Pregnancy per- and polyfluoroalkyl substance concentrations and postpartum health in Project Viva, a prospective cohort.

By Susanna D Mitro, Sharon K Sagiv, Abby F Fleisch, Lindsay M Jaacks, Paige L Williams, Sheryl L Rifas-Shiman, Antonia M Calafat, Marie-France Hivert, Emily Oken, and Tamarra M James-Todd
J. Clin. Endocrinol. Metab.
July 7, 2020
DOI: 10.1210/clinem/dgaa431


Per- and polyfluoroalkyl substances (PFAS) are environmental chemicals linked to weight gain and type 2 diabetes.


We examined the extent to which PFAS plasma concentrations during pregnancy were associated with postpartum anthropometry and biomarkers.

Design, Patients, Measures

We studied women recruited between 1999-2002 in the Project Viva prospective cohort with pregnancy plasma concentrations of PFAS, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamide) acetic acid (EtFOSAA). Three-year postpartum anthropometry measurements were available from 786-801 women, blood pressure from 761 women, and blood biomarkers from 450-454 women. We used multivariable regression to evaluate the association of log2-transformed PFAS with postpartum anthropometry, blood pressure, and blood biomarkers (leptin, adiponectin, sex hormone binding globulin [SHBG], hemoglobin A1c [HbA1c], interleukin-6 [IL-6], C-reactive protein [CRP]), adjusting for age, pre-pregnancy BMI, marital status, race/ethnicity, education, income, smoking, parity, and breastfeeding history.


Pregnancy concentrations of certain PFAS were associated with greater adiposity (e.g., 0.4 cm [95%CI: -0.1, 0.9] greater waist circumference per doubling in EtFOSAA; 0.2 cm [95%CI: -0.1, 0.5] greater mid-upper arm circumference per doubling in PFOA; 1.2 mm [95%CI: 0.1, 2.2] thicker sum of subscapular and triceps skinfolds per doubling in PFOS) and higher systolic blood pressure (e.g., 1.2 mm Hg [95%CI: 0.3, 2.2] per doubling in PFOS) at three years postpartum. Higher EtFOSAA concentrations were also associated with 10.8% higher IL-6 (95%CI: 3.3, 18.9) and 6.1% lower SHBG (95%CI: 0.7, 11.2) per doubling.


Pregnancy concentrations of EtFOSAA, PFOS, and PFOA were associated with adverse postpartum cardiometabolic markers.

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