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Cited by 145Per- and polyfluoroalkyl substances researchThyroid Disorders and TreatmentsEffects and risks of endocrine disrupting chemicals

Associations between Perfluoroalkyl acids (PFASs) and maternal thyroid hormones in early pregnancy: A population-based cohort study

Webster, Glenys M., Venners, Scott A., Mattman, Andre, Martin, Jonathan W.·2014·Environmental Research
DOI 10.1016/j.envres.2014.06.012
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Abstract

Background Associations between perfluoroalkyl acids (PFASs) and human thyroid hormone levels remain unclear, especially during early pregnancy when small changes in maternal thyroid hormones can affect fetal brain development.Objectives To examine associations between maternal serum PFAS levels and maternal thyroid hormone levels in the early 2nd trimester of pregnancy.Methods Participants were euthyroid pregnant women (n=152) enrolled in the Chemicals, Health and Pregnancy (CHirP) study based in Vancouver, Canada. Associations between maternal serum PFASs, including perfluorohexanesulfonate (PFHxS), perfluorononanoate (PFNA), perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS) and repeated measures of maternal thyroid hormones, including free thyroxine (fT4), total thyroxine (TT4) and thyroid stimulating home (TSH) were examined using mixed effects linear models. Associations were considered in all women, then separately in women with high (≥ 9 IU/mL) vs normal (<9 IU/mL) levels of thyroid peroxidase antibody (TPOAb), a marker of autoimmune hypothyroidism (Hashimoto's disease).Results Median PFAS concentrations (ng/mL) in maternal sera were 1.0 (PFHxS), 0.6 (PFNA), 1.7 (PFOA) and 4.8 (PFOS). PFASs were not associated with fT4, TT4 or TSH among women with normal TPOAb. However, among the 9% of women with high TPOAb (n=14), interquartile range (IQR) increases of PFASs were associated with a 46-69% increase in maternal TSH (95% CIs ranging from 8% to 123%) (PFNA, PFOA and PFOS only), and with a 3% to 7% decrease in maternal fT4 (95% CIs ranging from -18% to 5%) (all 4 PFASs). PFNA was also associated with higher maternal TSH in the whole sample.Conclusions PFASs were positively associated with TSH, and weakly negatively associated with fT4 in the subset of pregnant women with high TPOAb, which occurs in 6-10% of pregnancies. PFASs may exacerbate the already high TSH and low fT4 levels in these women during early pregnancy, which is a critical time of thyroid hormone-mediated fetal brain development. The clinical significance of these findings is not clear. We propose a "multiple hit hypothesis" to explain these findings; this hypothesis deserves evaluation in larger, more representative study samples.

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  • A majority of evidence for PFAS-induced endocrine disruption is at the level of circulating stress, sex, and thyroid hormones, while data regarding PFAS-associated disruption of synthesis enzymes and receptors is more limited, especially within the brain.

    “A majority of evidence for PFAS-induced endocrine disruption is at the level of circulating stress, sex, and thyroid hormones, while data regarding PFAS associated disruption of synthesis enzymes and receptors is more limited, especially within the brain”

    From A Critical Review and Meta-Analysis of Impacts of Per- and Polyfluorinated Substances on the Brain and Behavior (2022) · cites this paper as Webster et al., 2014

  • The results of the thyroid studies were contradictory in some aspects, such as serum PFC-related increases in T4 and fT4 and decreases in T3 and hypothyroidism.

    “The three studies proposed that higher PFC serum levels might change thyroid hormone levels [26–28]; however, the results of these studies were contradictory in some aspects, such as serum PFC-related increases in T4 and fT4 and decreases in T3 and hypothyroidism.”

    From Overview of emerging contaminants and associated human health effects (2015) · cites this paper as [28]

  • Higher PFC serum levels might change thyroid hormone levels.

    “The three studies proposed that higher PFC serum levels might change thyroid hormone levels [26–28]; however, the results of these studies were contradictory in some aspects, such as serum PFC-related increases in T4 and fT4 and decreases in T3 and hypothyroidism.”

    From Overview of emerging contaminants and associated human health effects (2015) · cites this paper as [28]

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Authors
Webster, G. M., Venners, S. A., Mattman, A., & Martin, J. W.
Affiliations
  • Simon Fraser University (CA)
  • BC Children's Hospital (CA)
  • University of Alberta (CA)
Corresponding author
Webster, Glenys M.
ORCID
Martin, Jonathan W.
Venue
Environmental Research
Publisher
Elsevier BV
Published
2014-08
Volume
133
Pages
338-347
ISSN
0013-9351 (ISSN-L)
DOI
10.1016/j.envres.2014.06.012
OpenAlex
W2018354811
Cited by
145
References
72
Citations by year
2026: 9 · 2025: 10 · 2024: 15 · 2023: 11 · 2022: 16 · 2021: 13 · 2020: 21 · 2019: 13 · 2018: 10 · 2017: 6 · 2016: 12 · 2015: 8 · 2014: 1
FWCI
6.84
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Environmental Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
University of British Columbia
Topics
  • Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
Keywords
perfluoroalkyl acids, PFASs, maternal thyroid hormones, thyroid-stimulating hormone, free thyroxine, thyroid peroxidase antibodies, Hashimoto's thyroiditis, autoimmune hypothyroidism, perfluorooctanoic acid, PFOS, PFHxS, perfluorononanoate, early pregnancy, fetal brain development
MeSH terms
Adolescent, Adult, Caprylates, Environmental Pollutants, Female, Fluorocarbons, Humans, Pregnancy, Pregnancy Trimester, Second, Sulfonic Acids, Thyrotropin, Thyroxine, Cohort Studies, Alkanesulfonic Acids, Young Adult

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