Adiposity in Midlife Linked to PFAS Exposure During Pregnancy

Exposure to per- and polyfluoroalkyl substances (PFAS) during early pregnancy is associated with midlife adiposity, according to results of a study published in the Journal of Clinical Endocrinology & Metabolism.

Endocrine disrupting chemicals, such as PFAS, may have obesogenic effects. These PFAS can be found in food packaging and stain-resistant materials and persist in the environment. However, the long-term effect of PFAS on adiposity among pregnant individuals remains unclear.  

To assess the long-term effects of exposure to PFAS in pregnancy, investigators from Harvard TH Chan School of Public Health sourced data from Project Viva, which was a longitudinal prebirth cohort that recruited participants between 1999 and 2002. Pregnant women (N=547) provided plasma samples early in their pregnancy (mean gestation, 10.0 weeks).

Adiposity outcomes included weight, waist circumference, trunk fat mass, and total body mass. The researchers assessed 6 PFAS, including perfluorooctane sulfonate (PFOS), 2-(N-ethyl-perfluorooctane sulfonamido) acetate (EtFOSAA), perfluorononanoate (PFNA), perfluorohexane sulfonate (PFHxS), perfluorononanoate (PFOA), and 2-(N-methyl-perfluorooctane sulfonamido) acetate (MeFOSAA).

Among the study population (mean [SD] age, 32.5 [5.0] years, 63.1% had a pre-pregnancy BMI of less than 25.0 kg/m², 70.4% were White, 49.9% were nulliparous, and 71.5% never smoked.

All 6 PFAS were detected in over 99% of samples.

After a mean 17.7-year follow-up, the participants were a mean (SD) age of 50.7 (5.0) years, weight of 76.3 (19.5) kg, trunk fat mass of 14.5 (7.4) kg, total fat mass of 30.5 (12.7) kg, and waist circumference of 93.4 (16.0) cm.

In the multivariate linear regression analysis, each doubling of PFOS was associated with a 3.8-kg increase in body weight at midlife and each doubling of EtFOSAA was associated with a 2.9-kg increase in body weight. Conversely, each doubling of PFNA was associated with a -1.1-cm decrease in waist circumference.

Results of the sensitivity analyses were consistent with the main analysis. Pre-pregnancy BMI did not modify the effects of PFAS on midlife adiposity.

In the Bayesian regression analysis, PFOS levels in the 75th percentile were associated with a 7.7-kg increase in body weight, a 1.2-kg increase in trunk fat mass, and a 3.0-kg increase in total fat mass.

Conversely, PFNA and PFHxS levels in the 75th percentile were associated with -6.0- and -2.0-kg decreases in body weight, -0.8- and -0.8-kg decreases in trunk fat mass, and -1.4- and -1.4-kg decreases in total fat mass, respectively. Higher levels of PFNA levels were also associated with a -1.8-cm decrease in waist circumference.

The analysis that evaluated the effect of PFAS mixtures revealed weak associations with adiposity outcomes.

Study limitations include a lack of generalizability to present-day populations, as PFOS and perfluorooctanoate PFAS were phased out after plasma samples were collected for this study.

The study authors concluded, “These findings support the idea that pregnancy may be a sensitive period of exposure as it relates to the development of long-term maternal adiposity measures, with potential implications for subsequent adverse cardiometabolic health outcomes.”

This article originally appeared on Endocrinology Advisor