Some studies have linked certain PFAS chemicals with gestational hypertension or changes in blood-pressure patterns, but results are mixed and do not prove that PFAS causes high blood pressure in an individual pregnancy. There is no validated way to use a person’s exposure history or a PFAS blood test to predict who will develop hypertension. The practical step is ordinary prenatal care with blood pressure monitored closely, as the Agency for Toxic Substances and Disease Registry (ATSDR) advises.
What studies say about PFAS and pregnancy blood pressure
Per- and polyfluoroalkyl substances (PFAS) are a broad group of chemicals. Pregnancy studies have examined particular PFAS and different outcomes, so their results do not support one simple conclusion about the group as a whole.
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Project Viva found an association with gestational hypertension
A Project Viva study followed 1,558 pregnant participants recruited from 1999 to 2002. Researchers measured eight PFAS in plasma collected at a median of 9.7 weeks of pregnancy. In this cohort, 7% developed gestational hypertension and 4% developed preeclampsia. For each doubling of PFOA, PFOS, and PFHxS, the study reported higher odds of gestational hypertension; it did not find higher odds of preeclampsia for those chemicals. Some trimester-specific models also linked doubled PFOA and PFOS levels with modest increases in mean diastolic blood pressure. These are observational findings, not evidence that the chemicals caused the outcomes. Read the Project Viva study in Environmental International.
A separate cohort found no association
An analysis of 513 participants in the Atlanta African American Maternal-Child Cohort, enrolled from 2014 through 2020, found no association between PFAS measured in serum at 8–14 weeks and hypertensive disorders of pregnancy. The authors noted that the comparatively low PFAS levels in this population might be relevant to the result. One study’s null finding does not settle the question, but it shows why associations from one cohort should not be treated as universal. See the Atlanta cohort study.
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Blood-pressure patterns are not the same as a diagnosis
A second Project Viva analysis examined blood-pressure trajectories rather than whether participants developed a diagnosed hypertensive disorder. In some models, PFOS was associated with higher trajectory magnitude and faster systolic trajectory velocity; some measures showed stronger associations among participants with at least one prior live birth. The overall PFAS mixture was not significantly associated with either trajectory measure. These results describe patterns in blood pressure and do not demonstrate that PFOS causes gestational hypertension or preeclampsia. See the blood-pressure trajectory analysis.
ATSDR’s public-facing summary also describes epidemiological associations between PFOA or PFOS and pregnancy-induced hypertension and preeclampsia, while noting that human findings can be inconsistent and research continues. Read ATSDR’s summary of PFAS and pregnancy.
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Who may be at risk?
Current evidence does not identify a PFAS-specific patient profile or clinical score that can predict who will develop hypertension in pregnancy. Risk depends on more than whether exposure may have occurred: ATSDR identifies dose, frequency, route, and duration of exposure, individual sensitivity and disease burden, and broader determinants such as access to safe water and quality healthcare as relevant factors. An exposure history can provide context, but it cannot predict an individual outcome. ATSDR’s clinician guidance explains PFAS exposure and health care.
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General risk factors for hypertensive disorders of pregnancy include advanced maternal age, obesity, pre-existing diabetes or hypertension, a family history of these disorders, and socioeconomic disadvantage such as lower educational attainment. These are established clinical risk factors—not proven modifiers of PFAS effects. Your prenatal clinician can assess your personal health history and determine the care you need. The Atlanta cohort paper discusses these risk factors.
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What to do if you may have been exposed
Keep up with routine prenatal care
ATSDR’s clinician guidance says: “Usual prenatal care, including monitoring a patient’s blood pressure closely, is appropriate.” Tell your prenatal clinician about a known or plausible PFAS source and any relevant exposure circumstances. Your clinician can consider that information alongside your medical history; a suspected exposure does not, on its own, establish a need for a different screening plan. Read ATSDR’s clinical guidance, updated August 18, 2026.
Understand what a blood test can—and cannot—tell you
A PFAS blood test can measure concentrations of certain PFAS at a point in time, but it is not a pregnancy screening test for hypertension or preeclampsia. ATSDR says results do not identify where exposure came from, may not cover every PFAS a person encountered, cannot establish that PFAS caused an illness, and do not predict future health outcomes. Comparing results between laboratories can also be difficult.
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When deciding whether testing would be useful, ATSDR advises considering the person’s exposure history, whether water or other exposure routes can be tested, and whether the result could guide exposure reduction or health promotion. Discuss that decision with a clinician rather than using a test to forecast pregnancy complications. ATSDR’s clinician guidance covers PFAS testing.
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What the evidence does not establish
- It does not prove that PFAS caused gestational hypertension, preeclampsia, or a particular blood-pressure pattern in any participant.
- It does not show that every PFAS has the same relationship with pregnancy blood pressure, or that findings from one population apply to everyone.
- It does not provide a dependable way to identify an individual who will develop PFAS-related hypertension.
- It does not support using PFAS blood testing to diagnose or predict pregnancy hypertension.
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