Table 1.
Summary of studies assessing associations between prenatal PFAS exposure and fetal growth.
| PFAS group | Timing of exposures | Outcomes | ||||||
|---|---|---|---|---|---|---|---|---|
| Early pregnancy | Mid-late pregnancy | Cord blood | Not available | Birth weight | Birth length | Ponderal index | Gestational age | |
| PFOA | ▼ (17–19); ▼ (20)*; ↔ (21–26) | ▼ (27); ↔ (19, 22, 24–26) | ↔ (27) | ▲ (19); ▼ (18); ↔ (23, 24) | ||||
| ▼ (17–19, 28–31); ▼ (32)*; ↔ (21, 22, 25, 26, 33–42); ↔ (43)** | ▼ (28); ↔ (19, 22, 25, 26, 32, 33, 37–41); ↔ (43)** | ▼ (37); ↔ (28, 32, 44) | ▲ (19); ▼ (18, 28); ↔ (31, 32, 34, 35, 39, 41, 42) | |||||
| ▼ (18, 44, 45); ↔ (21, 25, 26, 37, 46–48) | ↔ (25, 26, 37, 45–48) | ▼ (37, 45); ↔ (46, 47) | ▼ (18); ↔ (44–46) | |||||
| ↔ (49, 50) | ↔ (49, 50) | |||||||
| PFNA | ▼ (18, 23); ▼ (20)*; ↔ (19, 21, 22, 24, 26) | ▼ (26); ↔ (19, 22, 24) | ▼ (18); ▼ (23)**; ↔ (19, 24) | |||||
| ▼ (18, 40); ▼ (38)*; ↔ (19, 21, 22, 26, 29, 41, 42); ↔ (43)** | ▼ (40); ↔ (19, 22, 26, 38, 41); ↔ (43)** | ▼ (18, 42); ↔ (19, 41) | ||||||
| ▼ (18); ↔ (21, 26, 44, 46, 47, 51) | ↔ (26, 46, 47) | ↔ (46, 47) | ▼ (18); ↔ (44, 46) | |||||
| PFDA | ▼ (20)*; ↔ (18, 19, 22, 26) | ▼ (26); ↔ (19, 22) | ↔ (19) | |||||
| ▼ (40); ▼ (38)*; ↔ (18, 19, 22, 26, 29, 42) | ↔ (19, 22, 26, 38, 40) | ↔ (19, 42) | ||||||
| ↔ (26, 44, 47, 51) | ↔ (26, 47) | ↔ (47) | ↔ (44) | |||||
| PFUnDA | ▼ (20)*; ↔ (19, 26) | ▼ (26); ↔ (19) | ↔ (19) | |||||
| ▼ (38)*; ↔ (19, 26, 29, 40) | ↔ (19, 26, 38, 40) | ↔ (19) | ||||||
| ↔ (26, 44, 46, 47, 51) | ▼ (47)**; ↔ (26, 46) | ↔ (46, 47) | ↔ (44, 46) | |||||
| PFDoDA | ↔ (20, 26) | ▼ (26) | ||||||
| ▼ (38)*; ↔ (26, 29, 40) | ↔ (26, 38, 40) | |||||||
| ▼ (44)*; ↔ (26, 51) | ↔ (26) | ↔ (44) | ||||||
| PFTrDA | ▼ (40)* | ↔ (40)* | ||||||
| PFBA | ↔ (44) | ↔ (44) | ||||||
| PFHpA | ↔ (20, 26) | ↔ (26) | ||||||
| ↔ (26, 29) | ↔ (26) | |||||||
| ▼ (44)**; ↔ (26) | ↔ (26) | ↔ (44) | ||||||
| PFOS | ▼ (18, 23); ▼ (20)*; ↔ (17, 19, 21, 22, 24–26) | ▼ (26); ↔ (19, 22, 27, 33) | ↔ (27) | ▼ (18); ▼ (23)**; ↔ (19, 24) | ||||
| ▼ (18, 31); ▼ (32, 33, 36)*; ▼ (43)**; ↔ (19, 21, 22, 26, 29, 30, 34, 35, 37, 39–42) | ▼ (32)*; ▼ (43)**; ↔ (19, 26, 32, 33, 37, 39–41) | ▼ (30, 37); ↔ (32) | ▼ (18); ↔ (19, 31, 32, 34, 35, 39, 41, 42) | |||||
| ▼ (18, 45, 46, 48); ▼ (44)**; ↔ (21, 26, 37, 47, 51) | ▼ (48); ↔ (26, 37, 45–47) | ▼ (37, 45); ↔ (46, 47) | ▲ (44); ▼ (18, 46); ↔ (45) | |||||
| ▼ (49, 50) | ↔ (49, 50) | |||||||
| PFHpS | ▼ (18); ↔ (19, 22) | ↔ (19, 22) | ▼ (18); ↔ (19) | |||||
| ▼ (18); ↔ (19) | ↔ (19, 22) | ▼ (18); ↔ (19) | ||||||
| PFHxS | ↔ (18–26) | ↔ (19, 22, 24, 26) | ↔ (18, 19, 23, 24) | |||||
| ▼ (32)*; ↔ (18, 19, 21, 22, 26, 29, 34, 40–42); ↔ (43)** | ▼ (32)*; ↔ (19, 22, 26, 40, 41); ↔ (43)** | ↔ (32) | ↔ (18, 19, 32, 34, 41, 42) | |||||
| ↔ (18, 21, 26, 37, 44, 47, 51) | ▲ (47)** | ▼ (37); ↔ (47) | ↔ (18, 44) | |||||
| Me-PFOSA-AcOH | ▼ (41); ↔ (42) | ↔ (41) | ↔ (41, 42) | |||||
| PFBS | ↔ (26) | ↔ (26) | ||||||
| ↔ (26) | ↔ (26) | |||||||
| ↔ (26) | ↔ (26) | |||||||
| Mixture | ▼ (52) | |||||||
PFOA, perfluorooctanoic acid; PFNA, perfluorononanoic acid; PFDA, perfluorodecanoic acid; PFUnDA, perfluoroundecanoic acid; PFDoDA, perfluorododecanoic acid; PFTrDA, perfluorotridecanoic acid; PFBA, pentafluorobenzoic acid; PFHpA, perfluoroheptanoic acid; PFOS, perfluorooctane sulfonic acid; PFHpS, perfluoroheptanane sulfonic acid; PFHxS, perfluorohexane sulfonic acid; Et-PFOSA-AcOH, N-ethyl-perfluorooctane sulfonamidoacetic acid; Me-PFOSA-AcOH, N-methyl-perfluorooctane sulfonamidoacetic acid; PFBS, perfluorobutane sulfonic acid ▲, Positive associations; ▼, Inverse association; ↔, Null association; * significant only in girls; ** significant only in boys.
Early and mild-late pregnancy refer to 1st trimester, and 2nd or 3rd trimester, respectively.
Long-chain PFAS include PFOA, PFNA, PFDA, PFUnDA, and PFDoDA in perfluoroalkyl carboxylic acids (PFCA) group, and PFOS, PFHpS, PFHxS, Et-PFOSA-AcOH, and Me-PFOSA-AcOH in perfluoroalkane sulfonic acids (PFSA) group. Short-chain PFAS include PFBA and PFHpA in PFCA group, and PFBS in PFSA group.
Shading boxes indicate exposure timing.
Four studies with small sample size (less than 100) (53–56), 6 studies investigating the effects of mixture of various chemicals (57–62), and 6 studies focusing on the mediating factors (63–68) are not described in the table. Further information of the included studies are described in Supplementary Table 2.