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Cited by 54Per- and polyfluoroalkyl substances researchToxic Organic Pollutants ImpactEffects and risks of endocrine disrupting chemicals

Prenatal and childhood exposure to per-/polyfluoroalkyl substances (PFASs) and its associations with childhood overweight and/or obesity: A systematic review with meta-analyses

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Frigerio, Gianfranco, Ferrari, Chiara Matilde, Fustinoni, Silvia·2023·Environmental Health
DOI 10.1186/s12940-023-01006-6PMC PMC10424367

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Abstract

Background: Per-/polyfluoroalkyl substances (PFASs) are persistent organic pollutants and suspected endocrine disruptors. Objective: The aim of this work was to conduct a systematic review with meta-analysis to summarise the associations between prenatal or childhood exposure to PFASs and childhood overweight/obesity. Methods: The search was performed on the bibliographic databases PubMed and Embase with text strings containing terms related to prenatal, breastfeeding, childhood, overweight, obesity, and PFASs. Only papers describing a biomonitoring study in pregnant women or in children up to 18 years that assessed body mass index (BMI), waist circumference (WC), or fat mass in children were included. When the estimates of the association between a PFAS and an outcome were reported from at least 3 studies, a meta-analysis was conducted; moreover, to correctly compare the studies, we developed a method to convert the different effect estimates and made them comparable each other. Meta-analyses were performed also stratifying by sex and age, and sensitivity analyses were also performed. Results: In total, 484 and 779 articles were retrieved from PubMed and Embase, respectively, resulting in a total of 826 articles after merging duplicates. The papers included in this systematic review were 49: 26 evaluating prenatal exposure to PFASs, 17 childhood exposure, and 6 both. Considering a qualitative evaluation, results were conflicting, with positive, negative, and null associations. 30 papers were included in meta-analyses (19 prenatal, 7 children, and 4 both). Positive associations were evidenced between prenatal PFNA and BMI, between PFOA and BMI in children who were more than 3 years, and between prenatal PFNA and WC. Negative associations were found between prenatal PFOS and BMI in children who were 3 or less years, and between PFHxS and risk of overweight. Relatively more consistent negative associations were evidenced between childhood exposure to three PFASs (PFOA, PFOS, and PFNA) and BMI, in particular PFOS in boys. However, heterogeneity among studies was high. Conclusion: Even though heterogeneous across studies, the pooled evidence suggests possible associations, mostly positive, between prenatal exposure to some PFASs and childhood BMI/WC; and relatively stronger evidence for negative associations between childhood exposure to PFASs and childhood BMI.

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Authors
Frigerio, G., Ferrari, C. M., & Fustinoni, S.
Affiliations
  • University of Luxembourg (LU)
  • University of Milan (IT)
Corresponding author
Frigerio, Gianfranco
ORCID
Venue
Environmental Health
Publisher
Springer Science and Business Media LLC
Published
2023-08-14
Volume
22
Issue
1
Pages
56-56
ISSN
1476-069X (ISSN-L)
DOI
10.1186/s12940-023-01006-6
PMC
PMC10424367
OpenAlex
W4385807574
Cited by
54
References
120
Citations by year
2026: 23 · 2025: 16 · 2024: 13 · 2023: 2
FWCI
1.25
Type
journal article
Language
en
Open access
Licence
Locations
  • Environmental Health (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
  • Open Repository and Bibliography (University of Luxembourg) (submittedVersion, cc-by-nc-sa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Fonds National de la Recherche Luxembourg (A18/BM/12341006)
Topics
  • Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
Keywords
per- and polyfluoroalkyl substances, PFAS exposure, prenatal exposure, children's exposure, childhood obesity, childhood overweight, body mass index, waist circumference, fat mass, perfluorooctanoic acid, PFOS, PFNA, PFHxS, endocrine disruptors, persistent organic pollutants, breastfeeding, sex differences
MeSH terms
Child, Environmental Pollutants, Female, Fluorocarbons, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Alkanesulfonic Acids, Overweight, Pediatric Obesity

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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