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Fetal growth in relation to prenatal per- and polyfluoroalkyl substances exposure: A prospective birth cohort study

Liuqiao Sun1, Yuting Gong2, Doudou Li2

  • 1The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; College of Public Health, Zhengzhou University, Zhengzhou, China.

Environment International
|June 4, 2026
PubMed

Insights

Prenatal exposure to certain per- and polyfluoroalkyl substances (PFAS) like PFPeS, PFHxS, and 6:2 Cl-PFESA may negatively impact fetal growth. This study highlights potential risks associated with these common environmental contaminants during pregnancy.

Area of Science:

  • Environmental Health
  • Reproductive Toxicology
  • Perinatal Epidemiology

Background:

  • Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) is a growing concern.
  • Existing research suggests links between PFAS and adverse birth outcomes, but evidence on specific effects on fetal growth is limited.

Purpose of the Study:

  • To investigate the association between prenatal exposure to various PFAS and fetal growth parameters.
  • To analyze the impact of specific PFAS compounds on fetal development using detailed ultrasound measurements.

Main Methods:

  • A cohort of 2856 pregnant women and their fetuses were analyzed.
  • Sixteen PFAS concentrations were measured, and five fetal ultrasound parameters (BPD, HC, AC, FL, EFW) were collected at multiple gestational weeks.
  • Statistical models including generalized linear, linear mixed, and multinomial logistic regression were employed to assess associations.

Main Results:

  • Higher prenatal exposure to perfluoropentane sulfonate (PFPeS) was associated with reduced biparietal diameter (BPD) and head circumference (HC) standard deviation scores (SDS).
  • Elevated perfluorohexane sulfonate (PFHxS) exposure correlated with reduced femur length (FL) and estimated fetal weight (EFW) SDS, and an increased likelihood of slower FL growth trajectory.
  • Higher 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA) exposure was linked to reduced BPD, HC, FL, and EFW SDS, and an increased likelihood of slow EFW growth trajectory, though these trajectory findings were attenuated after multiple testing correction.

Conclusions:

  • Prenatal exposure to PFPeS, PFHxS, and 6:2 Cl-PFESA may be associated with retarded fetal growth.
  • These findings underscore the potential risks of specific PFAS compounds to fetal development.
Abstract

Keywords:
Birth cohortFetal growthPer- and polyfluoroalkyl substancesPrenatal exposure

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