Effects of per- and polyfluoroalkyl substances on placental features and size at birth - PROJECT SUMMARY Per- and polyfluoroalkyl substances (PFAS) are ubiquitous and highly persistent chemicals, that have been used widely in industry for seven decades and are known to adversely influence maternal and child health. PFAS have recently become a public health priority evidenced by President Biden’s call to action to prevent the adverse impacts from PFAS present in our air, water, and food supply. Achieving this goal necessitates monitoring a broad range of PFAS and determining the health effects of realistic scenarios of exposures to PFAS mixtures, though most prior research has investigated PFAS one at a time. Moreover, data are needed to inform national policies, and clinical guidelines can only be determined by studying the most susceptible populations, namely pregnant women and newborns. Therefore, to inform national policies and clinical guidelines, we propose to investigate the risks associated with prenatal exposure to PFAS in the New Hampshire Birth Cohort Study, a large rural U.S. cohort of over 2,400 mother-infant dyads with anticipated enrollment of 3,000. We will investigate the effects of PFAS, measured in maternal blood during pregnancy, on placental features and birth size, which is a sentinel outcome, with both insufficient and excessive fetal growth contributing to infant morbidity and mortality and enduring risk of cardiovascular and metabolic morbidity well into adulthood. We will leverage extensive extant data from our decade-long cohort, including toxicant exposure and clinical metadata. We will test the hypothesis that PFAS, alone and as mixtures, adversely affect placental features and reduce size at birth. Further, we will explore whether associations of PFAS with size at birth are mediated by the influence of PFAS on the placenta. Our work will integrate advances in statistical methodologies for evaluating exposure mixtures and evaluate PFAS for which effective federal regulations do not yet exist.
