PDF(Pubmed)
Abstract：
Evidence suggests that exposure to per- and polyfluoroalkyl substances (PFAS) increases risk of high blood pressure (BP) during pregnancy. Prior studies did not examine associations with BP trajectory parameters (i.e., overall magnitude and velocity) during pregnancy, which is linked to adverse pregnancy outcomes.
To estimate associations of multiple plasma PFAS in early pregnancy with BP trajectory parameters across the second and third trimesters. To assess potential effect modification by maternal age and parity.
In 1297 individuals, we quantified six PFAS in plasma collected during early pregnancy (median gestational age: 9.4 weeks). We abstracted from medical records systolic BP (SBP) and diastolic BP (DBP) measurements, recorded from 12 weeks gestation until delivery. BP trajectory parameters were estimated via Super Imposition by Translation and Rotation modeling. Subsequently, Bayesian Kernel Machine Regression (BKMR) was employed to estimate individual and joint associations of PFAS concentrations with trajectory parameters - adjusting for maternal age, race/ethnicity, pre-pregnancy body mass index, income, parity, smoking status, and seafood intake. We evaluated effect modification by age at enrollment and parity.
We collected a median of 13 BP measurements per participant. In BKMR, higher concentration of perfluorooctane sulfonate (PFOS) was independently associated with higher magnitude of overall SBP and DBP trajectories (i.e., upward shift of trajectories) and faster SBP trajectory velocity, holding all other PFAS at their medians. In stratified BKMR analyses, participants with ≥ 1 live birth had more pronounced positive associations between PFOS and SBP velocity, DBP magnitude, and DBP velocity - compared to nulliparous participants. We did not observe significant associations between concentrations of the overall PFAS mixture and either magnitude or velocity of the BP trajectories.
Early pregnancy plasma PFOS concentrations were associated with altered BP trajectory in pregnancy, which may impact future cardiovascular health of the mother.
To estimate associations of multiple plasma PFAS in early pregnancy with BP trajectory parameters across the second and third trimesters. To assess potential effect modification by maternal age and parity.
In 1297 individuals, we quantified six PFAS in plasma collected during early pregnancy (median gestational age: 9.4 weeks). We abstracted from medical records systolic BP (SBP) and diastolic BP (DBP) measurements, recorded from 12 weeks gestation until delivery. BP trajectory parameters were estimated via Super Imposition by Translation and Rotation modeling. Subsequently, Bayesian Kernel Machine Regression (BKMR) was employed to estimate individual and joint associations of PFAS concentrations with trajectory parameters - adjusting for maternal age, race/ethnicity, pre-pregnancy body mass index, income, parity, smoking status, and seafood intake. We evaluated effect modification by age at enrollment and parity.
We collected a median of 13 BP measurements per participant. In BKMR, higher concentration of perfluorooctane sulfonate (PFOS) was independently associated with higher magnitude of overall SBP and DBP trajectories (i.e., upward shift of trajectories) and faster SBP trajectory velocity, holding all other PFAS at their medians. In stratified BKMR analyses, participants with ≥ 1 live birth had more pronounced positive associations between PFOS and SBP velocity, DBP magnitude, and DBP velocity - compared to nulliparous participants. We did not observe significant associations between concentrations of the overall PFAS mixture and either magnitude or velocity of the BP trajectories.
Early pregnancy plasma PFOS concentrations were associated with altered BP trajectory in pregnancy, which may impact future cardiovascular health of the mother.
摘要：
背景：证据表明，暴露于全氟烷基和多氟烷基物质（PFAS）会增加怀孕期间高血压（BP）的风险。先前的研究没有检查与BP轨迹参数的关联(即，总体幅度和速度)在怀孕期间，这与不良妊娠结局有关。
目的：评估妊娠早期多血浆PFAS与妊娠中期和妊娠晚期BP轨迹参数的相关性。评估产妇年龄和产次的潜在影响。
方法：在1297个人中，我们量化了妊娠早期收集的血浆中的6种PFAS(中位胎龄:9.4周).我们从医疗记录中提取收缩压血压（SBP）和舒张压血压（DBP）测量值，从妊娠12周到分娩记录。通过平移和旋转建模，通过超级施加估计BP轨迹参数。随后，贝叶斯内核机回归（BKMR）用于估计PFAS浓度与轨迹参数的个体和联合关联-根据母亲年龄进行调整，种族/民族,孕前体重指数,收入,奇偶校验，吸烟状况,和海鲜摄入量。我们根据入学时的年龄和平价评估了效果变化。
结果：我们收集了每位参与者13个BP测量值的中位数。在BKMR,较高浓度的全氟辛烷磺酸(PFOS)与较高的总体SBP和DBP轨迹(即，轨迹向上移位)和更快的SBP轨迹速度，持有所有其他PFAS在他们的中位数。在分层BKMR分析中，≥1例活产的参与者在PFOS和SBP速度之间有更明显的正相关,DBP震级,和DBP速度-与未分娩参与者相比。我们没有观察到整个PFAS混合物的浓度与BP轨迹的大小或速度之间的显着关联。
结论：妊娠早期血浆全氟辛烷磺酸浓度与妊娠期血压轨迹改变有关，这可能会影响母亲未来的心血管健康。
目的：评估妊娠早期多血浆PFAS与妊娠中期和妊娠晚期BP轨迹参数的相关性。评估产妇年龄和产次的潜在影响。
方法：在1297个人中，我们量化了妊娠早期收集的血浆中的6种PFAS(中位胎龄:9.4周).我们从医疗记录中提取收缩压血压（SBP）和舒张压血压（DBP）测量值，从妊娠12周到分娩记录。通过平移和旋转建模，通过超级施加估计BP轨迹参数。随后，贝叶斯内核机回归（BKMR）用于估计PFAS浓度与轨迹参数的个体和联合关联-根据母亲年龄进行调整，种族/民族,孕前体重指数,收入,奇偶校验，吸烟状况,和海鲜摄入量。我们根据入学时的年龄和平价评估了效果变化。
结果：我们收集了每位参与者13个BP测量值的中位数。在BKMR,较高浓度的全氟辛烷磺酸(PFOS)与较高的总体SBP和DBP轨迹(即，轨迹向上移位)和更快的SBP轨迹速度，持有所有其他PFAS在他们的中位数。在分层BKMR分析中，≥1例活产的参与者在PFOS和SBP速度之间有更明显的正相关,DBP震级,和DBP速度-与未分娩参与者相比。我们没有观察到整个PFAS混合物的浓度与BP轨迹的大小或速度之间的显着关联。
结论：妊娠早期血浆全氟辛烷磺酸浓度与妊娠期血压轨迹改变有关，这可能会影响母亲未来的心血管健康。
