ESPE Abstracts

Background and aims: Poly- and perfluoroalkyl substances (PFAS) are non-degradable, man-made-chemicals. PFAS are considered to be ‘Endocrine Disrupting Chemicals’ (EDCs), a group of chemicals which have been reported to interfere with endocrine processes and cause adverse effects on perinatal, neurodevelopmental, metabolic and reproductive outcomes. Especially when exposure occurs during susceptible periods of human development, such as early life. Infants who were exclusively breastfed (EBF) for at least 3 months, have persistently 3-times higher PFAS plasma levels compared to exclusively formula fed (EFF) infants during the first 2 years of life. Thus, PFAS could potentially reduce breastfeeding’s health benefits. We investigated the associations between plasma PFAS levels and breastfeeding in infancy and height, body composition and total body bone mineral density (BMD) at age 3 years.

Methods: In 237 healthy term-born infants (99 EBF, 57 EFF and 81 mix), included in Sophia Pluto cohort, we determined anthropometrics, and body composition and BMD by Dual-energy-X-ray Absorptiometry (DXA), longitudinally until age 3 years. Plasma levels of 5 individual and of total PFAS were determined by liquid-chromatography-electrospray-ionization-tandem-mass-spectrometry (LC-ESI-MS/MS) in samples collected at age 3 months and 2 years. We studied the associations between plasma PFAS levels, exclusive breastfeeding and outcomes at age 3 years using multiple regression models, corrected for confounders.

Results: Higher plasma PFAS levels at age 2 years were associated with lower height SDS (β:-0.35, P <0.001), lean body mass (LBM) SDS (β: -0.17, P = 0.023) and bone mineral density (BMD) SDS (β: -0.22, P = 0.037) at age 3 years. In contrast, exclusive breastfeeding for at least 3 months was positively associated with the same outcomes; β: 0.16 (P = 0.048), β: 0.17 (P = 0.021), and β: 0.23 (P = 0.022), respectively. Plasma PFAS levels at age 2 years were negatively associated with height gain from birth to age 3 years (β: -0.39 (P <0.001)), while EBF was not associated. Plasma PFAS levels and EBF were both not associated with fat mass percentage (FM%) SDS at age 3 years.

Conclusions: We found opposite associations between higher plasma PFAS levels and exclusive breastfeeding during infancy and height, LBM and BMD at age 3 years. As exclusively breastfed infants have 3-times higher PFAS plasma levels than those formula fed, our findings suggest that PFAS might diminish the health benefits of breastfeeding in terms of growth and body composition, which warrants further research.