title: Perfluoroalkyl substances during pregnancy and validated preeclampsia among nulliparous women in the Norwegian Mother and Child Cohort Study.
abstract: Perfluoroalkyl substances (PFAS) are persistent and ubiquitous environmental contaminants, and human exposure to these substances may be related to preeclampsia, a common pregnancy complication. Previous studies have found serum concentrations of PFAS to be positively associated with pregnancy-induced hypertension and preeclampsia in a population with high levels of exposure to perfluorooctanoate. Whether this association exists among pregnant women with background levels of PFAS exposure is unknown. Using data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health, we carried out a study of nulliparous pregnant women enrolled in 2003-2007 (466 cases, 510 noncases) to estimate associations between PFAS concentrations and an independently validated diagnosis of preeclampsia. We measured levels of 9 PFAS in maternal plasma extracted midpregnancy; statistical analyses were restricted to 7 PFAS that were quantifiable in more than 50% of samples. In proportional hazards models adjusted for maternal age, prepregnancy body mass index (weight (kg)/height (m)(2)), educational level, and smoking status, we observed no strongly positive associations between PFAS levels and preeclampsia. We found an inverse association between preeclampsia and the highest quartile of perfluoroundecanoic acid concentration relative to the lowest quartile (hazard ratio = 0.55, 95% confidence interval: 0.38, 0.81). Overall, our findings do not support an increased risk of preeclampsia among nulliparous Norwegian women with background levels of PFAS exposure.
authors.forename: Anne P
authors.initials: AP
authors.lastname: Starling
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Engel
authors.forename: David B
authors.initials: DB
authors.lastname: Richardson
authors.forename: Donna D
authors.initials: DD
authors.lastname: Baird
authors.forename: Line S
authors.initials: LS
authors.lastname: Haug
authors.forename: Alison M
authors.initials: AM
authors.lastname: Stuebe
authors.forename: Kari
authors.initials: K
authors.lastname: Klungsøyr
authors.forename: Quaker
authors.initials: Q
authors.lastname: Harmon
authors.forename: Georg
authors.initials: G
authors.lastname: Becher
authors.forename: Cathrine
authors.initials: C
authors.lastname: Thomsen
authors.forename: Azemira
authors.initials: A
authors.lastname: Sabaredzovic
authors.forename: Merete
authors.initials: M
authors.lastname: Eggesbø
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Travlos
authors.forename: Ralph E
authors.initials: RE
authors.lastname: Wilson
authors.forename: Lill I
authors.initials: LI
authors.lastname: Trogstad
authors.forename: Per
authors.initials: P
authors.lastname: Magnus
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Longnecker
mesh_terms: D000293:Adolescent; D000328:Adult; D017738:Alkanesulfonic Acids / Q000097:blood; D002210:Caprylates / Q000097:blood; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D004785:Environmental Pollutants / Q000009:adverse effects / Q000097:blood*; D005227:Fatty Acids / Q000097:blood; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D009664:Norway; D010298:Parity; D011225:Pre-Eclampsia / Q000097:blood* / Q000209:etiology; D011247:Pregnancy; D016016:Proportional Hazards Models; D055815:Young Adult
chemical_list: D017738:Alkanesulfonic Acids; D002210:Caprylates; D004785:Environmental Pollutants; D005227:Fatty Acids; D005466:Fluorocarbons; C586085:perfluoroundecanoic acid; C023036:perfluorooctanoic acid; C076994:perfluorooctane sulfonic acid
keywords: Norwegian Mother and Child Cohort Study; perfluoroalkyl substances; perfluorooctane sulfonate; perfluorooctanoic acid; perfluoroundecanoic acid; preeclampsia