Gestational exposure to perfluoroalkyl substances and congenital heart defects: A nested case-control pilot study
Background: Accumulating evidence suggests that environmental pollutants may contribute to the occurrence of congenital heart defects (CHDs). However, no previous studies have evaluated the impact of perfluoroalkyl substances (PFAS), persistent environmental pollutants, on CHDs. This exploratory stu...
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Elsevier
2021-09-01
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Series: | Environment International |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412021001926 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yanqiu Ou Xiaowen Zeng Shao Lin Michael S. Bloom Fengzhen Han Xiaohua Xiao Hui Wang Rosemary Matala Xiaohong Li Yanji Qu Zhiqiang Nie Guanghui Dong Xiaoqing Liu |
spellingShingle |
Yanqiu Ou Xiaowen Zeng Shao Lin Michael S. Bloom Fengzhen Han Xiaohua Xiao Hui Wang Rosemary Matala Xiaohong Li Yanji Qu Zhiqiang Nie Guanghui Dong Xiaoqing Liu Gestational exposure to perfluoroalkyl substances and congenital heart defects: A nested case-control pilot study Environment International Nested case-control study Perfluoroalkyl substances Maternal peripheral blood Cord blood Congenital heart defects |
author_facet |
Yanqiu Ou Xiaowen Zeng Shao Lin Michael S. Bloom Fengzhen Han Xiaohua Xiao Hui Wang Rosemary Matala Xiaohong Li Yanji Qu Zhiqiang Nie Guanghui Dong Xiaoqing Liu |
author_sort |
Yanqiu Ou |
title |
Gestational exposure to perfluoroalkyl substances and congenital heart defects: A nested case-control pilot study |
title_short |
Gestational exposure to perfluoroalkyl substances and congenital heart defects: A nested case-control pilot study |
title_full |
Gestational exposure to perfluoroalkyl substances and congenital heart defects: A nested case-control pilot study |
title_fullStr |
Gestational exposure to perfluoroalkyl substances and congenital heart defects: A nested case-control pilot study |
title_full_unstemmed |
Gestational exposure to perfluoroalkyl substances and congenital heart defects: A nested case-control pilot study |
title_sort |
gestational exposure to perfluoroalkyl substances and congenital heart defects: a nested case-control pilot study |
publisher |
Elsevier |
series |
Environment International |
issn |
0160-4120 |
publishDate |
2021-09-01 |
description |
Background: Accumulating evidence suggests that environmental pollutants may contribute to the occurrence of congenital heart defects (CHDs). However, no previous studies have evaluated the impact of perfluoroalkyl substances (PFAS), persistent environmental pollutants, on CHDs. This exploratory study aimed to generate testable hypotheses of the association between gestational PFAS and the risk of CHDs. Methods: A nested case-control study was conducted in a cohort of 11,578 newborns. Exposure odds ratios were compared between 158 CHD cases and 158 non-malformed controls delivered at the same hospital, individually matched by maternal age (±5 years) and parity. Concentrations of 27 PFAS, including linear and branched isomers, were determined in maternal peripheral blood and cord blood plasma collected before and during delivery using a ultra-performance liquid chromatography coupled to mass spectrometry. Conditional logistic regression was utilized to evaluate associations between individual PFAS and the risk of CHDs, adjusted for confounding variables. Results: Maternal gestational exposure to the highly branched perfluorooctanesulfonate (PFOS) isomer potassium 6-trifluoromethyperfluoroheptanesulfonate [6 m-PFOS, adjusted odds ratio (aOR) (95% CI) = 2.47(1.05,5.83)] and perfluorodecanoic acid [PFDA, aOR (95% CI) = 2.33(1.00,5.45)] were associated with increased odds of septal defects with statistical significance, while linear PFOS [aOR (95% CI) = 3.65(1.09,12.16)] and perfluoro-n-dodecanoic acid [PFDoA, aOR (95% CI) = 6.82(1.75, 26.61)] were associated with conotruncal defects. Effect estimates also suggested associations for higher maternal 6 m-PFOS and PFDA concentrations with ventricular septal defect. However, we did not observe these associations in cord blood. Conclusion: These exploratory findings suggested that gestational exposure to most PFAS, especially linear PFOS, 6 m-PFOS, PFDA, and PFDoA, was associated with greater risks for septal and conotruncal defects. However, a larger, adequately powered study is needed to confirm our findings, and to more comprehensively investigate the potential teratogenic effects of other more recently introduced PFAS, and on associations with individual CHD subtypes. |
topic |
Nested case-control study Perfluoroalkyl substances Maternal peripheral blood Cord blood Congenital heart defects |
url |
http://www.sciencedirect.com/science/article/pii/S0160412021001926 |
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doaj-8c4b6a67fbd74663885d62041073e6b82021-06-15T04:13:25ZengElsevierEnvironment International0160-41202021-09-01154106567Gestational exposure to perfluoroalkyl substances and congenital heart defects: A nested case-control pilot studyYanqiu Ou0Xiaowen Zeng1Shao Lin2Michael S. Bloom3Fengzhen Han4Xiaohua Xiao5Hui Wang6Rosemary Matala7Xiaohong Li8Yanji Qu9Zhiqiang Nie10Guanghui Dong11Xiaoqing Liu12Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, #96 Dongchuan Road, Guangzhou 510080, ChinaDepartment of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, ChinaDepartments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USA; Corresponding authors at: Guangdong Cardiovascular Institute, #96 Dongchuan Road, Guangzhou 510080, China (X. Liu); Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China (G. Dong); GEC 100, One University Place, Rensselaer, Albany, NY, USA (S. Lin).Department of Global and Community Health, George Mason University, Fairfax, VA, 22030 USADepartment of Obstetrics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, ChinaBoai Hospital of Zhongshan, 6 Chenggui Road, East District, Zhongshan 528403, Guangdong, ChinaDepartment of Obstetrics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, ChinaDepartments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY 12144, USAResearch Department of Medical Science, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou 510080, Guangdong, ChinaDepartment of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, #96 Dongchuan Road, Guangzhou 510080, ChinaDepartment of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, #96 Dongchuan Road, Guangzhou 510080, ChinaDepartment of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China; Corresponding authors at: Guangdong Cardiovascular Institute, #96 Dongchuan Road, Guangzhou 510080, China (X. Liu); Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China (G. Dong); GEC 100, One University Place, Rensselaer, Albany, NY, USA (S. Lin).Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, #96 Dongchuan Road, Guangzhou 510080, China; Corresponding authors at: Guangdong Cardiovascular Institute, #96 Dongchuan Road, Guangzhou 510080, China (X. Liu); Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China (G. Dong); GEC 100, One University Place, Rensselaer, Albany, NY, USA (S. Lin).Background: Accumulating evidence suggests that environmental pollutants may contribute to the occurrence of congenital heart defects (CHDs). However, no previous studies have evaluated the impact of perfluoroalkyl substances (PFAS), persistent environmental pollutants, on CHDs. This exploratory study aimed to generate testable hypotheses of the association between gestational PFAS and the risk of CHDs. Methods: A nested case-control study was conducted in a cohort of 11,578 newborns. Exposure odds ratios were compared between 158 CHD cases and 158 non-malformed controls delivered at the same hospital, individually matched by maternal age (±5 years) and parity. Concentrations of 27 PFAS, including linear and branched isomers, were determined in maternal peripheral blood and cord blood plasma collected before and during delivery using a ultra-performance liquid chromatography coupled to mass spectrometry. Conditional logistic regression was utilized to evaluate associations between individual PFAS and the risk of CHDs, adjusted for confounding variables. Results: Maternal gestational exposure to the highly branched perfluorooctanesulfonate (PFOS) isomer potassium 6-trifluoromethyperfluoroheptanesulfonate [6 m-PFOS, adjusted odds ratio (aOR) (95% CI) = 2.47(1.05,5.83)] and perfluorodecanoic acid [PFDA, aOR (95% CI) = 2.33(1.00,5.45)] were associated with increased odds of septal defects with statistical significance, while linear PFOS [aOR (95% CI) = 3.65(1.09,12.16)] and perfluoro-n-dodecanoic acid [PFDoA, aOR (95% CI) = 6.82(1.75, 26.61)] were associated with conotruncal defects. Effect estimates also suggested associations for higher maternal 6 m-PFOS and PFDA concentrations with ventricular septal defect. However, we did not observe these associations in cord blood. Conclusion: These exploratory findings suggested that gestational exposure to most PFAS, especially linear PFOS, 6 m-PFOS, PFDA, and PFDoA, was associated with greater risks for septal and conotruncal defects. However, a larger, adequately powered study is needed to confirm our findings, and to more comprehensively investigate the potential teratogenic effects of other more recently introduced PFAS, and on associations with individual CHD subtypes.http://www.sciencedirect.com/science/article/pii/S0160412021001926Nested case-control studyPerfluoroalkyl substancesMaternal peripheral bloodCord bloodCongenital heart defects |