Association of maternal exposure to perfluoroalkyl and polyfluroalkyl substances with infant growth from birth to 12 months: A prospective cohort study

Although maternal perfluoroalkyl and polyfluroalkyl substances (PFASs) were associated with adverse birth outcomes, much less is known about their impact on infant growth during early infancy.We investigated the association between maternal PFASs exposure and infant growth during the first 12 months of life.Participating 2395 pregnancies were recruited from Shanghai Birth Cohort between 2013 and 2016. Ten PFASs were quantified from maternal plasma collected during early pregnancy (median, 15 gestational weeks). We measured infant length, weight, and head circumference at birth, 42 days, 6 months, and 12 months. Linear mixed regression model was used to estimate the associations between PFAS concentrations and repeated measurements of infant growth. Effect modification by infant sex was estimated.Elevated perfluoroheptanoic acid (PFHpA) concentration was negatively associated with infant length-for-age Z score (LAZ) (β = -0.06, 95% confidence interval (CI): -0.11, -0.01) during the first year. Adverse associations were also observed for perfluorobutane sulfonate (PFBS) and weight-for-length Z score (WFL) (β = -0.02, 95% CI: -0.04, -0.00) and BMI-for-age Z score (BAZ) (β = -0.02, 95% CI: -0.04, -0.00). However, perfluorododecanoic acid (PFDoA) was positively associated with WFL (β = 0.03, 95% CI: 0.00, 0.06) and BAZ (β = 0.03, 95% CI: 0.00, 0.06). The adverse association of PFHpA and LAZ was more pronounced among males (β = -0.06; 95% CI: -0.11, -0.00) than females (β = 0.06; 95% CI: 0.01, 0.12).In our study, negative associations were found for maternal PFHpA exposure and infant LAZ, PFBS and WFL and BAZ. Meanwhile, maternal PFDoA exposure was positively related with WFL and BAZ. The adverse association of maternal PFHpA exposure and infant LAZ was more pronounced among males. The results should be interpreted with caution, further prospective cohort studies with longitudinal and detailed measures are warranted to confirm these findings.