ArticleEnvironmental health perspectives2023
Birth Outcomes in Relation to Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Stress in the Environmental Influences on Child Health Outcomes (ECHO) Program.
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Article in Environmental health perspectives, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 1 of them a synthesis that pooled it.
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58citing papers in PubMed, 1 pooled it
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Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Birth weight in relation to maternal and neonatal biomarker concentration of perfluorooctane sulfonic acid: a meta-analysis and meta-regression from a systematic review.Journal of exposure science & environmental epidemiology · 2025Pooled it
- Handling of multicohort data in pooled analysis of environmental exposures: confounding by cohort of the relationship between perfluoroalkyl substances and birthweight in the ECHO Program.American journal of epidemiology · 2026Article
- Dietary folate, vitamin D, and inflammation modify associations between prenatal per- and polyfluoroalkyl substance (PFAS) exposures and fetal growth.Nutrition and health · 2026Article
- Early Life Exposure to PFOS or F‑53B is Associated with Increased Asthma Susceptibility in Offspring and Alterations in the Pulmonary Barrier, Immune Function, and Gut Microbiota.Environment & health (Washington, D.C.) · 2026Article
- In Utero Per- and Polyfluoroalkyl Substances (PFAS) Exposure and Changes in Infant T Helper Cell Development among UPSIDE-ECHO Cohort Participants.Environmental health perspectives · 2026Article
- Associations between prenatal per- and polyfluoroalkyl substances (PFAS) exposure and fetal growth measurements in utero and at birth in the LIFECODES cohort: 2006-2019.Environmental research · 2026Article
- Stress-activated pathways mediate PFAS effects on human placental syncytiotrophoblast cells.Toxicological sciences : an official journal of the Society of Toxicology · 2026Article
- Association between parental firefighting status and adverse birth outcomes in Arizona: a cross-sectional study.Occupational and environmental medicine · 2026Article
- Unraveling Plastic-Related Chemical Exposures during Pregnancy and Their Associations with Pregnancy Outcomes Using Suspect Screening Analysis.Environment & health (Washington, D.C.) · 2026Article
- New Mechanistic Evidence for Perfluorodecanoic Acid (PFDA) Teratogenicity via CYP26A1-Mediated Retinoic Acid Metabolism and Signaling.Chemical research in toxicology · 2026Article
- Role of one-carbon metabolism variants in the associations between perfluoroalkyl substances exposure and birth size in the Taiwan Birth Panel Study.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- Per- and polyfluoroalkyl substances serum concentrations during pregnancy and gestational weight gain in the Healthy Start Study.International journal of hygiene and environmental health · 2026Article
- Effects of gestational perfluorohexanesulfonic acid exposure at human realistic dose on social communication deficit in mouse offspring.EBioMedicine · 2026Article
- Associations between PFAS in public water system drinking water and serum among Southern California adults.Journal of exposure science & environmental epidemiology · 2026Article
- Association between gestational PFAS exposure biomarkers and risk of preeclampsia in the ECHO Cohort.Environmental research · 2026Article
- A prospective study of per- and polyfluoroalkyl substances (PFAS), stress, and birth size in a cohort of U.S. Black women.Environmental health : a global access science source · 2026Article
- Associations between prenatal per- and polyfluoroalkyl substances (PFAS) and repeated measures of bioactive lipids during pregnancy in the LIFECODES cohort.The Science of the total environment · 2026Article
- Psychosocial stressors as modifiers of the associations between well-studied and understudied chemicals and birth outcomes in the ECHO Cohort.Environmental pollution (Barking, Essex : 1987) · 2026Article
- Gestational PFAS concentrations in association with maternal depression and perceived stress during pregnancy and postpartum in the ECHO cohort.Environmental research · 2025Article
- Association between prenatal exposures to per- and polyfluoroalkyl substances and early language development in the ECHO cohort.Neurotoxicology · 2025Article
Corrections and comments
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Authors and funding
30 authors.
Amy M PadulaProgram for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0003-1435-4814
Xuejuan NingDepartment of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0002-8523-0483
Shivani BakreDepartment of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
Emily S BarrettDepartment of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA.
Tracy BastainDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Deborah H BennettDepartment of Public Health Sciences, University of California, Davis, Davis, California, USA.
Michael S BloomDepartment of Global and Community Health, George Mason University, Fairfax, Virginia, USA.
Carrie V BretonDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Anne L DunlopDepartment of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Stephanie M EickProgram for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA.
Assiamira FerraraDivision of Research, Kaiser Permanente Northern California, Oakland, California, USA.
Abby FleischCenter for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, Maine, USA.
Sarah GeigerDepartment of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA.
Dana E GoinProgram for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA.
Kurunthachalam KannanDepartment of Pediatrics and Department of Environmental Medicine, New York University Grossman School of Medicine, New York, New York, USA.
Margaret R KaragasDepartment of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA.
Susan KorrickDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
John D MeekerDepartment of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA.
Rachel Morello-FroschSchool of Public Health and Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, California, USA.
Thomas G O'ConnorDepartment of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Emily OkenDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Morgan RobinsonDepartment of Pediatrics and Department of Environmental Medicine, New York University Grossman School of Medicine, New York, New York, USA.
Megan E RomanoDepartment of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA.
Susan L SchantzBeckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA.
Rebecca J SchmidtDepartment of Public Health Sciences, University of California, Davis, Davis, California, USA.
Anne P StarlingCenter for Lifecourse Epidemiology of Adiposity and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Yeyi ZhuDivision of Research, Kaiser Permanente Northern California, Oakland, California, USA.
Ghassan B HamraDepartment of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
Tracey J WoodruffProgram for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA.
program collaborators for Environmental influences on Child Health Outcomes
Funding
Project-005U2COD023375 · OD · DUKE UNIVERSITY · PI Phillip Brian Smith · 2016 to 2026
$215.9MECHODAC (Environmental Influences on Child Health Outcomes Data Analysis Center)U24OD023382 · OD · JOHNS HOPKINS UNIVERSITY · PI Diane J Catellier, LISA P JACOBSON · 2016 to 2026
$148.4MTranslational Research Support CoreP30ES005022 · NIEHS · UNIV OF MED/DENT NJ-R W JOHNSON MED SCH · PI BRIAN T BUCKLEY · 1988 to 2026
$47.4MTranslational Research Support CoreP30ES007048 · NIEHS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI ROB S MCCONNELL · 1996 to 2026
$46.4MA prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort StudyUH3OD023275 · OD · DARTMOUTH COLLEGE · PI MARGARET Rita KARAGAS, Juliette Madan · 2018 to 2026
$44.3MThe ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child HealthU24OD023319 · OD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Courtney K Blackwell, RICHARD GERSHON · 2016 to 2026
$43.7MPrenatal and Early Childhood Pathways To Health: An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUH3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2018 to 2022
$37.3MUNC-CH CENTER FOR ENVIRONMENTAL HEALTH &SUSCEPTIBILITYP30ES010126 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Hazel B Nichols · 2001 to 2026
$36.3MLifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory Health (LA DREAMERs)UH3OD023287 · OD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BASTAIN, THERESA M, BRETON, CARRIE VAN DOREN · 2018 to 2022
$28.4MUC Davis Environmental Health Sciences Core CenterP30ES023513 · NIEHS · UNIVERSITY OF CALIFORNIA AT DAVIS · PI Irva Hertz-Picciotto · 2015 to 2026
$26.0MEarly Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and NeurodevelopmentUH3OD023289 · OD · KAISER FOUNDATION RESEARCH INSTITUTE · PI ASSIAMIRA FERRARA, Monique Marie Hedderson · 2018 to 2026
$25.1MRelation Between In-utero Vitamin D and Immune Function in Early Childhood P20GM104416 · NIGMS · DARTMOUTH COLLEGE · PI SALAS DIAZ, LUCAS A · 2013 to 2022
$23.7MNICHD NIH HHS R01 HD083369NIEHS NIH HHS P01 ES022841NIEHS NIH HHS P30 ES005022NIEHS NIH HHS P30 ES007048NIEHS NIH HHS P30 ES010126NIEHS NIH HHS P30 ES017885NIEHS NIH HHS P30 ES023513NIEHS NIH HHS P30 ES030284NIEHS NIH HHS P50 ES026086NIEHS NIH HHS R01 ES027051NIEHS NIH HHS R24 ES028533NIEHS NIH HHS U24 ES028533NIEHS NIH HHS U2C ES026542NIGMS NIH HHS P20 GM104416NIH HHS U24 OD023319NIH HHS U24 OD023382NIH HHS U2C OD023375NIH HHS UG3 OD023271NIH HHS UG3 OD023272NIH HHS UG3 OD023316NIH HHS UH3 OD023248NIH HHS UH3 OD023271NIH HHS UH3 OD023272NIH HHS UH3 OD023275NIH HHS UH3 OD023286NIH HHS UH3 OD023287NIH HHS UH3 OD023289NIH HHS UH3 OD023318NIH HHS UH3 OD023349NINR NIH HHS R01 NR014800
Abstract
backgroundPer- and polyfluoroalkyl substances (PFAS) are persistent and ubiquitous chemicals associated with risk of adverse birth outcomes. Results of previous studies have been inconsistent. Associations between PFAS and birth outcomes may be affected by psychosocial stress.
objectivesWe estimated risk of adverse birth outcomes in relation to prenatal PFAS concentrations and evaluate whether maternal stress modifies those relationships.
methodsWe included 3,339 participants from 11 prospective prenatal cohorts in the Environmental influences on the Child Health Outcomes (ECHO) program to estimate the associations of five PFAS and birth outcomes. We stratified by perceived stress scale scores to examine effect modification and used Bayesian Weighted Sums to estimate mixtures of PFAS.
resultsWe observed reduced birth size with increased concentrations of all PFAS. For a 1-unit higher log-normalized exposure to perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS), we observed lower birthweight-for-gestational-age z-scores of DISCUSSION: Our large, multi-cohort study of PFAS and adverse birth outcomes found a negative association between prenatal PFAS and birthweight-for-gestational-age, and the associations were not different in groups with high vs. low perceived stress. This study can help inform policy to reduce exposures in the environment and humans. https://doi.org/10.1289/EHP10723.
Indexed as
Alkanesulfonic AcidsEnvironmental PollutantsFluorocarbonsPrenatal Exposure Delayed EffectsBayes TheoremBirth WeightChildCohort StudiesDecanoic AcidsFatty AcidsFemaleHumansOutcome Assessment, Health CarePregnancyProspective StudiesAlkanesulfonic AcidsDecanoic AcidsEnvironmental PollutantsFatty AcidsFluorocarbonsperfluorodecanoic acidperfluoro-n-nonanoic acid
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