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Journal article
Gestational PFAS concentrations in association with maternal depression and perceived stress during pregnancy and postpartum in the ECHO Cohort
Environmental research, v 286(Part 3), 122997
01 Oct 2025
PMID: 41043503
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Depression and perceived stress are common perinatal morbidities. We assessed associations between prenatal per- and polyfluoroalkyl substances (PFAS) with prenatal and postpartum depression and perceived stress. We analyzed concentrations of 7 PFAS in maternal plasma or serum in the Environmental influences on Child Health Outcomes (ECHO) cohort (n=4,403). We ascertained prenatal depression diagnosis; prenatal and postpartum depressive symptom severity using a Patient-Reported Outcomes Measurement Information System Depression (PROMIS-D) t-score; and prenatal and postpartum perceived stress using a Perceived Stress Scale (PSS) t-score. Linear and modified Poisson models assessed associations of PFAS with outcomes. Quantile g-computation assessed PFAS mixtures. We evaluated effect modification by nativity and Social Vulnerability Index. N-MeFOSAA was positively associated, PFDA was inversely associated, and PFOS and PFOA were nonlinearly associated with multiple outcomes. For example, the highest category of N-MeFOSAA was associated with 0.93 (95%CI: -0.17, 2.03) units higher postpartum PROMIS-D t-scores, and 1.88 (95%CI: 1.05, 2.72) units higher postpartum PSS t-scores. In contrast, the highest category of PFDA was associated with 25% (risk ratio [RR]: 0.75 [95%CI: 0.56, 1.01]) lower risk of depression diagnosis and 0.83 (95%CI: 0.14, 1.51) units lower prenatal PSS t-scores. The middle and highest categories of PFOS were associated with 26% (RR: 1.26 [95%CI: 1.05,1.52]) higher and 38% (RR: 0.62 [95%CI: 0.37, 1.05]) lower risk of depression diagnosis; and 0.97 (95%CI: 0.09, 1.84) units higher and 0.04 (95%CI: -1.53, 1.62) units lower prenatal PSS t-score. Some PFAS may be associated with altered depressive symptoms and perceived stress; investigation into mechanisms is needed.
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Details
- Title
- Gestational PFAS concentrations in association with maternal depression and perceived stress during pregnancy and postpartum in the ECHO Cohort
- Creators
- Susanna D Mitro - Kaiser PermanenteWei Yang - Kaiser PermanenteAssiamira Ferrara - Kaiser PermanenteMonique Hedderson - Kaiser PermanenteMax Aung - University of Southern CaliforniaHimal Suthar - University of Southern CaliforniaRadhika S Raghunathan - Johns Hopkins UniversityYeyi Zhu - Kaiser PermanenteAlicia K Peterson - Kaiser PermanenteMorgan Reynolds - New York State Department of HealthKurunthachalam Kannan - New York State Department of HealthEmily Oken - Harvard UniversityMargaret R Karagas - Dartmouth CollegeAlison E Hipwell - University of PittsburghThomas G O'Connor - University of Rochester Medical CenterCourtney Carignan - Michigan State UniversityCarrie V Breton - University of Southern CaliforniaTheresa M Bastain - University of Southern CaliforniaCatherine Karr - University of WashingtonKristen Lyall - Drexel UniversityLyndsay A Avalos - Kaiser PermanenteECHO Cohort Consortium
- Publication Details
- Environmental research, v 286(Part 3), 122997
- Publisher
- Elsevier
- Number of pages
- 12
- Grant note
- Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health: U2COD023375, U24OD023382, U24OD023319 Office of Behavioral and Social Science Research (Measurement Core): U24OD035523, ES0266542, U24ES026539, U2CES026533, U2CES026542, U2CES030859, U2CES030857, U2CES026555, U2CES026561, U2CES030851, UG3/UH3OD023251, UH3OD023320, UG3OD035546, UH3OD023332, UG3/UH3OD023253, UG3/UH3OD023248, UG3OD035526, UG3/UH3OD023313, UH3OD023328, UH3OD023318, UG3/UH3OD023279, UG3/UH3OD023289, UG3/UH3OD023282, UH3OD023287, UG3/UH3OD023365, UG3/UH3OD023244, UG3/UH3OD023275, UH3OD023271, UH3OD023347, UG3/UH3OD023389, UG3/UH3OD023344, UH3OD023268, UG3/UH3OD023288, UG3/UH3OD023342, UG3/UH3OD023349, UH3OD023286, UG3OD035533, UG3/UH3OD023348, UG3/UH3OD023285, UG3/UH3OD023290, UG3/UH3OD023272, UG3/UH3OD023249, UG3/UH3OD023305, UG3/UH3OD023337, UG3OD035508, UG3OD035509, UG3OD035513, UG3OD035532, UG3OD035521, UG3OD035527, UG3OD035540, UG3OD035543, UG3OD035537, UG3OD035529, UG3OD035542, UG3OD035536, UG3OD035550, UG3OD035544
Research reported in this publication was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core), U24OD035523 (Lab Core), ES0266542 (HHEAR), U24ES026539 (HHEAR Barbara O'Brien), U2CES026533 (HHEAR Lisa Peterson), U2CES026542 (HHEAR Patrick Parsons, Kannan Kurunthachalam), U2CES030859 (HHEAR Manish Arora), U2CES030857 (HHEAR Timothy R. Fennell, Susan J. Sumner, Xiuxia Du), U2CES026555 (HHEAR Susan L. Teitelbaum), U2CES026561 (HHEAR Robert O. Wright), U2CES030851 (HHEAR Heather M. Stapleton, P. Lee Ferguson), UG3/UH3OD023251 (Akram Alshawabkeh), UH3OD023320 and UG3OD035546 (Judy Aschner), UH3OD023332 (Clancy Blair, Leonardo Trasande), UG3/UH3OD023253 (Carlos Camargo), UG3/UH3OD023248 and UG3OD035526 (Dana Dabelea), UG3/UH3OD023313 (Daphne Koinis Mitchell), UH3OD023328 (Cristiane Duarte), UH3OD023318 (Anne Dunlop), UG3/UH3OD023279 (Amy Elliott), UG3/UH3OD023289 (Assiamira Ferrara), UG3/UH3OD023282 (James Gern), UH3OD023287 (Carrie Breton), UG3/UH3OD023365 (Irva Hertz-Picciotto), UG3/UH3OD023244 (Alison Hipwell), UG3/UH3OD023275 (Margaret Karagas), UH3OD023271 and UG3OD035528 (Catherine Karr), UH3OD023347 (Barry Lester), UG3/UH3OD023389 (Leslie Leve), UG3/UH3OD023344 (Debra MacKenzie), UH3OD023268 (Scott Weiss), UG3/UH3OD023288 (Cynthia McEvoy), UG3/UH3OD023342 (Kristen Lyall), UG3/UH3OD023349 (Thomas O'Connor), UH3OD023286 and UG3OD035533 (Emily Oken), UG3/UH3OD023348 (Mike O'Shea), UG3/UH3OD023285 (Jean Kerver), UG3/UH3OD023290 (Julie Herbstman), UG3/UH3OD023272 (Susan Schantz), UG3/UH3OD023249 (Joseph Stanford), UG3/UH3OD023305 (Leonardo Trasande), UG3/UH3OD023337 (Rosalind Wright), UG3OD035508 (Sheela Sathyanarayana), UG3OD035509 (Anne Marie Singh), UG3OD035513 and UG3OD035532 (Annemarie Stroustrup), UG3OD035516 and UG3OD035517 (Tina Hartert), UG3OD035518 (Jennifer Straughen), UG3OD035519 (Qi Zhao), UG3OD035521 (Katherine Rivera-Spoljaric), UG3OD035527 (Emily S Barrett), UG3OD035540 (Monique Marie Hedderson), UG3OD035543 (Kelly J Hunt), UG3OD035537 (Sunni L Mumford), UG3OD035529 (Hong-Ngoc Nguyen), UG3OD035542 (Hudson Santos), UG3OD035550 (Rebecca Schmidt), UG3OD035536 (Jonathan Slaughter), UG3OD035544 (Kristina Whitworth).
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001594445000006
- Scopus ID
- 2-s2.0-105018623779
- Other Identifier
- 991022121727004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Environmental Sciences
- Public, Environmental & Occupational Health