Prenatal exposure to perfluorooctanoate and risk of overweight at 20 years of age: A prospective cohort study
Open accessAbstract
BACKGROUND: Perfluoroalkyl acids are persistent compounds used in various industrial -applications. Of these compounds, perfluorooctanoate (PFOA) is currently detected in humans worldwide. A recent study on low-dose developmental exposure to PFOA in mice reported increased weight and elevated biomarkers of adiposity in postpubertal female offspring. OBJECTIVE: We examined whether the findings of increased weight in postpubertal female mice could be replicated in humans. METHODS: A prospective cohort of 665 Danish pregnant women was recruited in 1988-1989 with offspring follow-up at 20 years. PFOA was measured in serum from gestational week 30. Offspring body mass index (BMI) and waist circumference were recorded at follow-up (n = 665), and biomarkers of adiposity were quantified in a subset (n = 422) of participants. RESULTS: After adjusting for covariates, including maternal pre-pregnancy BMI, smoking, education, and birth weight, in utero exposure to PFOA was positively associated with anthropometry at 20 years in female but not male offspring. Adjusted relative risks comparing the highest with lowest quartile (median: 5.8 vs. 2.3 ng/mL) of maternal PFOA concentration were 3.1 [95% confidence interval (CI): 1.4, 6.9] for overweight or obese (BMI ≥ 25 kg/m2) and 3.0 (95% CI: 1.3, 6.8) for waist circumference > 88 cm among female offspring. This corresponded to estimated increases of 1.6 kg/m2 (95% CI: 0.6, 2.6) and 4.3 cm (95% CI: 1.4, 7.3) in average BMI and waist circumference, respectively. In addition, maternal PFOA concentrations were positively associated with serum insulin and leptin levels and inversely associated with adiponectin levels in female offspring. Similar associations were observed for males, although point estimates were less precise because of fewer observations. Maternal perfluorooctane sulfonate (PFOS), perfluorooctane sulfonamide (PFOSA), and perfluorononanoate (PFNA) concentrations were not independently associated with offspring anthropometry at 20 years. CONCLUSIONS: Our findings on the effects of low-dose developmental exposures to PFOA are in line with experimental results suggesting obesogenic effects in female offspring at 20 years of age.
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Halldorsson et al. found that elevated prenatal plasma PFOA levels were linked to an increased incidence of overweight and greater waist circumference in female offspring at 20 years of age, but no such connection in males.
“Aprospective study by Halldorsson et al. [212] revealed that elevated prenatal plasma PFOA levels were linked to an increased incidence of overweight and greater waist circumference in female offspring at 20 years of age, though no such connection was observed in males.”
From Industrial Applications, Environmental Fate, Human Exposure, and Health Effects of PFAS (2025) · cites this paper as [212]
The Results report higher waist circumference and a greater likelihood of overweight at age 20 among female offspring with higher maternal PFOA concentrations; associations in males were not statistically significant. The Conclusion describes overweight as a prevalence finding, not an increased incidence of new cases. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe impacts of PFAS on body weight are not consistent in the literature, with many studies reporting associations between PFAS exposure and increased body weight gain and metabolic syndrome-like phenotypes in human and rodent studies.
“the impacts of PFAS on body weight are not consistent in the literature, with many studies reporting associations between PFAS exposure and increased body weight gain and metabolic syndrome-like phenotypes in human and rodent studies”
From A Critical Review and Meta-Analysis of Impacts of Per- and Polyfluorinated Substances on the Brain and Behavior (2022) · cites this paper as Halldorsson et al., 2012
The Discussion (page unavailable) says findings on body weight have been inconsistent. It reports an association between prenatal PFOA exposure and overweight in female offspring, alongside one mouse study finding increased weight, insulin, and leptin. The paper does not establish that many PFAS studies found increased weight gain or metabolic syndrome-like phenotypes across humans and rodents; it also describes animal studies that found no increased weight. (LLM, conf=0.86)
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Self-citation
- Authors
- Halldorsson, T. I., Rytter, D., Haug, L. S., Bech, B. H., Danielsen, I., Becher, G., Henriksen, T. B., & Olsen, S. F.
- Affiliations
- Statens Serum Institut (DK)
- Aarhus University (DK)
- Norwegian Institute of Public Health (NO)
- Aarhus University Hospital (DK)
- Corresponding author
- Halldorsson, Thorhallur I.
- ORCID
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2012-02-03
- Volume
- 120
- Issue
- 5
- Pages
- 668-673
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC3346773
- OpenAlex
- W2001077154
- Cited by
- 353
- References
- 48
- Citations by year
- 2026: 7 · 2025: 16 · 2024: 16 · 2023: 16 · 2022: 30 · 2021: 32 · 2020: 35 · 2019: 29 · 2018: 25 · 2017: 21 · 2016: 30 · 2015: 35 · 2014: 28 · 2013: 24 · 2012: 9
- FWCI
- 24.46
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (vor, 2156 d)
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Keywords
- perfluorooctanoic acid, prenatal exposure, obesity, body mass index, waist circumference, adiposity biomarkers, insulin, leptin, adiponectin, sex differences, PFOS, perfluorooctane sulfonamide, perfluorononanoate
- MeSH terms
- Adult, Caprylates, Denmark, Environmental Pollutants, Female, Fluorocarbons, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Prospective Studies, Risk Factors, Biomarkers, Overweight, Limit of Detection
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