Perfluoroalkyl substances during pregnancy and offspring weight and adiposity at birth: Examining mediation by maternal fasting glucose in the healthy start study
Open accessAbstract
BACKGROUND: Certain perfluoroalkyl and polyfluoroalkyl substances (PFAS) are widespread, persistent environmental contaminants. Prenatal PFAS exposure has been associated with lower birth weight; however, impacts on body composition and factors responsible for this association are unknown. OBJECTIVES: We aimed to estimate associations between maternal PFAS concentrations and offspring weight and adiposity at birth, and secondarily to estimate associations between PFAS concentrations and maternal glucose and lipids, and to evaluate the potential for these nutrients to mediate associations between PFAS and neonatal outcomes. METHODS: Within the Healthy Start prospective cohort, concentrations of 11 PFAS, fasting glucose, and lipids were measured in maternal mid-pregnancy serum (n=628). Infant body composition was measured using air displacement plethysmography. Associations between PFAS and birth weight and adiposity, and between PFAS and maternal glucose and lipids, were estimated via linear regression. Associations were decomposed into direct and indirect effects. RESULTS: Five PFAS were detectable in >50% of participants. Maternal perfluorooctanoate (PFOA) and perfluorononanoate (PFNA) concentrations were inversely associated with birth weight. Adiposity at birth was approximately 10% lower in the highest categories of PFOA, PFNA, and perfluorohexane sulfonate (PFHxS) compared to the lowest categories. PFOA, PFNA, perfluorodecanoate (PFDeA), and PFHxS were inversely associated with maternal glucose. Up to 11.6% of the effect of PFAS on neonatal adiposity was mediated by maternal glucose concentrations. Perfluorooctane sulfonate (PFOS) was not significantly associated with any outcomes studied. CONCLUSIONS: Follow-up of offspring will determine the potential long-term consequences of lower weight and adiposity at birth associated with prenatal PFAS exposure. https://doi.org/10.1289/EHP641.
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Many observational studies have demonstrated the presence of EDC in maternal and fetal serum and urine, amniotic fluid, cord blood and breast milk.
“Many observational studies have demonstrated the presence of EDC in maternal and fetal serum and urine, amniotic fluid, cord blood and breast milk [196,197,198].”
From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [198]
The Methods (Exposure Measurement; page unavailable) describe measuring PFAS in maternal serum, and the Introduction reports PFAS detection among pregnant women and infants. The References include studies of PFAS in cord serum and breast milk. Our copy does not substantiate the full list of specimens—particularly maternal or fetal urine and amniotic fluid—or extend this finding beyond PFAS to EDCs generally. (LLM, conf=0.85)
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- Authors
- Starling, A. P., Adgate, J. L., Hamman, R. F., Kechris, K., Calafat, A. M., Ye, X., & Dabelea, D.
- Affiliations
- Colorado School of Public Health (US)
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Starling, Anne P.
- ORCID
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2017-06-23
- Volume
- 125
- Issue
- 6
- Pages
- 067016-067016
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC5743451
- OpenAlex
- W2732882797
- Cited by
- 142
- References
- 70
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 15 · 2023: 24 · 2022: 21 · 2021: 17 · 2020: 16 · 2019: 15 · 2018: 9
- FWCI
- 6.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK076648)
- National Institute of Environmental Health Sciences (K99ES025817, R01ES022934)
- 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 › Toxic Organic Pollutants Impact
- Keywords
- per- and polyfluoroalkyl substances, birth weight, neonatal adiposity, maternal fasting glucose, mediation analysis, perfluorooctanoic acid, perfluorononanoate, PFHxS, PFOS, infant body composition
- MeSH terms
- Adult, Caprylates, Environmental Pollutants, Fasting, Female, Fluorocarbons, Glucose, Humans, Infant, Newborn, Male, Pregnancy, Prospective Studies, Alkanesulfonic Acids, Maternal Exposure, Adiposity, Pediatric Obesity
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