New study suggests association between early pregnancy PFOA exposure and increased risk of miscarriage during first trimester
A study released today in the Nature journal Scientific Reports finds that exposure to PFOA during the early stages of pregnancy is positively associated with an increased risk for sporadic miscarriage during the second half of the first trimester .
The study is part of the Swedish SELMA pregnancy cohort, in which researchers previously showed associations between exposures to PFAS during early pregnancy, including PFOS, PFOA and PFNA, and preeclampsia, as well as lower birth weight . For this study, seventy-eight women with non-recurrent first trimester miscarriage were included, and 1,449 women were available as live birth controls. Eight types of PFAS were measured in first trimester serum and the focus was on unexplained sporadic miscarriages happening during the first trimester.
The cohort study found that:
- PFOA serum levels in early pregnancy are positively associated with increased risk for sporadic miscarriage during the second half of the first trimester (with adjustment for parity, age, and tobacco smoke).
- The doubling of the PFOA exposure (an increase from 25:th to 75:th percentile of exposure) is associated with an increased risk for miscarriage by 50% in adjusted analyses.
- The possible mechanisms behind an association between PFOA exposure and miscarriage remain unknown, although researchers highlight that the increasing evidence base suggesting a positive association between PFAS exposures and reproduction effects such as miscarriage, preeclampsia and impaired fetal growth point towards possible shared mechanisms.
For the Health and Environment Alliance (HEAL), these findings are concerning because they add to growing scientific evidence about the health and environmental risks from PFAS. PFAS are known to be persistent in human tissues, have an ability to cross the human placenta and to be transmitted from mother to child through breast milk.
Natacha Cingotti, Senior Policy Officer for Health and Chemicals at HEAL said: “By pointing towards positive associations between early pregnancy PFOA exposure and risk of miscarriages, this study adds to existing concerns related to associations between exposure to various PFAS compounds and several averse reproductive outcomes.
Current EU developments to restrict non-essential uses of PFAS can, if well-designed, play an important role for health promotion, by preventing exposure to these toxic chemicals during pregnancy and early stages of life.”
Minimising the currently widespread exposure to PFAS is one of the priorities of the recently published Chemicals Strategy for Sustainability. Five Member States are currently leading on the development of a European restriction of all non-essential uses of PFAS .
Natacha Cingotti, Senior Policy Officer for Health and Chemicals at the Health and Environment Alliance (HEAL), email@example.com
Ivonne Leenen, Communications Officer at the Health and Environment Alliance (HEAL), firstname.lastname@example.org
 “Exposure to perfluoroalkyl substances in early pregnancy and risk of sporadic first trimester miscarriage”, Scientific Reports, 11th February 2021 https://www.nature.com/articles/s41598-021-82748-6
PFAS have been used in a wide variety of consumer products due to their water and stain repellent properties. The chemical group includes the more well-known perfluorooctanoid acid (PFOA) and perfluorooctane sulfonic acid (PFOS).
 Wikstrom, S., Lindh, C. H., Shu, H. & Bornehag, C. G. Early pregnancy serum levels of perfluoroalkyl substances and risk of preeclampsia in Swedish women. Sci. Rep. 9, 9179. https://www.nature.com/articles/s41598-019-45483-7 (2019)
Wikstrom, S., Lin, P. I., Lindh, C. H., Shu, H. & Bornehag, C. G. Maternal serum levels of perfluoroalkyl substances in early pregnancy and offspring birth weight. Pediatr. Res. https://www.nature.com/articles/s41390-019-0720-1 (2019)
 https://ec.europa.eu/environment/strategy-offline/chemicals-strategy_en ; https://echa.europa.eu/-/five-european-states-call-for-evidence-on-broad-pfas-restriction ; https://www.rivm.nl/en/pfas/pfas-news