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. 2023 Feb 15;219:115067.
doi: 10.1016/j.envres.2022.115067. Epub 2022 Dec 14.

Cross-sectional associations of maternal PFAS exposure on SARS-CoV-2 IgG antibody levels during pregnancy

Kirtan Kaur  1 , Corina Lesseur  1 , Lixian Chen  1 , Syam S Andra  1 , Srinivasan Narasimhan  1 , Divya Pulivarthi  1 , Vishal Midya  1 , Yula Ma  1 , Erona Ibroci  2 , Frederieke Gigase  2 , Molly Lieber  3 , Whitney Lieb  3 , Teresa Janevic  4 , Lotje D De Witte  2 , Veerle Bergink  2 , Anna-Sophie Rommel  2 , Jia Chen  5
Affiliations
Free PMC article

Cross-sectional associations of maternal PFAS exposure on SARS-CoV-2 IgG antibody levels during pregnancy

Kirtan Kaur et al. Environ Res. .
Free PMC article

Abstract

Background: Perfluoroalkylated substances (PFAS) are man-made, persistent organic compounds with immune-modulating potentials. Given that pregnancy itself represents an altered state of immunity, PFAS exposure-related immunotoxicity is an important environmental factor to consider in SARS-CoV-2 infection during pregnancy as it may further affect humoral immune responses.

Aim: To investigate the relationship between maternal plasma PFAS concentrations and SARS-CoV-2 antibody levels in a NYC-based pregnancy cohort.

Methods: Maternal plasma was collected from 72 SARS-CoV-2 IgG + participants of the Generation C Study, a birth cohort established at the beginning of the COVID-19 pandemic in New York City. Maternal SARS-CoV-2 anti-spike IgG antibody levels were measured using ELISA. A panel of 16 PFAS congeners were measured in maternal plasma using a targeted UHPLC-MS/MS-based assay. Spearman correlations and linear regressions were employed to explore associations between maternal IgG antibody levels and plasma PFAS concentrations. Weighted quantile sum (WQS) regression was also used to evaluate mixture effects of PFAS. Models were adjusted for maternal age, gestational age at which SARS-CoV-2 IgG titer was measured, COVID-19 vaccination status prior to IgG titer measurement, maternal race/ethnicity, parity, type of insurance and pre-pregnancy BMI.

Results: Our study population is ethnically diverse with an average maternal age of 32 years. Of the 16 PFAS congeners measured, nine were detected in more than 60% samples. Importantly, all nine congeners were negatively correlated with SARS-CoV-2 anti-spike IgG antibody levels; n-PFOA and PFHxS, PFHpS, and PFHxA reached statistical significance (p < 0.05) in multivariable analyses. When we examined the mixture effects using WQS, a quartile increase in the PFAS mixture-index was significantly associated with lower maternal IgG antibody titers (beta [95% CI] = -0.35 [-0.52, -0.17]). PFHxA was the top contributor to the overall mixture effect.

Conclusions: Our study results support the notion that PFAS, including short-chain emerging PFAS, act as immunosuppressants during pregnancy. Whether such compromised immune activity leads to downstream health effects, such as the severity of COVID-19 symptoms, adverse obstetric outcomes or neonatal immune responses remains to be investigated.

Keywords: COVID19; Immunotoxicity; PFAS; Pregnancy; SARS-CoV-2 IgG.

Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Spearman correlations between nine PFAS in final analytical panel measured in maternal plasma. Spearman coefficient (rho) with p-value <0.05 are displayed in the corresponding block.
Fig. 2
Fig. 2
WQS regression model weights of each individual PFAS contributing to the overall co-pollutant mixture effect (Beta [95% CI] = −0.35 [-0.52, −0.17], p-value = 0.0003) in the index. The black dotted line shows the selection threshold (1/9). Adjusted for maternal age, gestational age at which SARS-CoV-2 IgG titer was measured, COVID-19 vaccination status prior to IgG titer measurement, maternal race/ethnicity, parity, type of insurance and pre-pregnancy BMI.
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