Table 10.
Association of PFAAs exposure and infant T4 and T3 (adjusted results)
| Reference | Author Country Year |
Effect estimate | TH | PFHxS | PFOS | PFOA | PFNA | PFDA | PFUnA | PFDoA |
|---|---|---|---|---|---|---|---|---|---|---|
| Maternal PFAAs concentrations obtained during 1st Trimester | ||||||||||
| [39] |
Preston USA 2018 |
Difference in infant TH levels per quartile (Q2–4 vs. Q1) maternal PFAAs concentrations (95% CI) | TT4 | ↓ Q2: −0.76 (− 1.78, 0.26) | ↓ Q2: − 0.63 (− 1.64, 0.37) | ↓ Q2: − 0.44 (− 1.46, 0.59) | ↓ Q2: − 0.34 (− 1.42, 0.73) | – | – | – |
| ↓ Q3: − 0.96 (− 1.94, 0.03) | ↓ Q3: − 0.36 (− 1.39, 0.67) | ↓ Q3: − 0.35 (− 1.39, 0.69) | ↓ Q3: −0.60 (− 1.52, 0.31) | – | – | – | ||||
| ↓ Q4: −1.06 (− 2.06, − 0.06)* | ↓ Q4: − 1.10 (− 2.13, − 0.07)* | ↓ Q4: −1.13 (− 2.21, − 0.06)* | ↓ Q4: − 0.53 (− 1.56, 0.49) | – | – | – | ||||
| Maternal PFAAs concentrations obtained during 3rd Trimester | ||||||||||
| [38] |
Kato Japan 2016 |
Linear regression: Adjusted β (p value) |
FT4 | – | ↓: − 0.043 (0.452) | ↑: 0.003 (0.960) | – | – | – | – |
| [44] |
Wang Taiwan 2014 |
Linear regression: Adjusted β (95% CI) | FT4 | ↓: − 0.030 (− 0.098, 0.039) | ↑: 0.001 (− 0.006, 0.008) | ↓: − 0.029 (− 0.062, 0.004) | ↑: 0.001 (− 0.021, 0.023) | ↑: 0.020 (− 0.124, 0.164) | ↑: 0.002 (− 0.004, 0.007) | ↓: −0.009 (− 0.183, 0.165) |
| TT4 | ↑: 0.002 (−0.495, 0.500) | ↑: 0.032 (−0.024, 0.087) | ↑: 0.128 (− 0.094, 0.350) | ↓: − 0.213 (− 0.384, − 0.042)* | ↓: −0.513 (− 1.732, 0.706) | ↓: − 0.052 (− 0.095, − 0.010)* | ↓:-1.920 (− 3.345, − 0.495)* | |||
| TT3 | ↓: − 0.001 (− 0.007, 0.004) | ↑: 0.000 (− 0.000, 0.001) | ↓: −0.001 (− 0.004, 0.001) | ↓: − 0.002 (− 0.004, − 0.001)* | ↓: −0.017 (− 0.028, − 0.005)* | ↓: −0.001 (− 0.001, − 0.0002)* | ↓: −0.022 (− 0.035, − 0.009)* | |||
| [46] |
Yang China 2016 |
Infant TH vs maternal PFAAs Spearmans partial correlation analysis. p < 0.05. | FT3 | ↑: 0.125 | ↑: 0.191* | ↓: −0.105 | ↑: 0.094 | ↑: 0.154 | ↑: 0.108 | ↑: 0.116 |
| FT4 | ↓: −0.016 | ↑: 0.053 | ↓: −0.045 | ↓: − 0.023 | ↑: 0.027 | ↑: 0.033 | ↑: 0.011 | |||
| TT3 | ↑: 0.108 | ↑: 0.170* | ↓: −0.055 | ↑: 0.118 | ↑: 0.188* | ↑: 0.113 | ↑: 0.071 | |||
| TT4 | ↑: 0.111 | ↑: 0.172* | ↑: 0.107 | ↑: 0.147 | ↑: 0.181* | ↑: 0.172* | ↑: 0.058 | |||
| [47] |
Xiao Faroe Island 2019 |
Percent change in thyroid hormone levels per doubling of PFAA concentrations (95% CI) | FT4I | ↑: 0.3 (−6.2, 7.3) | ↑: 6.7 (−1.5, 15.6) | ↑: 2.6 (− 3.1, 8.9) | ↑: 8.2 (−0.3, 17.4) | ↑: 8.4 (0.5, 17.0)* | ↑: 3.1 (−2.4, 9.0) | ↓: −0.6 (− 3.1, 1.9) |
| FT3 | ↓: −2.4 (−9.2, 4.8) | ↓: −0.8 (− 9.1, 8.1) | ↑: 0.5 (− 5.6, 6.9) | ↑: 0.9 (− 7.6, 10.3) | ↑: 1.1 (− 6.9, 9.7) | ↑: 2.2 (− 3.6, 8.3) | ↓: − 1.5 (− 4.0, 1.2) | |||
| FT4 | ↑: 14.2 (− 2.6, 33.8) | ↑: 15.6 (−4.5, 40.1) | ↑: 1.9 (− 11.5, 17.2) | ↑: 6.0 (− 13.1, 29.3) | ↑: 7.6 (− 10.7, 29.4) | ↓: − 0.4 (− 12.7, 8.3) | ↑: 1.6 (− 4.2, 1.2) | |||
| TT4 | ↓: − 2.5 (− 9.1, 4.6) | ↑: 2.5 (− 5.7, 11.6) | ↑: 1.9 (− 4.1, 8.3) | ↑: 4.1 (− 4.5, 13.5) | ↑: 5.4 (− 2.8, 14.3) | ↑: 0.6 (− 5.1, 6.5) | ↓: −1.6 (− 4.1, 1.0) | |||
| T3RU | ↑: 2.8 (− 0.6, 6.3) | ↑: 3.6 (− 0.5, 7.8) | ↑: 0.6 (− 2.4, 3.6) | ↑: 3.7 (− 0.6, 8.0) | ↑: 2.7 (− 1.1, 6.8) | ↑: 2.4 (− 0.4, 5.2) | ↑: 0.8 (− 0.4, 2.0) | |||
| Cord blood serum/plasma PFAAs concentrations | ||||||||||
| [49] |
Shah-Kulkarni Korea 2016 |
Linear regression: Adjusted β (95% CI) | TT3 |
↑: 1.81 (− 0.66, 4.28) |
↑: 0.65 (− 0.80, 2.10) |
↓: − 0.01 (− 2.22, 2.20) |
↑: 0.07 (− 1.74, 1.92) |
↑: 2.40 (− 0.27, 5.09) |
↑: 1.06 (− 1.21, 3.34) |
↑: 1.69 (− 1.57, 4.96) |
| TT4 |
↑: 0.03 (− 0.26, 0.32) |
↑: 0.14 (− 0.03, 0.31) |
↑: 0.001 (− 0.26, 0.26) |
↑: 0.04 (− 0.17, 0.26) |
↑: 0.13 (− 0.18, 0.45) |
↓: − 0.02 (− 0.29, 0.24) |
↓: − 0.07 (− 0.46, 0.31) |
|||
| [50] |
De Cock Netherland 2014 |
Linear regression coefficients (95% CI): Change across quartiles (Q1 reference) Infant sex analysed separately |
Male TT4 |
↓: Q2: −7.9 (− 31.56, 15.74) |
↑: Q2: 7.9 (− 18.04, 33.92) |
|||||
| – |
↓: Q3: − 16.5 (− 40.32, 7.34) |
↓: Q3: − 2.1 (− 20.94, 16.78) |
– | – | – | – | ||||
|
↓: Q4: −9.6 (−32.57, 13.31) |
↑: Q4: 6.2 (− 16.08, 28.50) |
|||||||||
| Female TT4 |
↓: Q2: −1.3 (−30.45, 27.94) |
↓: Q2: −5.9 (− 26.75, 14.94) |
||||||||
| – |
↑: Q3: 4.5 (− 25.95, 34.92) |
↑: Q3: 11.8 (− 19.08, 42.72) |
– | – | – | – | ||||
|
↑: Q4: 15.9 (− 10.67, 42.40) |
↑: Q4: 38.6 (13.34, 63.83)* |
|||||||||
| [51] |
Tsai Taiwan 2017 |
Linear regression: Adjusted β (95% CI) | TT4 | – |
↓: −0.458 (− 0.916,-0.001)* |
↓:-0.031 (− 0.404, 0.342) |
↑: 0.067 (− 0.252, 0.119) |
– |
↑: 0.045 (− 0.223,0.313) |
– |
| TT3 | – |
↑: 0.027 (− 0.072, 0.125) |
↑: 0.025 (− 0.054, 0.103) |
↓: − 0.03 (− 0.069, 0.009) |
– |
↑: 0.048 (− 0.008, 0.104) |
– | |||
| [52] |
Aimuzi China 2019 |
Sparse partial least squares (SPLS): Adjusted β (95% CI) | FT4 | # | # | # | # | # | # |
↑: 0.19 (0.063, 0.304)* |
| FT3 | # |
↑: 0.059 (0.023, 0.100)* |
# |
↑: 0.024 (−0.027, 0.071) |
↓: − 0.008 (− 0.04, 0.026) |
↑: 0.018 (− 0.034, 0.077) |
↓: − 0.153 (− 0.212, − 0.106)* |
|||
TT3 (total triiodothyronine), FT3 (total triiodothyronine), TT4 (total thyroxine), FT4 (free thyroxine), FT4I (free thyroxine index), ↓ decreasing, ↑ increasing, bold format and star* indicate significant results P < 0.05, −: PFAAs not examined, # indicates association was not selected in SPLS model, Q1 (1st quartile), Q2 (2nd quartile), Q3 (3rd quartile), Q4 (4th quartile), IQR (interquartile range)
PFOS Perfluorooctane sulfonate, PFOA Perfluorooctanoate, PFHxS Perfluorohexane sulfonate, PFNA Perfluorononanoic acid, PFDA Perfluorodecanoic acid, PFUnA Perfluoroundecanoic acid, PFDoA Perfluorododecanoic acid