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Low-Level Environmental Per- and Polyfluoroalkyl Substances and Preterm Birth: A Nested Case–Control Study Among a Uyghur Population in Northwestern China

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Abstract

Evidence concerning associations between exposure to per- and polyfluoroalkyl substances (PFASs) and preterm birth is limited. We evaluated the associations of preterm birth with gestational exposures to PFAS isomers, PFAS alternatives, and legacy PFASs using a nested case–control study (384 preterm vs. 384 term births) in a northwestern China Uyghur population. Levels of 23 PFASs were determined in cord serum samples. We estimated odds ratios (ORs) and mean differences (βs) for associations between preterm birth and gestational age with an interquartile range increase in each PFAS. Stratified analyses by maternal and infant characteristics were also performed. Although PFAS concentrations were low (median, < 0.455 ng/mL), several were significantly associated with preterm birth [OR for total perfluorooctane sulfonic acid (PFOS), linear PFOS, and branched PFOS were 1.44 (95% CI 1.18, 1.79), 1.41 (95% CI 1.19, 1.73), and 1.11 (95% CI 1.01, 1.29), respectively] and gestational age at delivery [β for perfluoro-n-dodecanoic acid, total PFOS, linear PFOS, ∑2 m-PFOS, and sodium perfluoro-1-heptanesulfonate were − 3.43 (95% CI − 5.55, − 1.32), − 1.26 (95% CI − 2.46, − 0.05), − 1.80 (95% CI − 3.24, − 0.37), − 3.03 (95% CI − 4.45, − 1.60), and − 3.02 (95% CI − 4.93, − 1.11), respectively]. Additionally, the associations between several PFASs and gestational age were stronger among newborn girls, those born to mothers being older, of “other” ethnicity, having higher income, and without periconceptional folic acid intake, compared to their counterparts. In summary, our results suggest that gestational exposure to low-level PFASs, PFOS in particular, was associated with higher odds of preterm birth in a Uyghur population.

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Data Availability

The raw data supporting the conclusions will be made available by the corresponding author (Guang-Hui Dong) on reasonable request.

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Acknowledgements

The research was supported by the Natural Science Foundation of the Xinjiang Uyghur Autonomous Region, China (No. 2018D01C013; 2018D01C021); the National Key Research and Development Program of China (No. 2018YFC1004300; No. 2018YFC1004302); the Fundamental Research Funds for the Central Universities (No. 20ykzd10). The authors acknowledge the cooperation of participants in this study who have been very generous with their time and assistance.

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  1. Bo-Yi Yang, Jianhua Wu and Xilong Niu have contributed equally to this work

Authors and Affiliations

  1. Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China

    Bo-Yi Yang, Qi-Zhen Wu, Chu Chu, Ya-Na Luo, Xiao-Xuan Liu, Xiao-Wen Zeng & Guang-Hui Dong

  2. Department of Toxicology, School of Public Health, Xinjiang Medical University, 393 Xinyi Road, Xinshi District, Ürümqi, 830011, China

    Bo-Yi Yang & Tao Liu

  3. Department of Gynecology and Obstetrics, The First People’s Hospital of Kashi Prefecture (The Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, 844000, China

    Bo-Yi Yang, Xilong Niu, Maihefuzaimu Abudoukade & Mairiyemu Abulizi

  4. Department of Scientific Research, The First People’s Hospital of Kashi, The Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, 844000, China

    Jianhua Wu, Aimin Xu & Beibei Li

  5. Department of Clinical Laboratory, The First People’s Hospital of Kashi, (The Affiliated Kashi Hospital of Sun Yat-Sen University), Kashi, China

    Chuanjiang He

  6. Department of Global and Community Health, George Mason University, Fairfax, VA, USA

    Michael S. Bloom

  7. Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Kashi, (The Affiliated Kashi Hospital of Sun Yat-Sen University), 66 Yingbin Road, Kashi, 844000, China

    Li Li, Xuemei Zhong & Xiaoguang Zou

  8. State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China, Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, China

    Yunjiang Yu

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  1. Bo-Yi Yang
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Contributions

BYY, GHD, XZ, TL, and JW contributed to the study conception and design. Material preparation, blood sample collection, and data analysis were performed by XN, CH, MSB, MA (Maihefuzaimu Abudoukade), MA (Mairiyemu Abulizi), AX, BL, XZ, QZW, CC, YNL, XXL, XWZ, and YY. The first draft of the manuscript was written BYY and all authors commented on previous versions of the manuscript. All authors contributed critically to the draft and gave final approval for publication.

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Correspondence to Guang-Hui Dong, Xiaoguang Zou or Tao Liu.

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The Human Subjects Committees of the First People's Hospital of Kashgar approved this study.

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Yang, BY., Wu, J., Niu, X. et al. Low-Level Environmental Per- and Polyfluoroalkyl Substances and Preterm Birth: A Nested Case–Control Study Among a Uyghur Population in Northwestern China. Expo Health 14, 793–805 (2022). https://doi.org/10.1007/s12403-021-00454-0

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