Per- and polyfluoroalkyl substances (“PFAS”), more generally referred to as forever chemicals, are a group of synthetic, fluorine-containing endocrine disrupting chemicals that are prominent in the global environment due to their use in a wide range of industrial and consumer products.
Exposure to PFAS comes in many forms, including via ingestion, inhalation, and skin contact. For humans, PFAS exposure can occur through their presence in water, air, food, and dust. In addition, PFAS exposure can occur via maternal to fetal transfer in utero and through breastfeeding. Once present in the body, these chemicals can take years to eliminate and can accumulate in various organs with continuous PFAS exposure linked to multiple health and reproductive-related issues.
In pregnant women, PFAS exposure poses a unique problem. The risks associated with these chemicals are increased in pregnancy as the body naturally goes through a series of hormonal, cardiovascular, metabolic, and immune-related changes. In addition, studies have confirmed the placenta is a known site of PFAS accumulation, which results in direct fetal exposure to these synthetic chemicals. Given the important role the placenta plays in fetal development, and the known presence of PFAS within the placental tissue, two studies recently explored the potential link between placental-associated PFAS and reproductive function.
A study by Xia et al., published in 2025 was the first in vitro study investigating a placenta-relevant PFAS mixture in a placental tissue model. The study found a mixture of six types of PFAS directly disrupted trophoblastic function. Trophoblasts are specialized cells that provide the embryo with nutrients and later form a significant portion of the placenta. In addition, the research team found hCG production – the hormone produced by the trophoblastic cells directly responsible for early pregnancy support – declined after 48 hours of PFAS mixture exposure.
A second study, conducted by researchers at the Yale School of Public Health evaluated the relationship between exposure to seven PFAS and miscarriage risk in women recruited from 1996 to 2002 for the Danish National Birth Cohort. After evaluating blood samples provided around 8 weeks of pregnancy, the research team discovered a nearly 80% to 120% increased risk of miscarriage in women with the highest levels of two common PFAS compared to women with the lowest levels.
These studies add to the growing evidence in the medical literature that PFAS may be impacting healthy pregnancies and causing reproductive issues by linking exposure to trophoblastic dysfunction, diminished hCG production, and an increased risk of miscarriage.
Additional research is needed to further evaluate the potential reproductive impact resulting from exposure to this group of synthetic chemicals, which may be a modifiable risk factor for placental issues and early pregnancy loss.
References:
[1] Blake BE, Fenton SE. Early life exposure to per- and polyfluoroalkyl substances (PFAS) and latent health outcomes: A review including the placenta as a target tissue and possible driver of peri- and postnatal effects. Toxicology. 2020 Oct;443:152565. doi: 10.1016/j.tox.2020.152565. Epub 2020 Aug 27. PMID: 32861749; PMCID: PMC7530144.
[2] Greenwood, M. (2020, April 23). Commonly used chemicals associated with miscarriage, Yale School of Public Health Study finds. Yale School of Medicine. https://medicine.yale.edu/news-article/commonly-used-chemicals-associated-with-miscarriage-yale-school-of-public-health-study-finds/
[3] Liew Z, Luo J, Nohr EA, Bech BH, Bossi R, Arah OA, Olsen J. Maternal Plasma Perfluoroalkyl Substances and Miscarriage: A Nested Case-Control Study in the Danish National Birth Cohort. Environ Health Perspect. 2020 Apr;128(4):47007. doi: 10.1289/EHP6202. Epub 2020 Apr 22. PMID: 32319790; PMCID: PMC7228130.
[4] Xia Y, Fu Q, Voss H, Fest S, Arnold S, Bauer M, Fink B, Zenclussen AC, Stojanovska V. Real-life per- and polyfluoroalkyl substances mixture impairs placental function: insights from a trophoblast spheroid model. Environ Res. 2025 Dec 15;287:123037. doi: 10.1016/j.envres.2025.123037. Epub 2025 Oct 9. PMID: 41067679.
