Low transplacental transfer of PFASs in the small-for-gestational-age (SGA) new-borns: Evidence from a Chinese birth cohort

Early life in utero exposure to per- and polyfluoroalkyl substances (PFASs) and infiltration through the placenta into cord blood pose significant risk to fetal development. Accumulating knowledge suggests that PFASs pass through the placenta in multiple transportation ways, not limiting to passive transport but also active transport or facilitated diffusion. Therefore, we propose that the transplacental transfer efficiency (TTE) could be re-evaluated as traditional cord to maternal ratio-based method might overlook certain biological or health information from the mother and fetus. In this study, we investigated 30 PFAS chemicals in paired maternal and cord serum from 195 births classified as small-for-gestational-age (SGA) and matched appropriate-for-gestational-age (AGA). PFASs were ubiquitously detected in the maternal and serum samples, with PFOA, PFOS, 6:2 Cl-PFESA and other dominant compounds. We adopted a modified TTE estimation method (TTEm), taking into consideration of the total burden mass of PFASs in the blood from mother to fetus. Using the modified TTEm, a significant (p < 0.05) decrease was observed in the PFAS transplacental transfer potential in SGA (1.6%–11.3%) compared to AGA (2.3%–21.1%), suggesting a reverse association between TTE and SGA birth risk. This is the first study attempted to re-evaluate the TTE of PFAS and indicates that TTEm might be more advantageous to reflect the transplacental transfer potency of chemicals particularly when transportation mechanisms are multi-faceted.