or head circumference. Page numbers are unavailable in our copy. (LLM, conf=0.90)

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Authors
Chu, C., Zhou, Y., Li, Q.-Q., Bloom, M. S., Lin, S., Yu, Y.-J., Chen, D., Yu, H.-Y., Hu, L.-W., Yang, B.-Y., Zeng, X.-W., & Dong, G.-H.
Affiliations
  • Sun Yat-sen University (CN)
  • University at Albany, State University of New York (US)
  • Jinan University (CN)
Corresponding author
Dong, Guang-Hui
ORCID
Venue
Environment International
Publisher
Elsevier BV
Published
2020-02
Volume
135
Pages
105365
ISSN
0160-4120 (ISSN-L)
DOI
10.1016/j.envint.2019.105365
OpenAlex
W2992604222
Cited by
117
References
75
Citations by year
2026: 21 · 2025: 19 · 2024: 16 · 2023: 21 · 2022: 20 · 2021: 15 · 2020: 5
FWCI
4.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Environment International (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Natural Science Foundation of Guangdong Province
  • National Basic Research Program of China
  • Fundamental Research Funds for the Central Universities
  • National Natural Science Foundation of China
Topics
  • Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
Keywords
perfluorooctanoic acid, PFOS, PFAS, maternal serum, birth weight, preterm birth, prenatal exposure, reproductive toxicity
MeSH terms
Caprylates, Fluorocarbons, Humans, Infant, Newborn, Sulfonic Acids, Cohort Studies, Alkanesulfonic Acids

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