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Association Between Prenatal Per- and Polyfluoroalkyl Substance Exposure and Maternal Serum Total Bile Acid Levels During Pregnancy: Effect Modification by Infant Sex and Maternal Prepregnancy BMI

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Abstract

Bile acids play an important role in metabolic modulation and elevated serum total bile acid (sTBA) levels during pregnancy are linked to adverse perinatal outcomes. Previous studies have reported that per- and polyfluoroalkyl substances (PFAS) have a strong impact on bile acid synthesis in vitro. However, epidemiological evidence regarding PFAS exposure and maternal sTBA levels is limited. Our aim in this study was to determine the effects of PFAS exposure on maternal sTBA levels, with exploration of the interaction effect of infant sex and prepregnancy BMI on the association between PFAS exposure and maternal sTBA levels. We included 975 pregnant women from the Guangxi Zhuang Birth Cohort. Nine PFAS were quantified by ultraperformance liquid chromatography‒mass spectrometry. sTBA data were obtained from medical records. In single-exposure analysis, exposure to perfluoroundecanoic acid (PFUnA) was positively associated with maternal sTBA levels, and this finding was more pronounced in pregnant women with female infants and a prepregnancy BMI ≥ 24 kg/m2. In multiple-exposure analysis, there was no significant association of mixed PFAS exposure with maternal sTBA levels. Infant sex might modify this effect. There was a decreasing trend of mixed PFAS exposure with sTBA levels in pregnant women with male infants, and perfluorooctane sulfonate (PFOS) was the main contributor. In contrast, there was an increasing trend of mixed PFAS exposure with sTBA levels in pregnant women with female infants, and PFUnA was the main contributor. In summary, prenatal exposure to PFAS are associated with maternal sTBA levels during pregnancy, and the association may exhibit heterogeneity according to infant sex and prepregnancy BMI.

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Acknowledgements

The authors truly appreciate all the participants who collaborated with this study and provided serum samples as well as all the staff in the collaborating hospitals for assisting in collecting the samples and data.

Funding

This research was supported by the Guangxi Key Research Program (AB17195012) and the National Natural Science Foundation of China (81860587).

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Author notes

  1. Qian Liao, Huishen Huang, and Peng Tang have contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China

    Qian Liao, Huishen Huang, Jun Liang, Jiehua Chen, Lei Lei, Dongxiang Pan, Xiaoyun Zeng & Xiaoqiang Qiu

  2. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China

    Peng Tang

  3. The Third Affiliated Hospital of Guangxi Medical University, Nanning, 530031, Guangxi, China

    Yanye Song

  4. Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China

    Mengrui Lin & Dongping Huang

  5. Department of Maternal, Child and Adolescent Health, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China

    Fangfang Lv & Shun Liu

  6. The First Affiliated Hospital of Guangxi Medical University, Nanning, 530031, Guangxi, China

    Xue Liang

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Contributions

QL participated in the Methodology, Formal analysis, Writing of the original draft, and Visualization; HH participated in the Methodology, Investigation, Data curation, and Validation; PT participated in the Methodology, Investigation, Data curation, and Validation; JL participated in the Data curation, Validation, and Investigation; JC participated in the Validation and Investigation; LL participated in the Data curation and Validation; YS participated in the Methodology, Validation, and Investigation; DP participated in the Validation and Investigation; ML participated in the Validation and Investigation; XL participated in the Validation and Investigation; XZ participated in the Methodology and Supervision; SL participated in the Conceptualization, Data Curation, Project Administration, Supervision, and Writing, reviewing, & editing of the manuscript; DH participated in the Conceptualization, Data Curation, Project Administration, Supervision, and Writing, reviewing, & editing of the manuscript; XQ participated in the Conceptualization, Project administration, Resources, Data curation, Writing, reviewing, & editing of the manuscript, Supervision, and Funding acquisition.

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Correspondence to Shun Liu, Dongping Huang or Xiaoqiang Qiu.

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Liao, Q., Huang, H., Tang, P. et al. Association Between Prenatal Per- and Polyfluoroalkyl Substance Exposure and Maternal Serum Total Bile Acid Levels During Pregnancy: Effect Modification by Infant Sex and Maternal Prepregnancy BMI. Expo Health (2023). https://doi.org/10.1007/s12403-023-00588-3

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