Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Maternal and Neonatal Thyroid Function in the Project Viva Cohort: A Mixtures Approach
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Maternal and neonatal thyroid function is critical for growth and neurodevelopment. Exposure to individual per- and polyfluoroalkyl substances (PFAS) can alter circulating thyroid hormone levels, but few studies have investigated effects of combined exposure to multiple PFAS. Estimate associations of exposure to multiple PFAS during early pregnancy with maternal and neonatal thyroid function. The study population consisted of 726 mothers and 465 neonates from Project Viva, a Boston, Massachusetts area longitudinal pre-birth cohort. We measured six PFAS [perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoate (PFNA), perfluorohexane sulfonate (PFHxS), 2-(N-ethyl-perfluorooctane sulfonamido)acetate (EtFOSAA), and 2-(N-methyl-perfluorooctane sulfonamido)acetate (MeFOSAA)] and thyroxine (T4), Free T4 Index (FT4I), and thyroid stimulating hormone (TSH) in maternal plasma samples collected during early pregnancy, and neonatal T4 in postpartum heel sticks. We estimated individual and joint effects of PFAS exposure with thyroid hormone levels using weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR), and evaluated potential non-linearity and interactions among PFAS using BKMR. Higher concentrations of the PFAS mixture were associated with significantly lower maternal FT4I, with MeFOSAA, EtFOSAA, PFOA, and PFHxS contributing most to the overall mixture effect in BKMR and WQS regression. In infants, higher concentrations of the PFAS mixture were associated with lower T4 levels, primarily in males, with PFHxS and MeFOSAA contributing most in WQS, and PFHxS contributing most in BKMR. The PFAS mixture was not associated with maternal T4 or TSH levels. However, in maternal BKMR analyses, ln-PFOS was positively associated with T4 levels (Δ25th to 75th percentile: 0.21 µg/dL; 95% credible interval: −0.03, 0.47) and ln-PFHxS was associated with a non-linear effect on TSH levels. These findings support the hypothesis that there may be combined effects of prenatal exposure to multiple PFAS on maternal and neonatal thyroid function, but the direction and magnitude of these effects may vary across individual PFAS.
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A small number of studies have demonstrated that mixtures of PFAS have complex interactions that can cause different toxicological effects than each individual chemical.
“A small number of studies have demonstrated that mixtures of PFAS have complex interactions that can cause different toxicological effects than each individual chemical (Ding et al., 2013; Hoover et al., 2019; Preston et al., 2020).”
From A Critical Review and Meta-Analysis of Impacts of Per- and Polyfluorinated Substances on the Brain and Behavior (2022) · cites this paper as Preston et al., 2020
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- Authors
- Preston, E. V., Webster, T. F., Claus Henn, B., McClean, M. D., Gennings, C., Oken, E., Rifas-Shiman, S. L., Pearce, E. N., Calafat, A. M., Fleisch, A. F., & Sagiv, S. K.
- Affiliations
- Harvard University (US)
- Boston University (US)
- Icahn School of Medicine at Mount Sinai (US)
- Centers for Disease Control and Prevention (US)
- Maine Medical Center Research Institute (US)
- University of California, Berkeley (US)
- Corresponding author
- Preston, Emma V.
- ORCID
- Venue
- Environment International
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 139
- Pages
- 105728
- ISSN
- 0160-4120 (ISSN-L)
- PMC
- PMC7282386
- OpenAlex
- W3016540095
- Cited by
- 169
- References
- 54
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 39 · 2023: 42 · 2022: 27 · 2021: 17 · 2020: 5
- FWCI
- 8.53
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Environment International (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute of Environmental Health Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institutes of Health
- 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
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Keywords
- per- and polyfluoroalkyl substances, PFAS mixtures, prenatal exposure, maternal thyroid function, neonatal thyroid function, thyroxine, free thyroxine index, thyroid-stimulating hormone, perfluorooctanoic acid, PFOS, PFHxS, PFNA, Project Viva cohort
- MeSH terms
- Bayes Theorem, Boston, Environmental Pollutants, Female, Fluorocarbons, Humans, Infant, Infant, Newborn, Male, Massachusetts, Pregnancy, Prenatal Exposure Delayed Effects, Thyroid Gland, Alkanesulfonic Acids
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