Evidence map›Paper›PMID 35400049›Full record

SynthesisFrontiers in public health2022

Association Between Exposure to Per- and Polyfluoroalkyl Substances and Birth Outcomes: A Systematic Review and Meta-Analysis.

Si-Yu Gui, Yue-Nan Chen, Ke-Jia Wu, Wen Liu, Wen-Jing Wang, Huan-Ru Liang, Zheng-Xuan Jiang, Ze-Lian Li, Cheng-Yang Hu

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Frontiers in public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Article
  7. Stress-activated pathways mediate PFAS effects on human placental syncytiotrophoblast cells.Toxicological sciences : an official journal of the Society of Toxicology · 2026
    Article
  8. Article
  9. Article
  10. Article
  11. FIGO committee opinion: Environmental drivers of obstetric health and early childhood development.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
    Article
  12. Review
  13. Article
  14. Article
  15. Review
  16. Epigenetic Consequences of In Utero PFAS Exposure: Implications for Development and Long-Term Health.International journal of environmental research and public health · 2025
    Review
  17. Observational
  18. Perfluoroalkyl substances and preterm birth.Journal of perinatology : official journal of the California Perinatal Association · 2025
    Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Si-Yu GuiDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Yue-Nan ChenDepartment of Pharmacy, School of Clinical Pharmacy, Anhui Medical University, Hefei, China.
Ke-Jia WuDepartment of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, Hefei, China.
Wen LiuDepartment of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, Hefei, China.
Wen-Jing WangDepartment of Pharmacy, School of Clinical Pharmacy, Anhui Medical University, Hefei, China.
Huan-Ru LiangDepartment of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Zheng-Xuan JiangDepartment of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Ze-Lian LiDepartment of Gynecology and Obstetrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Cheng-Yang HuDepartment of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, Hefei, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A large body of emerging evidence suggests that per- and polyfluoroalkyl substances (PFAS) affect birth outcomes in various pathways, but the evidence is inconsistent. Therefore, this study aimed to systematically review the epidemiological evidence on PFAS exposure and birth outcomes. Methods: Three electronic databases were searched for epidemiological studies through February 13, 2021. We used random-effects meta-analysis for eight birth outcome indicators to calculate summary effect estimates for various exposure types. The risk of bias and the overall quality and level of evidence for each exposure-outcome pair were assessed. Results: The initial search identified 58 potentially eligible studies, of which 46 were ultimately included. Many PFAS were found to have previously unrecognized statistically significant associations with birth outcomes. Specifically, birth weight (BW) was associated with PFAS, with effect sizes ranging from -181.209 g (95% confidence interval (CI) = -360.620 to -1.798) per 1 ng/ml increase in perfluoroheptanesulfonate (PFHpS) to -24.252 g (95% CI = -38.574 to -9.930) per 1 ln (ng/ml) increase in perfluorodecaoic acid (PFDA). Similar patterns were observed between other PFAS and birth outcomes: perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) with birth length (BL) and ponderal index (PI), PFOS and perfluorododecanoic acid (PFDoDA) with head circumference (HC), PFHpS with gestational age (GA), and perfluorononanoic acid (PFNA) and PFHpS with preterm birth (PTB). Additionally, PFDA showed a statistically significant association with small for gestational age (SGA). The level of the combined evidence for each exposure-outcome pair was considered to be "moderate". Conclusion: This study showed that PFAS exposure was significantly associated with increased risks of various adverse birth outcomes and that different birth outcome indicators had different degrees of sensitivity to PFAS. Further studies are needed to confirm our results by expanding the sample size, clarifying the effects of different types or doses of PFAS and the time of blood collection on birth outcomes, and fully considering the possible confounders.

Indexed as

Environmental PollutantsFluorocarbonsPremature BirthGestational AgeHumansInfant, NewbornEnvironmental PollutantsFluorocarbonsbirth outcomebirth weightmeta-analysisper- and polyfluoroalkyl substancessystematic review

Identifiers

PMID35400049
PMCPMC8988915

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.