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Association between prenatal PFAS exposure and catch-up growth in children born with adverse outcomes: evidence from

Su-Qin Tan1, Yan-Xi Li2, Shao-Ya Huang3

  • 1Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.

Journal of Hazardous Materials
|January 3, 2026
PubMed

Insights

Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) was linked to faster catch-up growth (CUG) in infants born with adverse outcomes. This suggests PFAS may impact early childhood development and long-term health trajectories.

Area of Science:

  • Environmental Health
  • Pediatric Health
  • Toxicology

Background:

  • Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) is linked to adverse birth outcomes.
  • Catch-up growth (CUG) is crucial for infants born with adverse outcomes to achieve normal growth.
  • The impact of prenatal PFAS exposure on CUG has not been previously established.

Purpose of the Study:

  • To investigate the association between prenatal PFAS exposure and catch-up growth (CUG) in children born with adverse birth outcomes.
  • To evaluate the impact of specific PFAS chemicals and their mixtures on CUG.
  • To assess the longitudinal effects of PFAS on growth trajectories.

Main Methods:

  • Longitudinal study of 430 children born with adverse outcomes, monitoring length and weight from 42 days to 36 months.
  • Maternal serum PFAS levels were measured to assess prenatal exposure.
  • Statistical models (single-contaminant and mixture) were used to analyze associations between PFAS levels and CUG in length (L-CUG) and weight (W-CUG).

Main Results:

  • Prenatal PFAS exposure was positively associated with accelerated L-CUG and W-CUG, particularly after 12 months.
  • Specific PFAS, including perfluorooctane sulfonate, perfluorononanoic acid, and perfluorohexane sulfonate (PFHxS), showed significant associations with W-CUG.
  • PFAS mixture exposure was also linked to increased odds of both L-CUG and W-CUG at 18 months.
  • Longitudinal analyses and sensitivity analyses excluding exclusively breastfed children confirmed these robust associations.

Conclusions:

  • This study provides the first evidence that prenatal PFAS exposure is associated with accelerated catch-up growth in infants born with adverse outcomes.
  • Prenatal PFAS exposure may influence early-life growth trajectories and potentially subsequent health outcomes.
  • Further research is warranted to understand the mechanisms and long-term implications of PFAS-associated CUG.

Keywords:
Adverse birth outcomesCatch-up growth in lengthCatch-up growth in weightPer- and polyfluoroalkyl substancesProspective birth cohort study

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