Association of Prenatal Exposure to Perfluorinated and Polyfluoroalkyl Substances with Childhood Neurodevelopment: A Systematic Review and Meta-Analysis
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BACKGROUND: Although previous studies have shown an association between prenatal exposure to perfluorinated and polyfluoroalkyl substances (PFAS) and neurodevelopmental disorders in children, the results have been inconsistent. We summarize studies on the association between prenatal PFAS exposure and neurodevelopment in children in order to better understand the relationship. OBJECTIVE: We conducted a meta-analysis of prenatal PFAS exposure and developmental outcomes associated with intellectual, executive function and behavioral difficulty in children to explore the relationship between prenatal exposure to perfluorinated and polyfluoroalkyl substances (PFAS) and neurodevelopmental disorders in children. METHODS: We searched for articles published up to August 3, 2023, included and quantified original studies on PFAS and child Intelligence Quotient (IQ), executive function and behavioral difficulty during pregnancy, and systematically summarized articles that could not be quantified. CONCLUSION: There is evidence of sex-specific relationship between PFAS exposure and children's PIQ. We found that PFOS [β = -1.56, 95% CI = -2.96, - 0.07; exposure = per 1 ln (ng/ml) increase], PFOA [β = -1.87, 95% CI = -3.29, - 0.46; exposure = per 1 ln (ng/ml) increase], PFHxS [β = -2.02, 95% CI = -3.23, - 0.81; exposure = per 1 ln (ng/ml) increase] decreased performance IQ in boys, but PFOS [β = 1.56, 95% CI = 0.06, 3.06; exposure = per 1 ln (ng/ml) increase] increased performance IQ in girls. PFAS are associated with executive function impairments in children, but not related to behavioral difficulty in children.
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Elevated prenatal PFOS, PFOA, and PFHxS levels were linked to 1.6-2.0 point reductions in boys' performance IQ per log-unit increase.
“Additionally, elevated prenatal PFOS, PFOA, and PFHxS levels were linked to 1.6–2.0 point reductions in boys’ performance IQ per log-unit increase; furthermore, PFAS exposure was also associated with a decline in executive function, although not clearly with behavioral difficulties [94].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [94]
PFAS exposure was associated with a decline in executive function, although not clearly with behavioral difficulties.
“Additionally, elevated prenatal PFOS, PFOA, and PFHxS levels were linked to 1.6–2.0 point reductions in boys’ performance IQ per log-unit increase; furthermore, PFAS exposure was also associated with a decline in executive function, although not clearly with behavioral difficulties [94].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [94]
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- Authors
- Liu, D., Yan, S., Liu, Y., Chen, Q., & Ren, S.
- Affiliations
- Jilin University (CN)
- Corresponding author
- Ren, Shuping
- Venue
- Ecotoxicology and Environmental Safety
- Publisher
- Elsevier BV
- Published
- 2024-02
- Volume
- 271
- Pages
- 115939
- ISSN
- 0147-6513 (ISSN-L)
- OpenAlex
- W4390721127
- Cited by
- 44
- References
- 76
- Citations by year
- 2026: 18 · 2025: 12 · 2024: 14
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Ecotoxicology and Environmental Safety (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Department of Science and Technology of Jilin Province (20210204024YY)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Keywords
- prenatal exposure, child neurodevelopment, intellectual quotient, performance IQ, sex differences, PFOS, perfluorooctanoic acid, PFHxS, executive function, neurodevelopmental disorders
- MeSH terms
- Child, Child Development, Child, Preschool, Environmental Pollutants, Female, Fluorocarbons, Humans, Intelligence, Intelligence Tests, Male, Pregnancy, Prenatal Exposure Delayed Effects, Alkanesulfonic Acids, Maternal Exposure, Executive Function, Neurodevelopmental Disorders
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