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Peer-reviewedCC BY-NC-NDEnvironmental science & technology

Gestational Exposure to Endocrine-Disrupting Chemicals and Small Vulnerable Newborns: A Systematic Review and Meta-Analysis.

  • Guoqi Yu1,2,3
  • Xi Meng4
  • Yue Qian Tan1,2
  • Claire Guivarch1,2,3
  • Shuman Li5
  • Xin Yin1,2,3,6
  • Wei Wei Pang1,2,3,7
  • Jiaxi Yang1,2,3
  • Xiaobin Wang8,9
  • Howard Bauchner10
  • Cuilin Zhang1,2,3,11
11 affiliations
  1. 1Global Centre for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, 117549, Singapore.
  2. 2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore.
  3. 3Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, 117456, Singapore.
  4. 4Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200025, China.
  5. 5Division of Child and Adolescent Health, Shanghai Municipal Center for Disease Control and Prevention, Shanghai200336, China.
  6. 6School of Medicine, The Chinese University of Hong Kong, Shenzhen, Guangdong518172, China.
  7. 7Institute for Human Development and Potential (IHDP), Agency for Science, Technology and Research (A*STAR), Singapore117609, Singapore.
  8. 8Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland21205, United States.
  9. 9Department of Pediatrics, Division of General Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland21205, United States.
  10. 10Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts02118, United States.
  11. 11Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts02108, United States.
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Abstract

Endocrine-disrupting chemicals (EDCs) have been implicated in adverse birth outcomes, yet epidemiological findings remain inconsistent. We conducted a systematic review and meta-analysis to evaluate associations between gestational EDC exposure and small vulnerable newborns (SVNs), including preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). PubMed, Web of Science, and Embase were searched from inception to January 5, 2026. A total of 106 observational studies involving 98,133 births from 31 countries were included. Higher prenatal exposure to several per- and polyfluoroalkyl substances (PFAS), including perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), was associated with an increased risk of PTB, while PFOS was also associated with LBW. Perfluorooctanoic acid (PFOA), PFNA, PFDA, and perfluorohexanesulfonic acid (PFHxS) were positively associated with SGA. Among other EDCs, higher exposure to ∑DEHP, mono-2-cyclohexyl phthalate (MCPP), mono(2-ethylhexyl) phthalate (MECPP), monoisobutyl phthalate (MiBP), and bisphenol A (BPA) was associated with increased PTB risk. Stratified analyses suggested stronger associations in Asian populations, pregnancies with female fetuses, and countries without or with partial folic acid fortification. These findings indicate that prenatal exposure to PFAS and phthalates may increase the risk of SVNs, particularly PTB, and that population characteristics may modify these associations.

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Cite

BibTeXRIS
BibTeX
@article{yu2026gestational,
  title = {{Gestational Exposure to Endocrine-Disrupting Chemicals and Small Vulnerable Newborns: A Systematic Review and Meta-Analysis.}},
  author = {Guoqi Yu and Xi Meng and Yue Qian Tan and Claire Guivarch and Shuman Li and Xin Yin and Wei Wei Pang and Jiaxi Yang and Xiaobin Wang and Howard Bauchner and Cuilin Zhang},
  journal = {Environmental science \& technology},
  year = {2026},
  month = sep,
  doi = {10.1021/acs.est.6c06784},
  url = {https://europepmc.org/article/MED/42915439},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Gestational Exposure to Endocrine-Disrupting Chemicals and Small Vulnerable Newborns: A Systematic Review and Meta-Analysis.
AU  - Guoqi Yu
AU  - Xi Meng
AU  - Yue Qian Tan
AU  - Claire Guivarch
AU  - Shuman Li
AU  - Xin Yin
AU  - Wei Wei Pang
AU  - Jiaxi Yang
AU  - Xiaobin Wang
AU  - Howard Bauchner
AU  - Cuilin Zhang
PY  - 2026
DA  - 2026/09/01
JO  - Environmental science & technology
DO  - 10.1021/acs.est.6c06784
UR  - https://europepmc.org/article/MED/42915439
AB  - Endocrine-disrupting chemicals (EDCs) have been implicated in adverse birth outcomes, yet epidemiological findings remain inconsistent. We conducted a systematic review and meta-analysis to evaluate associations between gestational EDC exposure and small vulnerable newborns (SVNs), including preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). PubMed, Web of Science, and Embase were searched from inception to January 5, 2026. A total of 106 observational studies involving 98,133 births from 31 countries were included. Higher prenatal exposure to several per- and polyfluoroalkyl substances (PFAS), including perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), was associated with an increased risk of PTB, while PFOS was also associated with LBW. Perfluorooctanoic acid (PFOA), PFNA, PFDA, and perfluorohexanesulfonic acid (PFHxS) were positively associated with SGA. Among other EDCs, higher exposure to ∑DEHP, mono-2-cyclohexyl phthalate (MCPP), mono(2-ethylhexyl) phthalate (MECPP), monoisobutyl phthalate (MiBP), and bisphenol A (BPA) was associated with increased PTB risk. Stratified analyses suggested stronger associations in Asian populations, pregnancies with female fetuses, and countries without or with partial folic acid fortification. These findings indicate that prenatal exposure to PFAS and phthalates may increase the risk of SVNs, particularly PTB, and that population characteristics may modify these associations.
SN  - 0013-936X
SN  - 1520-5851
ER  -