Associations of Early Life Per- and Polyfluoroalkyl Substances (PFAS) Exposure with Body Mass Index and Risk of Overweight or Obesity at Age 2-18 Years: Mixture Analysis in the Prospective Boston Birth Cohort
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BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are a class of widespread persistent chemicals, which may have obesogenic effects during the fetal period. This study investigated the long-term association of maternal plasma PFAS concentrations at delivery and their mixture with child body mass index (BMI) and the risk of Overweight or Obesity (OWO) at the age of 2-18 years. METHODS: The study included 1189 mother-child dyads from the prospective Boston Birth Cohort. Eight PFAS were measured in maternal plasma samples collected 24-72 h after delivery. Outcomes were BMI Z-score and OWO status of children at 2-18 years. The exposure-outcome associations were evaluated with linear and modified Poisson mixed-effects regression for individual PFAS and Bayesian kernel machine regression and quantile-based g-computation models for PFAS mixture. We explored the effect modification by maternal pre-pregnancy OWO, child age, sex, and race. RESULTS: Maternal plasma samples had PFAS detection frequencies from 87 % to 100 % and geometric means ranging from 0.11 to 3.67 ng/mL. PFHpS and PFHxS were associated with higher child BMI Z-score. Such associations were stronger in children aged 6-12 years and 13-18 years than in 2-5 years. Stratified by maternal pre-pregnancy OWO, significant associations of the PFAS mixture with child BMI Z-score were only found in children of non-OWO mothers. In children aged 13-18 years, children with both high maternal plasma PFDeA, PFNA, and PFOA concentrations and maternal OWO had the highest risks of OWO compared to children with either only. Such synergistic effects were not found in younger children. CONCLUSIONS: Early life exposure to individual PFAS and their mixture were associated with a higher risk of childhood OWO, with stronger associations observed in older child age groups and in children of non-OWO mothers. Synergistic effects of PFAS exposures and maternal pre-pregnancy OWO became evident in adolescence.
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Early-life PFAS exposure may predispose children to obesity and overweight (OWO).
“Early-life PFAS exposure may also predispose children to obesity and overweight (OWO).”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [81]
Higher exposure to individual PFAS compounds and their mixtures is associated with increased risk of OWO, especially in older children and those whose mothers did not have pre-pregnancy OWO.
“Higher exposure to both individual PFAS compounds and their mixtures was associated with increased risk of OWO, especially in older children and in those whose mothers did not have pre-pregnancy OWO.”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [81]
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Briassoulis, G., Ilia, S., & Briassouli, E. (2025) · Life · doi:10.3390/life15071057 · Cited by 15 · see citing works
- Authors
- Li, Z., Wang, G., Braun, J. M., Hong, X., Choi, G., O’Leary, S. P., Yu, C. H., Pearson, C., Adams, W. G., Fan, Z. (., Buckley, J. P., & Wang, X.
- Affiliations
- Johns Hopkins University (US)
- Brown University (US)
- New Jersey Department of Health (US)
- Boston University (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Buckley, Jessie P.
- Wang, Xiaobin
- ORCID
- Venue
- Environment International
- Publisher
- Elsevier BV
- Published
- 2025-01
- Volume
- 195
- Pages
- 109206
- ISSN
- 0160-4120 (ISSN-L)
- PMC
- PMC11786237
- OpenAlex
- W4405394996
- Cited by
- 16
- References
- 57
- Citations by year
- 2026: 7 · 2025: 9
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Environment International (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Maternal and Child Health Bureau (K99ES035464, UT7MC45949)
- Centers for Disease Control and Prevention (U88EH001151)
- National Institutes of Health (R01ES030078, K99ES035464, R01ES033252, U01ES034983, 2R01HD041702, R01ES031521, R01ES031272, R01HD098232)
- U.S. Environmental Protection Agency
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- per- and polyfluoroalkyl substances, PFAS mixtures, childhood obesity, childhood overweight, body mass index, prenatal exposure, PFHxS, PFHpS, perfluorooctanoic acid, PFNA, synergistic effect, effect modification, adolescent obesity, Boston Birth Cohort
- MeSH terms
- Birth Cohort, Adolescent, Adult, Boston, Child, Child, Preschool, Environmental Exposure, Environmental Pollutants, Environmental Pollution, Female, Fluorocarbons, Humans, Male, Obesity, Pregnancy, Prenatal Exposure Delayed Effects, Prospective Studies, Body Mass Index, Maternal Exposure, Overweight, Young Adult, Pediatric Obesity
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