What every parent should know about preeclampsia and pfas exposure
Preeclampsia is a serious pregnancy complication involving high blood pressure and organ damage that affects 5-8% of pregnancies worldwide. Multiple epidemiological studies across Sweden, Denmark, China, and the United States have found associations between maternal PFAS blood levels and increased preeclampsia risk, with PFOA and PFOS as the most studied compounds.
Renee · Founder & Lead Researcher, R3
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Preeclampsia is one of those pregnancy complications that every expecting parent hopes to avoid. It develops after 20 weeks of pregnancy and involves dangerously high blood pressure that can damage the kidneys, liver, and other organs. In severe cases, it can progress to eclampsia (seizures) and threatens both the parent's and baby's life.
What's been getting our attention in the research world is a growing body of evidence linking PFAS exposure to increased preeclampsia risk. We want to walk you through what the science actually shows - no fear-mongering, just the facts parents deserve to know.
Preeclampsia affects roughly 5-8% of pregnancies globally and remains a leading cause of maternal and fetal morbidity. It is characterized by new-onset hypertension (blood pressure at or above 140/90 mmHg) combined with proteinuria (protein in urine) or other signs of organ dysfunction developing after 20 weeks of gestation.
Risk factors include first pregnancy, pre-existing hypertension, obesity, diabetes, kidney disease, and family history. But researchers have been investigating environmental chemical exposures as additional contributors - and PFAS have emerged as a significant area of concern.
The condition requires careful monitoring and sometimes early delivery. Severe preeclampsia can lead to HELLP syndrome, placental abruption, stroke, and organ failure. It is also associated with long-term cardiovascular risk for the birthing parent and adverse outcomes for the baby, including preterm birth and low birth weight.
The link between PFAS and preeclampsia has been investigated across multiple countries and populations, and the pattern is consistent enough to warrant serious attention.
The first major signal came from the C8 Health Project - the landmark study of 69,000+ residents near DuPont's Parkersburg, West Virginia plant. The C8 Science Panel found a "probable link" between PFOA exposure and pregnancy-induced hypertension, which encompasses preeclampsia. Women with higher serum PFOA levels had elevated rates of hypertensive disorders during pregnancy.
Swedish and Danish birth cohort studies have provided some of the strongest evidence. A 2014 study in the Swedish POPUP cohort found that women in the highest quartile of PFOS blood levels had approximately twice the odds of developing preeclampsia compared to those in the lowest quartile. Danish National Birth Cohort analyses have similarly reported positive associations between maternal PFOS concentrations and preeclampsia risk.
The Scandinavian studies are particularly valuable because their healthcare registries allow researchers to control for many confounding variables that plague observational studies in other populations.
Research from Chinese birth cohorts has added to the evidence base. A 2019 study in Shanghai found that higher maternal serum PFOA and PFOS concentrations in early pregnancy were associated with increased risk of preeclampsia. A nested case-control study in Guangzhou reported similar findings, with dose-response relationships observed for multiple PFAS compounds.
Beyond the C8 project, studies using NHANES data and other US cohorts have found consistent associations. A 2022 systematic review and meta-analysis published in Environmental Research synthesized the available evidence and concluded that PFAS exposure - particularly PFOA and PFOS - was associated with increased preeclampsia risk, though the authors noted heterogeneity across studies.
The biological mechanisms connecting PFAS to preeclampsia are becoming clearer, and they involve multiple pathways that converge on placental dysfunction.
Healthy placental development depends on proper angiogenesis - the formation of new blood vessels that supply the placenta with maternal blood. PFAS have been shown to disrupt angiogenic signaling pathways, interfering with vascular endothelial growth factor (VEGF) and placental growth factor (PlGF). Imbalanced angiogenesis is one of the core mechanisms in preeclampsia development.
PFAS cross the placenta and accumulate in placental tissue. Research shows they trigger inflammatory responses in trophoblast cells (the cells that form the outer layer of the placenta), increasing production of pro-inflammatory cytokines. Placental inflammation contributes to the endothelial dysfunction that characterizes preeclampsia.
PFAS exposure increases oxidative stress markers in placental tissue. This oxidative damage impairs placental function and contributes to the cascade of events leading to maternal hypertension and organ damage. The oxidative stress pathway overlaps with other PFAS health effects, including PFAS cancer risk.
PFAS are established endocrine disruptors that interfere with hormone signaling critical during pregnancy. They disrupt thyroid hormone pathways (relevant because subclinical hypothyroidism is a preeclampsia risk factor) and may alter progesterone and estrogen signaling needed for normal placental development. These endocrine effects are closely related to broader PFAS reproductive health concerns.
We want to be clear about what this research does and does not tell us.
The association between PFAS and preeclampsia is consistent across populations and biologically plausible. However, it has not been established as a definitive causal relationship. The studies are observational, meaning they show correlation that persists after adjusting for known confounders, but they cannot rule out all potential alternative explanations.
The effect sizes reported in studies vary, and the absolute risk increase for any individual is modest. PFAS exposure is one factor among many that influence preeclampsia risk. Traditional risk factors like first pregnancy, pre-existing conditions, and family history remain the strongest predictors.
That said, the consistency of findings across Swedish, Danish, Chinese, and US populations - combined with clear biological mechanisms - means this is not a pattern we can dismiss.
The goal is not to eliminate every possible PFAS exposure (that is essentially impossible in modern life). The goal is to reduce the most significant sources, especially during pregnancy and preconception.
For most families, drinking water is the largest controllable PFAS exposure source. If you are pregnant or planning to become pregnant, knowing your water's PFAS status matters. Check your utility's Consumer Confidence Report or search EWG's Tap Water Database. If PFAS are detected above EPA's 4 ppt MCL, an NSF/ANSI 58-certified reverse osmosis filter or NSF/ANSI 53/P473-certified carbon block filter can remove 70-99% of PFOA and PFOS.
Replace pre-2015 or damaged nonstick cookware and air fryers that may contain residual PFOA in their PTFE coatings. Ceramic-coated, stainless steel, or cast iron alternatives eliminate this exposure pathway entirely. For post-2015 cookware with intact coatings, this is a lower priority than water filtration.
Reduce reliance on fast-food packaging and microwave popcorn bags, which may contain PFAS in grease-resistant coatings. Cooking at home with fresh ingredients reduces this exposure route.
If you are planning a pregnancy, the preconception period is an ideal time to address PFAS sources. PFOA has a half-life of 2-4 years in the human body, and PFOS 3-8 years, so reducing exposure well before conception allows blood levels to decline before the critical window of placental development.
Preeclampsia does not occur in isolation from other PFAS-related health effects. Women who develop preeclampsia are at higher risk of delivering babies with low birth weight - another outcome independently associated with PFAS exposure. The PFAS thyroid disease pathway is relevant because thyroid dysfunction during pregnancy is itself a preeclampsia risk factor, creating a potential compounding effect.
Understanding these interconnections helps explain why reducing PFAS exposure during pregnancy addresses multiple risk pathways simultaneously.
If you are pregnant or planning to become pregnant and use an air fryer daily, check whether your model has a PTFE nonstick basket. Pre-2015 PTFE baskets were manufactured using PFOA, and scratched or worn coatings can release PFAS into food. Replacing a damaged basket with a stainless steel or ceramic-coated alternative is a simple step. For post-2015 air fryers with intact coatings, the exposure risk is low - addressing your drinking water PFAS status is a higher priority.
Preeclampsia is a leading cause of maternal and fetal morbidity affecting 5-8% of pregnancies. Multiple epidemiological studies across four countries have found associations between maternal PFAS blood levels (particularly PFOA and PFOS) and increased preeclampsia risk.
The C8 Health Project found a probable link between PFOA exposure and pregnancy-induced hypertension in 69,000+ participants. Swedish POPUP cohort data showed approximately double the odds of preeclampsia in the highest vs. lowest quartile of PFOS exposure. Danish National Birth Cohort and Chinese birth cohort studies report consistent positive associations.
Biological mechanisms include disrupted angiogenesis (new blood vessel formation critical for placental development), placental inflammation from PFAS accumulation in trophoblast cells, oxidative stress in placental tissue, and endocrine disruption affecting thyroid and sex hormone pathways during pregnancy.
The association is consistent and biologically plausible but not yet established as definitively causal. Effect sizes vary across studies. PFAS exposure compounds traditional preeclampsia risk factors rather than acting as a sole cause.
US Federal: EPA finalized Maximum Contaminant Levels of 4 ppt for PFOA and PFOS in public drinking water (April 2024). Compliance deadline is 2029. The EPA MCLG for both compounds is zero - no level considered safe. PFOA designated a Superfund hazardous substance (July 2024).
C8 Science Panel: Found "probable link" between PFOA and pregnancy-induced hypertension (2012), which carries legal weight in DuPont litigation.
ACOG Guidance: The American College of Obstetricians and Gynecologists has acknowledged environmental chemical exposures, including PFAS, as relevant to maternal health outcomes and recommends clinicians counsel patients about reducing exposures.
State Level: Minnesota banned PFAS in cookware (January 2025). Colorado followed (January 2026). Multiple states have drinking water standards more stringent than federal MCLs.
EU: PFOA banned under EU Persistent Organic Pollutants Regulation since 2020. Universal PFAS Restriction proposal under consideration.
Who is most at risk
When to seek medical attention
Discuss PFAS exposure with your OB-GYN or midwife at your first prenatal visit, especially if you live near a known PFAS contamination site, use private well water, or have other preeclampsia risk factors. If you develop symptoms of preeclampsia (persistent headache, vision changes, upper abdominal pain, sudden swelling, blood pressure above 140/90), seek immediate medical attention regardless of PFAS exposure status. Blood PFAS testing is available but not yet part of routine prenatal screening - your provider can help you decide whether testing is appropriate for your situation.
How to spot it on labels
There is no label that addresses preeclampsia risk specifically. Focus on reducing PFAS exposure through product choices: look for PTFE-free AND PFAS-free stated together on cookware and air fryers. For water filters, verify NSF/ANSI 58 (reverse osmosis) or NSF/ANSI 53/P473 (carbon block) certification at nsf.org. Standard pitcher filters do not reliably remove PFAS.
What this does NOT cover
Other causes of preeclampsia unrelated to environmental chemical exposure (genetic, immunological, cardiovascular) Clinical management or treatment of preeclampsia once diagnosed PFAS exposure from occupational sources (covered in PFAS main entry) Non-PFAS environmental chemicals that may affect pregnancy outcomes (lead, mercury, phthalates) Eclampsia and HELLP syndrome management
How to verify
For drinking water: check your utility's Consumer Confidence Report for PFAS test results, or search EWG's Tap Water Database at ewg.org/tapwater. For private wells, test through an NSF-certified laboratory. For cookware: contact the manufacturer and request third-party test results showing total organic fluorine below detectable limits. For personal exposure assessment during pregnancy, discuss PFAS blood testing with your OB-GYN or midwife - commercial blood PFAS panels are available through Quest Diagnostics and LabCorp.
PFOA
Most studied PFAS in relation to preeclampsia. C8 Science Panel found probable link. Swedish, Danish, and Chinese studies confirm association. Half-life 2-4 years in humans.
PFOS
Second most studied. Swedish POPUP cohort showed approximately doubled preeclampsia odds in highest exposure quartile. Half-life 3-8 years.
PFNA
Less studied for preeclampsia specifically but found in placental tissue. Part of the broader PFAS mixture exposure during pregnancy.
GenX (HFPO-DA)
PFOA replacement in PTFE manufacturing. Shorter half-life but limited pregnancy outcome data available. EPA MCL set at 10 ppt.
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The research shows an association between higher blood PFAS levels and increased preeclampsia risk, but cookware is typically not the primary PFAS exposure source. Drinking water and diet contribute more to total PFAS body burden for most people. That said, if your air fryer predates 2015 or has a damaged PTFE coating, replacing it reduces one exposure pathway. Post-2015 air fryers with intact coatings are a lower concern.
The evidence is emerging but consistent. Studies across Sweden, Denmark, China, and the United States all show positive associations between maternal PFAS blood levels and preeclampsia risk. The C8 Science Panel found a probable link in its 69,000-person study. Biological mechanisms (disrupted angiogenesis, placental inflammation) are plausible. However, the relationship has not been established as definitively causal, and effect sizes vary across studies.
Blood PFAS testing is available through Quest Diagnostics and LabCorp but is not part of standard prenatal screening. It may be worth discussing with your provider if you live near a known PFAS contamination site, use private well water in an area of concern, or have other reasons to suspect elevated exposure. The results can inform personal decisions about exposure reduction but there are no established clinical thresholds for intervention during pregnancy.
The research suggests that PFAS exposure may compound existing risk factors rather than acting as a standalone cause. If you have pre-existing hypertension, obesity, diabetes, or a family history of preeclampsia, reducing controllable environmental exposures including PFAS is a reasonable additional step. It does not replace standard prenatal monitoring and medical management of your existing risk factors.
For most families, filtering drinking water is the highest-impact step. An NSF/ANSI 58-certified reverse osmosis system removes 95-99% of PFOA and PFOS. NSF/ANSI 53 or P473-certified carbon block filters remove 70-99%. Standard pitcher filters are not effective for PFAS. After water, replace any pre-2015 or damaged nonstick cookware and reduce fast-food packaging consumption.
Yes, PFAS cross the placenta and are found in cord blood. Prenatal PFAS exposure has been independently associated with low birth weight, preterm birth, and effects on immune development and neurodevelopment in children. Preeclampsia itself also increases risks for the baby, including growth restriction and preterm delivery, so the maternal and fetal effects can compound each other.
Given that PFOA has a half-life of 2-4 years and PFOS 3-8 years in the human body, starting exposure reduction well before conception is ideal. Filtering water and replacing PFAS-containing cookware even 6-12 months before a planned pregnancy allows blood levels to begin declining before the critical window of early placental development when preeclampsia risk is being established.