Prenatal Per- and Polyfluoroalkyl Substances in Relation to Antibody Titers and Infections in Childhood.

Background: Per- and polyfluoroalkyl substances (PFAS) are persistent and ubiquitous chemicals posing environmental and health risks. Impact on the human immune system is of particular concern, especially during fetal immune development. Alterations to fetal immune development can impact immunity later in life, e.g., the response to vaccines and pathogens.

Objectives: This study investigated the association between PFAS concentrations in healthy pregnant women from Hamburg, Germany, and antibody levels to routine vaccines in childhood and occurrence of childhood infections.

Methods: Mid-pregnancy serum samples from 152 mothers-child pairs were analyzed for 18 PFAS compounds, and antibody levels to measles, mumps, rubella, diphtheria, and tetanus were assessed at age 5. Maternal questionnaires provided data on childhood infections each year at age 1-5. Linear and Poisson regression models were adjusted for maternal age, education, parity, and breastfeeding duration. Weighted quantile sum (WQS) regression was used to assess the PFAS mixture.

Results: Higher PFAS concentrations were associated with lower antibody titers at age 5 years, particularly for mumps, tetanus, diphtheria, and rubella. Several PFAS were also linked to increased childhood infections, especially respiratory infections, during ages 3 and 4 years. WQS regression revealed a negative association between combined PFAS and tetanus titers.

Conclusions: Maternal PFAS concentrations during pregnancy are inversely associated with antibody levels in children and positively associated with increased childhood infections, notably respiratory infections. These findings underscore the importance of understanding environmental exposures' impact on immune responses and call for continued monitoring of PFAS in both the environment and human populations to mitigate health risks.