Fat-soluble vitamins modulate transplacental transfer efficiencies of per- and polyfluoroalkyl substances and their association with neonatal anthropometric measurements.

Nutritional factors have garnered increasing attention in studies of the potential health effects of per- and polyfluoroalkyl substances (PFAS). In this study, we measured 23 PFAS concentrations in paired maternal and cord serum, as well as four fat-soluble vitamins in cord serum from 227 mother-infant pairs. We assessed associations of vitamin levels with PFAS concentrations and their transplacental transfer efficiencies, as well as associations of PFAS exposure with neonatal anthropometric measurements and the potential modifying role of vitamins. Vitamin K₁ was negatively associated with cord serum concentrations and transplacental transfer efficiencies of multiple PFAS. Vitamin E was negatively associated with the transplacental transfer efficiencies of perfluoroheptanoic acid and perfluorododecanoic acid. In contrast, vitamin A was positively associated with cord serum concentrations of several long-chain PFAS. No significant associations were observed between 25-hydroxyvitamin D and PFAS concentrations in either maternal or cord serum, or with PFAS transplacental transfer efficiencies. Interestingly, significant interaction effects were identified between vitamins and cord serum PFAS on neonatal anthropometric measurements. Positive interactions between vitamin A and both perfluorodecanoic acid and perfluorooctane sulfonate were observed for birth length z-score, whereas negative interactions between vitamin E and perfluorononanoic acid were observed for birth length and weight z-scores.