# 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. **Type:** conditions **Categories:** air-fryer, cookware-set, water-filter **Risk Level:** limit **Evidence Strength:** emerging **Source:** https://www.r3recs.com/learn/conditions/pfas-preeclampsia ## Reality Check ## Overview 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](/learn/ingredients/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. ## What Is Preeclampsia 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](/learn/ingredients/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](/learn/conditions/pfas-low-birth-weight). ## The Research Connecting PFAS to Preeclampsia 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 C8 Health Project 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](/learn/ingredients/pfoa) exposure and pregnancy-induced hypertension, which encompasses preeclampsia. Women with higher serum PFOA levels had elevated rates of hypertensive disorders during pregnancy. ### Scandinavian Birth Cohorts 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](/learn/ingredients/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. ### Chinese Cohort Studies 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. ### US Studies Beyond C8 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](/learn/ingredients/pfoa) and PFOS - was associated with increased preeclampsia risk, though the authors noted heterogeneity across studies. ## How PFAS May Cause Preeclampsia The biological mechanisms connecting PFAS to preeclampsia are becoming clearer, and they involve multiple pathways that converge on placental dysfunction. ### Angiogenesis Disruption 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. ### Placental Inflammation 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. ### Oxidative Stress 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](/learn/conditions/pfas-cancer-risk). ### Endocrine Disruption [PFAS](/learn/ingredients/pfas) are established [endocrine disruptors](/learn/concepts/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](/learn/conditions/pfas-reproductive-health) concerns. ## Important Context for Parents 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. ## What Parents Can Do 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. ### Drinking Water 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. ### Cookware Replace pre-2015 or damaged nonstick cookware and [air fryers](/category/air-fryer) 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. ### Food Packaging 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. ### Timing Matters If you are planning a pregnancy, the preconception period is an ideal time to address PFAS sources. [PFOA](/learn/ingredients/pfoa) has a half-life of 2-4 years in the human body, and [PFOS](/learn/ingredients/pfos) 3-8 years, so reducing exposure well before conception allows blood levels to decline before the critical window of placental development. ## Connection to Other PFAS Health Outcomes 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](/learn/conditions/pfas-low-birth-weight) - another outcome independently associated with PFAS exposure. The [PFAS thyroid disease](/learn/conditions/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. ## Also Known As - PFAS-associated preeclampsia - Pregnancy-induced hypertension from PFAS - Toxemia and PFAS exposure - PFAS gestational hypertension ## Where Found - Contaminated drinking water - the primary high-volume PFAS exposure source for most pregnant individuals - Pre-2015 nonstick cookware and air fryer baskets with PTFE coatings manufactured using PFOA - Grease-resistant food packaging including fast-food wrappers and microwave popcorn bags - Stain-resistant and water-resistant textiles, carpeting, and furniture coatings - Some cosmetics and personal care products containing PFAS compounds - Occupational environments at PFAS manufacturing and semiconductor facilities ## Health Concerns 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. ## Regulatory Status **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 At Risk - Pregnant individuals - preeclampsia develops after 20 weeks gestation and higher PFAS blood levels are associated with increased risk - Those planning pregnancy - PFAS half-lives of 2-8 years mean current blood levels reflect years of accumulated exposure - First-time pregnant parents - first pregnancy is already the strongest traditional risk factor for preeclampsia, and PFAS may compound this - People with pre-existing hypertension or kidney disease - these conditions increase baseline preeclampsia risk, and PFAS-driven placental dysfunction may add to it - Residents near PFAS-contaminated water sources - higher chronic exposure leads to higher serum PFAS levels during pregnancy - Individuals using pre-2015 or damaged nonstick cookware daily during pregnancy ## When To See A Doctor 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 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. ## Air Fryers and Pregnancy: A Practical Note 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. ## 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 ## R3 Bottom Line - Multiple studies across four countries consistently link higher maternal PFAS blood levels to increased preeclampsia risk. The C8 Science Panel found a probable link in 69,000+ participants, and Scandinavian birth cohort data shows roughly doubled odds at the highest PFOS exposure levels. - The evidence is emerging rather than definitive - we see consistent associations and plausible biological mechanisms (disrupted angiogenesis, placental inflammation), but a causal relationship has not been confirmed. PFAS is one factor among many that influence preeclampsia risk. - Drinking water filtration is the single highest-impact step for reducing PFAS exposure during pregnancy. An NSF/ANSI 58-certified reverse osmosis filter or NSF/ANSI 53/P473-certified carbon block filter addresses the largest exposure source for most families. ## FAQ ### Can PFAS from my air fryer cause preeclampsia? 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. ### How strong is the evidence linking PFAS to preeclampsia? 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. ### Should I get my blood tested for PFAS during pregnancy? 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. ### If I already have preeclampsia risk factors, does PFAS exposure make it worse? 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. ### What is the most effective way to reduce PFAS exposure during pregnancy? 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. ### Does PFAS exposure during pregnancy also affect the baby? 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. ### How long before pregnancy should I start reducing PFAS exposure? 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. ## Sources - [Perfluoroalkyl substances and risk of preeclampsia in the Danish National Birth Cohort](https://pubmed.ncbi.nlm.nih.gov/24529689/) — *Environmental Health Perspectives / PubMed* (2014) - [PFAS and New-Onset Maternal Hypertension in Pregnancy: The C8 Science Panel Findings](https://pmc.ncbi.nlm.nih.gov/articles/PMC3855507/) — *Environmental Health Perspectives / PMC* (2013) - [Prenatal exposure to perfluoroalkyl substances and risk of preeclampsia: A Swedish POPUP cohort study](https://pubmed.ncbi.nlm.nih.gov/30144680/) — *Environment International / PubMed* (2018) - [Per- and polyfluoroalkyl substance exposure and adverse pregnancy outcomes: A systematic review and meta-analysis](https://pubmed.ncbi.nlm.nih.gov/35850427/) — *Environmental Research / PubMed* (2022) - [Perfluoroalkyl and polyfluoroalkyl substances and preeclampsia risk in Chinese pregnant women](https://pubmed.ncbi.nlm.nih.gov/30849617/) — *Environment International / PubMed* (2019) - [Per- and Polyfluoroalkyl Substances (PFAS) and Reproductive Outcomes](https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2024/04/reducing-prenatal-exposure-to-toxic-environmental-agents) — *American College of Obstetricians and Gynecologists* (2024) - [Perfluoroalkyl substances and placental function: A review of mechanisms](https://pmc.ncbi.nlm.nih.gov/articles/PMC8276567/) — *Reproductive Toxicology / PMC* (2021) - [PFAS in Drinking Water: EPA Final Rule on PFAS National Primary Drinking Water Regulation](https://www.epa.gov/sdwa/and-polyfluoroalkyl-substances-pfas) — *US Environmental Protection Agency* (2024) - [Preeclampsia: Pathophysiology, Diagnosis, and Management](https://pubmed.ncbi.nlm.nih.gov/35025827/) — *Hypertension / American Heart Association / PubMed* (2022) - [Fourth National Report on Human Exposure to Environmental Chemicals - PFAS Data](https://www.cdc.gov/exposurereport/data-tables/pfas-data-tables.html) — *Centers for Disease Control and Prevention (CDC)* (2024) --- Source: https://www.r3recs.com/learn/conditions/pfas-preeclampsia Methodology: https://www.r3recs.com/methodology/how-we-score-products