Relative Risks of Adverse Perinatal Outcomes in Three Australian Communities Exposed to Per- and Polyfluoroalkyl Substances: Data Linkage Study

Hsei Di Law; Deborah A Randall; Bruce K Armstrong; Catherine D'este; Nina Lazarevic; Rose Hosking; Kayla S Smurthwaite; Susan M Trevenar; Robyn M Lucas; Archie C A Clements; Martyn D Kirk; Rosemary J Korda

doi:10.3390/ijerph20196886

Relative Risks of Adverse Perinatal Outcomes in Three Australian Communities Exposed to Per- and Polyfluoroalkyl Substances: Data Linkage Study

Int J Environ Res Public Health. 2023 Oct 5;20(19):6886. doi: 10.3390/ijerph20196886.

Affiliations

¹ National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia.
² Women and Babies Research, Northern Clinical School, The University of Sydney, St Leonards, NSW 2050, Australia.
³ School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia.
⁴ Office of Vice Chancellor, University of Plymouth, Plymouth PL4 8AA, UK.

Abstract

Introduction: Firefighting foams containing per- and polyfluoroalkyl substances (PFAS) have caused environmental contamination in several Australian residential areas, including Katherine in the Northern Territory (NT), Oakey in Queensland (Qld), and Williamtown in New South Wales (NSW). We examined whether the risks of adverse perinatal outcomes were higher in mothers living in these exposure areas than in selected comparison areas without known contamination.

Methods: We linked residential addresses in exposure areas to addresses collected in the jurisdictional Perinatal Data Collections of the NT (1986-2017), Qld (2007-2018), and NSW (1994-2018) to select all pregnancies from mothers who gave birth while living in these areas. We also identified one comparison group for each exposure area by selecting pregnancies where the maternal address was in selected comparison areas. We examined 12 binary perinatal outcomes and three growth measurements. For each exposure area, we estimated relative risks (RRs) of adverse outcomes and differences in means of growth measures, adjusting for sociodemographic characteristics and other potential confounders.

Results: We included 16,970 pregnancies from the NT, 4654 from Qld, and 7475 from NSW. We observed elevated risks of stillbirth in Oakey (RR = 2.59, 95% confidence interval (CI) 1.25 to 5.39) and of postpartum haemorrhage (RR = 1.94, 95% CI 1.13 to 3.33) and pregnancy-induced hypertension (RR = 1.88, 95% CI 1.30 to 2.73) in Williamtown. The risks of other perinatal outcomes were not materially different from those in the relevant comparison areas or were uncertain due to small numbers of events.

Conclusions: There was limited evidence for increased risks of adverse perinatal outcomes in mothers living in areas with PFAS contamination from firefighting foams. We found higher risks of some outcomes in individual areas, but these were not consistent across all areas under study and could have been due to chance, bias, or confounding.

Keywords: PFAS; birth outcomes; firefighting foams; mothers; perinatal; pregnancy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Female
Fluorocarbons*
Humans
Information Storage and Retrieval
Pregnancy
Risk
Stillbirth*

Substances

Fluorocarbons

Grants and funding

The Australian Government Department of Health funded the Australian National University to independently conduct this study and provided comments on the study protocol and final report. The study team was solely responsible for all outputs.