Today’s prenatal checkups often include key pregnancy screenings, such as blood tests that measure protein levels, infection detection for diseases, ultrasounds for chromosomal abnormalities and more. Could a PFAS exposure test be added to the list of key pregnancy screenings in the future?
It probably should, based on a new study from Mount Sinai Hospital researchers that reveals broader prenatal exposure to PFAS in umbilical cord blood than previously thought.
“Our study helps show that prenatal PFAS exposure is more complex and widespread than earlier studies suggested,” said study author Shelley Liu, associate professor of population health science and policy at the Icahn School of Medicine at Mount Sinai. “Understanding the full picture is essential if we want to protect child health and reduce preventable environmental risks.”
In fact, the American College of Obstetricians and Gynecologists has recently identified reducing exposure to toxic environmental chemicals like PFAS as a “critical area of intervention.”
Non-targeted analysis
For the study, published in Environmental Science & Technology, Liu and her team measured PFAS in archived umbilical cord blood samples collected between 2003 and 2006 from 120 babies in the HOME Study, based in Cincinnati.
The researchers decided to employ a non-targeted analytical workflow, as opposed to a targeted one. Both workflows are common forms of PFAS testing that offer their own sets of benefits depending on the type of material being analyzed and the desired outcome.
Where targeted workflows quantify known analytes or chemicals outlined by a regulatory body like the U.S. Environmental Protection Agency, non-targeted analysis casts a much wider net. With this approach, the team identified 42 confirmed PFAS chemicals in the umbilical cord blood samples. Many of the PFAS detected are not commonly screened in traditional testing methods and their health effects are yet unknown.
The Mt. Sinai team also created PFAS-omics burden scores, using item response theory methods, to summarize total exposure to PFAS. The PFAS-omics scores can be interpreted as a snapshot in time of a baby’s overall PFAS exposure.
Importantly, when researchers used this broader PFAS assessment, they did not observe exposure differences between babies born to first-time mothers and those born to mothers with previous pregnancies—a difference that earlier studies had reported using more limited PFAS panels.
“Our findings suggest that how we measure PFAS really matters,” said Liu. “When we look more comprehensively, we see that babies are exposed to far more PFAS chemicals before birth than we previously realized—and some of the patterns we thought we understood may change.”
Next steps
The team says this research introduces a new way to estimate cumulative PFAS exposure, which could eventually help clinicians identify individuals with higher exposure burdens, monitor at-risk populations more closely and inform future preventive medicine strategies.
“For now, this work helps lay the scientific foundation,” said Liu. “Our goal is to move toward earlier identification and prevention, especially during sensitive windows like pregnancy.”
Next, the Mt. Sinai Hospital team plans to further investigate the health effects of the new and understudied PFAS chemicals identified in the cord blood. They will also study whether higher cumulative PFAS exposure in early life leads to negative health outcomes, and hope to refine tools that can support primary disease prevention.