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

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

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