Associations of Gestational Perfluoroalkyl Substances Exposure with Early Childhood BMI z-Scores and Risk of Overweight/Obesity: Results from the ECHO Cohorts

• Authors: Yun Liu, Brown University; Adaeze C Wosu, Johns Hopkins Bloomberg Sch Publ Hlth; Abby F Fleisch, Maine Medical Center and Maine Medical Center Research Institute; Anne Dunlop, Emory University; Anne P Starling, University of North Carolina Chapel Hill; Assiamira Ferrara, Permanente Northern California; Dana Dabelea, University of Colorado Anschutz Medical Campus; Emily Oken, Harvard Medical School; Jessie P Buckley, Johns Hopkins Bloomberg School of Public Health; Leda Chatzi, University of Southern California; Margaret R Karagas, Dartmouth College; Megan E Romano, Dartmouth College; Susan Schantz, University of Illinois at Urbana-Champaign; Thomas G O'Connor, University of Rochester; Tracey J Woodruff, University of California San Francisco; Yeyi Zhu, University of Colorado Anschutz Medical Campus; Ghassan B Hamra, Johns Hopkins Bloomberg Sch Publ Hlth; Joseph M Braun, Brown University
• Journal Title: ENVIRONMENTAL HEALTH PERSPECTIVES
• Volume: Volume 131, Number 6
• Publisher: US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE | 2023-06-01, Pages 67001-67001
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1289/EHP11545
• Subjects: Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Environmental Sciences; Public, Environmental & Occupational Health; Toxicology; Environmental Sciences & Ecology; MATERNAL SERUM; PRENATAL EXPOSURE; EARLY-PREGNANCY; OBESITY; ADIPOSITY; PROJECT; FETAL; AGE

Abstract

BACKGROUND: Gestational per-and polyfluoroalkyl substances (PFAS) exposure may be associated with adiposity and increased risk of obesity among children and adolescents. However, results from epidemiological studies evaluating these associations are inconsistent. OBJECTIVES: We estimated the associations of pregnancy PFAS concentrations with child body mass index (BMI) z-scores and risk of overweight/ obesity in eight U.S. cohorts. METHODS: We used data from 1,391 mother–child pairs who enrolled in eight Environmental influences on Child Health Outcomes (ECHO) cohorts (enrolled: 1999–2019). We quantified concentrations of seven PFAS in maternal plasma or serum in pregnancy. We measured child weight and height between the ages of 2 and 5 y and calculated age-and sex-specific BMI z-scores; 19.6% children had more than one BMI measurement. We estimated covariate-adjusted associations of individual PFAS and their mixture with child BMI z-scores and risk of overweight/obesity using linear mixed models, modified Poisson regression models, and Bayesian approaches for mixtures. We explored whether child sex modified these associations. RESULTS: We observed a pattern of subtle positive associations of PFAS concentrations in pregnancy with BMI z-scores and risk of overweight/obesity. For instance, each doubling in perfluorohexane sulfonic acid concentrations was associated with higher BMI z-scores (b =0:07; 95% CI: 0.01, 0.12). Each doubling in perfluroundecanoic acid [relative risk ðRRÞ =1:10; 95% CI: 1.04, 1.16] and N-methyl perfluorooctane sulfonamido acetic acid (RR = 1:06; 95% CI: 1.00, 1.12) was associated with increased risk of overweight/obesity, with some evidence of a monotonic dose–response relation. We observed weaker and more imprecise associations of the PFAS mixture with BMI or risk of overweight/obesity. Associations did not differ by child sex. DISCUSSION: In eight U.S.-based prospective cohorts, gestational exposure to higher levels of PFAS were associated with slightly higher childhood BMI z-score and risk of overweight or obesity. Future studies should examine associations of gestational exposure to PFAS with adiposity and related cardiometabolic consequences in older children. https://doi.org/10.1289/EHP11545.