Association between prenatal exposure to per- and polyfluoroalkyl substances and hormone levels in fetal umbilical cord blood

Kang'ao SUN; Yanmei WU; Hongbing FU; Xia WANG; Hong LIANG; Jingchuan XUE

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Association between prenatal exposure to per- and polyfluoroalkyl substances and hormone levels in fetal umbilical cord blood

VernacularTitle:孕期全氟及多氟烷基化合物暴露与胎儿脐带血中激素水平的关联
Author: Kang'ao SUN ¹ ; Yanmei WU ¹ ; Hongbing FU ² ; Xia WANG ³ ; Hong LIANG ³ ; Jingchuan XUE ¹
Author Information

1. School of Ecology, Environment and Resources, Guangdong University of Technology, Guangzhou, Guangdong 510006, China.
2. The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China.
3. Institute of Public Health and Policy, Shanghai Institute of Biomedical and Pharmaceutical Technology, Shanghai 200237, China.
Publication Type:Selectedarticle
Keywords: per-and polyfluoroalkyl substance; prenatal exposure; endocrine disruption; mixed exposure; fetal umbilical cord blood hormone
From: Journal of Environmental and Occupational Medicine 2026;43(8):917-925
CountryChina
Language:Chinese
Abstract: Background Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals characterized by environmental persistence and have been ubiquitously detected in pregnant women. Although existing evidence suggests that PFAS may exert endocrine-disrupting effects, evidence remains limited regarding the associations of individual legacy and emerging PFAS congeners, as well as PFAS mixtures, with fetal hormonal homeostasis. Objective Based on the Jiashan Birth Cohort in China, to investigate the associations between maternal plasma concentrations of legacy and emerging PFAS in the second trimester and levels of multiple hormones in fetal cord blood. Methods A total of 336 women in the second trimester from the Jiashan Birth Cohort were enrolled. Concentrations of 53 legacy and emerging PFAS were measured in maternal plasma, and levels of eight key hormones were determined in fetal cord blood. Multiple linear regression, restricted cubic spline, and Bayesian kernel machine regression models were used to examine the linear, nonlinear, and joint associations of individual PFAS and PFAS mixtures with fetal cord blood hormone levels. Results Maternal plasma concentrations of perfluorononanoic acid, perfluorohexane sulfonic acid, perfluorooctanesulfonic acid, and 8:2 chlorinated perfluoroether sulfonic acid were positively associated with cord blood levels of insulin-like growth factor 1 (IGF1), with β values of 0.040, 0.050, 0.040, and 0.030, respectively (all P<0.05). In contrast, perfluoroheptanoic acid was negatively associated with prolactin levels (β=−0.060, P<0.01). Restricted cubic spline models revealed a nonlinear dose–response relationship between perfluorobutane sulfonic acid and growth hormone (likelihood ratio test P=0.045), with a positive association in the intermediate concentration interval (β=0.261, P=0.010) that turned negative at higher concentrations (β=−0.425, P=0.048), as well as a nonlinear trend between 6:2 fluorotelomer sulfonic acid and prolactin (likelihood ratio test P=0.074). Bayesian kernel machine regression analysis indicated a negative trend between PFAS mixture exposure and cord blood prolactin levels. Conclusion Maternal PFAS exposure in the second trimester is associated with higher insulin-like growth factor 1 levels and lower prolactin levels in fetal cord blood. Prolactin appears to be consistently associated with both individual PFAS congeners and PFAS mixtures. These findings suggest that maternal PFAS exposure may affect fetal endocrine homeostasis by disrupting the hypothalamic-pituitary-prolactin regulatory axis.