Prenatal exposure to perfluoroalkyl substances: Infant birth weight and early life growth

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Prenatal perfluoroalkyl substance (PFAS) exposure has been associated with reduced birth weight and excess child adiposity, but the relationship between PFAS and early life growth is unknown.


To determine if prenatal PFAS exposure was associated with birth weight, body composition, and growth until 2 years of age.


In a prospective cohort of women and their children from Cincinnati, OH, we quantified perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) in pregnant women’s serum. We used linear regression to estimate associations of PFAS with birth weight z-scores (n = 345) and linear mixed models to estimate associations with repeated weight and length/height measurements (n = 334) at 4 weeks and 1 and 2 years of age, after adjusting for sociodemographic, perinatal, nutritional, and environmental factors.


We found nonsignificant inverse associations between PFAS and infant birth weight. For example, each log2 increase in PFOA was associated with a 0.03 SD reduction in birth weight z-score (95% confidence interval [CI] = −0.17, 0.10). Compared to associations with birth weight, we observed stronger associations between PFAS and child anthropometry from 4 weeks to 2 years. For instance, each log2 increase in PFOA was associated with a 0.12 SD decrease in BMI z-score (95% CI = −0.25, 0.01). We did not observe any differences in growth rate associated with PFAS.


We observed inverse associations between prenatal serum PFAS concentrations and anthropometry until 2 years of age. Prenatal serum PFAS concentrations were not associated with growth rate in the first 2 years of life.

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