PFAS Exposure During Pregnancy Is Associated with Shorter Gestational Age at Birth and with Growth Trajectories During the First 2 Years of Life
Abstract
IntroductionPrenatal exposure to per- and polyfluoroalkyl substances (PFAS) may influence birth outcomes and postnatal growth and adiposity, yet prospective evidence is limited. We evaluated sex-specific associations of first trimester maternal PFAS exposure with birth outcomes and childrens growth and body composition through age two.
MethodsParticipants were enrolled in the Glowing prospective cohort study (2010-2014, NCT01131117). Levels of six PFAS (PFOS, PFOA, PFBS, PFHxS, PFNA, PFHxA) in maternal serum at 10-12 weeks gestation were analyzed. Five participants were excluded due to unsuccessful PFAS characterization. We tested associations between PFAS exposure and gestational age, birth weight, birth length, and 11 repeated measures of weight, length, fat mass, and fat-free mass (FFM) during the first two years of life with linear regression, SuperImposition by Translation And Rotation growth curve size and intensity, and quantile g-computation.
ResultsAmong 217 complete-case dyads, higher first trimester PFAS concentrations were associated with shorter gestation (PFOS and PFHxS; e.g., PFOS {beta} = -0.198 weeks per doubling, 95% CI -0.368 to -0.028). PFHxS was associated with lower birth weight ({beta} = -0.048 kg, 95% CI -0.093 to -0.002). Among males only, PFOS, PFHxS, PFOA, and PFNA were associated with shorter gestation and PFNA with shorter birth length. For postnatal growth, PFBS was associated with lower weight and fat-free mass growth intensity. PFHxS was associated with smaller length and fat-free mass among females. The joint six-PFAS mixture was not associated with any outcome. Associations were robust to adjustment for maternal albumin and estimated glomerular filtration rate.
ConclusionIn a Central Arkansas birth cohort, first trimester maternal PFAS concentrations, particularly PFHxS, were individually associated with shorter gestation and reduced early growth and fat-free mass accrual, with more sex-specific male associations among birth outcomes and more female associations in longitudinal postnatal growth through age two.
Graphical Abstract
O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=107 SRC="FIGDIR/small/26366022v1_ufig1.gif" ALT="Figure 1"> View larger version (45K): [email protected]@602d9dorg.highwire.dtl.DTLVardef@52cdccorg.highwire.dtl.DTLVardef@4523d6_HPS_FORMAT_FIGEXP M_FIG C_FIG
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BibTeX
@misc{campbell2026pfas,
title = {{PFAS Exposure During Pregnancy Is Associated with Shorter Gestational Age at Birth and with Growth Trajectories During the First 2 Years of Life}},
author = {Kyle A. Campbell and Clark R. Sims and Priyadarshni Patel and Lauren A. Havens and Andrew J. Morris and Kartik Shankar and Kevin J. Pearson and Aline Andres and Todd M. Everson},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.20.26366022},
url = {https://www.medrxiv.org/content/10.64898/2026.10.20.26366022v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - PFAS Exposure During Pregnancy Is Associated with Shorter Gestational Age at Birth and with Growth Trajectories During the First 2 Years of Life
AU - Kyle A. Campbell
AU - Clark R. Sims
AU - Priyadarshni Patel
AU - Lauren A. Havens
AU - Andrew J. Morris
AU - Kartik Shankar
AU - Kevin J. Pearson
AU - Aline Andres
AU - Todd M. Everson
PY - 2026
DA - 2026/10/20
PB - medRxiv
DO - 10.64898/2026.10.20.26366022
UR - https://www.medrxiv.org/content/10.64898/2026.10.20.26366022v1
AB - IntroductionPrenatal exposure to per- and polyfluoroalkyl substances (PFAS) may influence birth outcomes and postnatal growth and adiposity, yet prospective evidence is limited. We evaluated sex-specific associations of first trimester maternal PFAS exposure with birth outcomes and childrens growth and body composition through age two. MethodsParticipants were enrolled in the Glowing prospective cohort study (2010-2014, NCT01131117). Levels of six PFAS (PFOS, PFOA, PFBS, PFHxS, PFNA, PFHxA) in maternal serum at 10-12 weeks gestation were analyzed. Five participants were excluded due to unsuccessful PFAS characterization. We tested associations between PFAS exposure and gestational age, birth weight, birth length, and 11 repeated measures of weight, length, fat mass, and fat-free mass (FFM) during the first two years of life with linear regression, SuperImposition by Translation And Rotation growth curve size and intensity, and quantile g-computation. ResultsAmong 217 complete-case dyads, higher first trimester PFAS concentrations were associated with shorter gestation (PFOS and PFHxS; e.g., PFOS {beta} = -0.198 weeks per doubling, 95% CI -0.368 to -0.028). PFHxS was associated with lower birth weight ({beta} = -0.048 kg, 95% CI -0.093 to -0.002). Among males only, PFOS, PFHxS, PFOA, and PFNA were associated with shorter gestation and PFNA with shorter birth length. For postnatal growth, PFBS was associated with lower weight and fat-free mass growth intensity. PFHxS was associated with smaller length and fat-free mass among females. The joint six-PFAS mixture was not associated with any outcome. Associations were robust to adjustment for maternal albumin and estimated glomerular filtration rate. ConclusionIn a Central Arkansas birth cohort, first trimester maternal PFAS concentrations, particularly PFHxS, were individually associated with shorter gestation and reduced early growth and fat-free mass accrual, with more sex-specific male associations among birth outcomes and more female associations in longitudinal postnatal growth through age two. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=107 SRC="FIGDIR/small/26366022v1_ufig1.gif" ALT="Figure 1"> View larger version (45K): [email protected]@602d9dorg.highwire.dtl.DTLVardef@52cdccorg.highwire.dtl.DTLVardef@4523d6_HPS_FORMAT_FIGEXP M_FIG C_FIG
ER -