Association between Maternal Exposure to Per- and Polyfluoroalkyl Substances and Childhood Growth Trajectories up to 4 Years of Age: The Japan Environment and Children’s Study

Maternal exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) during pregnancy may influence fetal and postnatal growth. In this study, we examined the association between maternal plasma PFAS levels during pregnancy and child growth trajectories over the first 4 years of life. Pregnant women were enrolled in the Japan Environment and Children's Study between 2011 and 2014. Eight PFAS were selected, and exposure burden scores were calculated to assess the effects of the PFAS mixtures on child growth. Latent class trajectory models were applied to data from 23,058 children, identifying five growth trajectories based on age- and sex-specific standard deviation scores for weight, height, and body mass index. Perfluorooctanesulfonic acid (PFOS), perfluorohexanesulfonic acid, and perfluorooctanoic acid levels were negatively associated with the odds of high-rising, low-rising, and/or high-weight trajectories. All eight PFAS were positively associated with the low-rising-height trajectory. PFOS was also positively associated with a very low-height trajectory and negatively associated with a high-BMI trajectory. Maternal PFAS exposure may suppress high-stable and rising-weight growth in early childhood. PFAS exposure appears to inhibit fetal height growth; however, catch-up growth may occur during early childhood. PFOS, in particular, may exert a lasting effect on height growth.