Associations between exposure to perfluoroalkyl substances and birth outcomes: A meta-analysis

Although previous meta-analyses have shown that prenatal PFASs exposure is associated with reduction in birth weight, effects of prenatal PFASs exposure on birth outcomes have not been fully explored. We conducted a meta-analysis of 23 eligible studies searched from Embase, PubMed, and Web of Science before March 21, 2021 to analyze the association between prenatal PFASs exposure and birth outcomes, including premature birth (PTB), low birth weight (LBW), small for gestational age (SGA) and miscarriage. Odds ratio (OR) and corresponding confidence intervals were extracted for analysis. According to the heterogeneity of the included studies, fixed-effects (I² ≤ 50%) and random-effects (I² > 50%) models were applied respectively. The significant associations between PFOS and PTB (pooled OR = 1.54, 95% CI: 1.20-1.98), PFOA and miscarriage (pooled OR = 1.40, 95% CI: 1.15-1.70), and PFOS and LBW (pooled OR = 1.52, 95% CI: 1.19-1.94) were obtained. There were differences between included studies with different study regions, sampling time, and samples type used for PFASs assessment. These findings may provide insight in risk assessment and decision-making in producing products that contain PFASs.