Prenatal Exposure to Perfluoroalkyl Substances and Adiposity in Early and Mid-Childhood

Environ Health Perspect. 2017 Mar;125(3):467-473. doi: 10.1289/EHP246. Epub 2016 Jun 28.


Background: Few studies have examined whether prenatal exposure to perfluoroalkyl substances (PFASs) is associated with childhood adiposity.

Objective: We examined associations of prenatal exposure to PFASs with adiposity in early and mid-childhood.

Methods: We measured plasma PFAS concentrations in 1,645 pregnant women (median, 9.6 weeks gestation) enrolled in Project Viva, a prospective pre-birth cohort study in Massachusetts (USA), between 1999 and 2002. We assessed overall and central adiposity in 1,006 children in early childhood (median, 3.2 years) and 876 in mid-childhood (median, 7.7 years) using anthropometric and dual X-ray absorptiometry (DXA) measurements. We fitted multivariable linear regression models to estimate exposure-outcome associations and evaluated effect modification by child sex.

Results: Median (25-75th percentiles) prenatal plasma perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoate (PFNA) concentrations in children assessed in early childhood were 5.6 (4.1-7.7), 24.8 (18.4-33.9), 2.4 (1.6-3.8), and 0.6 (0.5-0.9) ng/mL, respectively. Among girls, each interquartile range increment of prenatal PFOA concentrations was associated with 0.21 kg/m2 (95% CI: -0.05, 0.48) higher body mass index, 0.76 mm (95% CI: -0.17, 1.70) higher sum of subscapular and triceps skinfold thickness, and 0.17 kg/m2 (95% CI: -0.02, 0.36) higher DXA total fat mass index in mid-childhood. Similar associations were observed for PFOS, PFHxS, and PFNA. We observed null associations for boys and early-childhood adiposity measures.

Conclusions: In this cohort, prenatal exposure to PFASs was associated with small increases in adiposity measurements in mid-childhood, but only among girls. Citation: Mora AM, Oken E, Rifas-Shiman SL, Webster TF, Gillman MW, Calafat AM, Ye X, Sagiv SK. 2017. Prenatal exposure to perfluoroalkyl substances and adiposity in early and mid-childhood. Environ Health Perspect 125:467-473;

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adiposity / physiology*
  • Alkanesulfonic Acids
  • Caprylates
  • Child, Preschool
  • Environmental Pollutants / blood*
  • Female
  • Fluorocarbons / blood*
  • Humans
  • Male
  • Massachusetts
  • Maternal Exposure / statistics & numerical data*
  • Obesity / epidemiology*


  • Alkanesulfonic Acids
  • Caprylates
  • Environmental Pollutants
  • Fluorocarbons
  • hexadecafluoro-nonanoic acid
  • perfluorooctanoic acid
  • perfluorooctane sulfonic acid
  • perflexane