Prenatal Exposure to Perfluoroalkyl Substances and Birth Outcomes; A Pooled Analysis in the Danish National Birth Cohort

Perfluoroalkyl substances (PFASs) are widespread industrial pollutants that are extremely persistent in the environment. Animal studies have indicated that in-utero PFAS exposures can affect fetal growth, but findings from human studies are inconclusive. Few human studies have sufficient sample size to study the influence of PFASs on adverse birth outcomes. Here, we conducted a pooled analysis using data of 3,535 mothers and infant pairs using three sub-samples originating from the Danish National Birth Cohort (DNBC), and we evaluated the associations between prenatal PFASs exposures and birth outcomes. Maternal plasma concentrations of six types of PFASs in early pregnancy (around 8.7 gestational weeks) were studied. We found that each LN-ng/ml increase in PFOS, PFOA, PFNA and PFHpS was associated with a 65g, 51g, 52g or 56g decrease in birth weight. Moreover, we also found that prenatal PFOS, PFHpS, PFDA levels were associated with the risks for preterm birth (< 37 completed gestational week). Our findings strengthen the evidence that in-utero PFAS exposures may affect fetal growth. These findings raise concerns considering the ubiquitous contamination of PFASs in the environment. Public health strategies to prevent or lower PFASs exposures in pregnant women are needed