The association between maternal perfluoroalkylated substances exposure and neonatal birth weight: a system review and meta-analysis

Abstract Some studies have shown that maternal exposure to perfluoroalkyl substances (PFAS) may be related to the neonatal birth weight. The purpose of this study was to explore this relationship between maternal exposure to PFAS and neonatal birth weight. All papers published before March 2024 were retrieved from the Web of Science, PubMed, and Embase databases. A thorough meta-analysis was carried out, involving data extracted from 1,673 samples obtained from a total of 24 articles. Our study found a significantly negative association between maternal PFOS exposure and neonatal birth weight ( β = −71.55; 95 %CI= −114.47, −28.62), with high heterogeneity ( I 2 =64.15 %, p<0.0001). Similarly, there was a significant negative correlation between maternal PFOA exposure and neonatal birth weight ( β = −81.26; 95 %CI= −126.08, −36.43), with high heterogeneity ( I 2 =67.23 %, p<0.0001). Subunit analysis showed that there was a significantly negative correlation between PFOS exposure and neonatal birth weight in mid-to-late pregnancy and after delivery ( β = −97.87; 95 %CI= −181.83, −13.92, β = −138.06; 95 %CI= −255.91, −20.20), PFOA exposure showed a negative correlation with neonatal birth weight in mid-to-late pregnancy ( β = −85.89; 95 %CI= −139.31, −32.47), while PFNA exposure also showed a negative correlation with neonatal birth weight in mid-to-late pregnancy ( β = −90.39; 95 %CI= −152.90, −27.88). However, no significant correlation was observed for PFNA exposure ( β =3.95; 95% CI= −10.41, 18.31), with medium heterogeneity ( I 2 =40.56 %, p=0.0574), or for PFHxS exposure ( β =4.61; 95 %CI= −10.60, 19.81), with medium heterogeneity ( I 2 =29.27 %, p=0.1368). Further research is needed to better understand the implications of these findings on maternal and neonatal health.