Preterm Birth: A Global Health Priority
Preterm birth (before 37 weeks gestation) is the leading cause of neonatal mortality globally, affecting approximately 15 million births annually. Environmental exposures during pregnancy that disrupt placental function are associated with preterm labor.
PFAS and Placental Biology
PFAS concentrate in placental tissue and alter trophoblast invasion, hormone synthesis, and immune tolerance. Impaired placentation increases risks of preeclampsia, intrauterine growth restriction, and spontaneous preterm labor through multiple mechanistic pathways.
Epidemiological Evidence
Meta-analyses of maternal-infant cohort studies show modest but consistent associations between first-trimester PFAS serum levels and increased preterm birth risk, particularly for PFOA and PFOS. Higher exposures correlate with greater prematurity risk.
Prenatal Care Integration
Obstetricians caring for high-risk pregnancies in PFAS-contaminated regions should document exposure history. Preterm birth prevention strategies including progesterone supplementation and cervical length monitoring may be particularly important for high-exposure pregnant women.