Factors associated with exposure of pregnant women to perfluoroalkyl acids in North China and health risk assessment

Highlights: • PFAAs were extensively detected in pregnant women in Northern China. • Age, BMI and consumption of some food items were factors associated with serum PFAAs levels. • A low risk of developmental and reproductive toxicity was seen for pregnant women. • Potential hepatotoxicity of PFAAs in pregnant women was of concern. -- Abstract: Perfluoroalkyl acids (PFAAs) have been frequently found in blood of pregnant women, but the predictors and potential health risk have not been well studied in China. We recruited 534 pregnant women in Tangshan City of Hebei Province in North China between 2013 and 2014 and measured five PFAAs in serum during their early term of pregnancy, including perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), perfluoro‑n‑undecanoic acid (PFUdA), and perfluorononanoic acid (PFNA). We explored the factors associated with the levels of serum PFAAs and assessed associated health risks. Food consumption information was obtained by food frequency questionnaire covering 100 items. Multiple linear regression model was used to determine the associations of sociodemographic, anthropometric, and food factors with the concentrations of serum PFAAs. Some PFAAs in serum were positively associated with age and body mass index (BMI). Consumption of beans, aquatic products, and eggs was positively associated with the concentrations of several PFAAs after adjusting for important covariates. Pregnant women who ate more cereal, vegetables, mushrooms and alga tended to have lower levels of serum PFOA, PFOS and PFNA. The Hazard index (HI) for reproductive toxicity and developmental toxicity was below 0.8, and the HI for hepatotoxicity beyond 1 was found in 0.37% of pregnant women. These results suggested that age, BMI, and some food consumption were predictors for the exposure to PFAAs in Chinese pregnant women. More attention should be paid to the hepatotoxicity for these exposures.