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Background: Per- 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.
Objectives: We estimated risk of adverse birth outcomes in relation to prenatal PFAS concentrations and evaluate whether maternal stress modifies those relationships.
Methods: We 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.
Results: We 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 [95% confidence interval (CI): , ], (95% CI: , ), (95% CI: , ), (95% CI: , 0.06), and (95% CI: , ), respectively. We observed a lower odds ratio (OR) for large-for-gestational-age: (95% CI: 0.38, 0.83), (95% CI: 0.35, 0.77). For a 1-unit increase in log-normalized concentration of summed PFAS, we observed a lower birthweight-for-gestational-age z-score [; 95% highest posterior density (HPD): , ] and decreased odds of large-for-gestational-age (; 95% HPD: 0.29, 0.82). Perfluorodecanoic acid (PFDA) explained the highest percentage (40%) of the summed effect in both models. Associations were not modified by maternal perceived stress.
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.
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http://dx.doi.org/10.1289/EHP10723 | DOI Listing |
JAMA Pediatr
September 2025
Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Importance: Neonatal intensive care has advanced over recent decades, yet premature birth remains associated with increased neonatal mortality and morbidity.
Objective: To describe health service use, morbidity, and medication needs up to age 5 years in a contemporary cohort of children born preterm.
Design, Setting, And Participants: This population-based cohort study was conducted in British Columbia (BC), Canada, using health service and pharmacy data linked using provincial administrative databases.
JAMA
September 2025
Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands.
Importance: Pregnant individuals with polycystic ovary syndrome (PCOS) present with a higher risk of pregnancy complications, including gestational diabetes, preeclampsia, and preterm birth. Myo-inositol supplementation may reduce these risks.
Objective: To determine whether daily supplementation with myo-inositol during pregnancy among individuals with PCOS reduces the risk of a composite outcome of gestational diabetes, preeclampsia, and preterm birth.
JAMA Pediatr
September 2025
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Importance: For the first time in nearly 2 decades, the US infant mortality rate has increased, coinciding with a rise in overdose-related deaths as a leading cause of pregnancy-associated mortality in some states. Prematurity and low birth weight-often linked to opioid use in pregnancy-are major contributors.
Objective: To assess the health and economic impact of perinatal opioid use disorder (OUD) treatment on maternal and postpartum health, infant health in the first year of life, and infant long-term health.
JAMA Netw Open
September 2025
Department of Epidemiology, University of Texas Health Science Center at Houston School of Public Health, Houston.
Importance: Trisomy 13 (T13) and trisomy 18 (T18) are chromosomal abnormalities with high mortality rates in the first year of life. Understanding differences in long-term survival between children with full vs mosaic or partial trisomy is crucial for prognosis and health care planning.
Objective: To examine the differences in 10-year survival between children with full T13 and T18 vs those with mosaic or partial trisomy.
Pediatr Surg Int
September 2025
Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Purpose: The timing of elective surgery for asymptomatic congenital pulmonary airway malformation (CPAM) at birth remains controversial. We aimed to describe characteristics and outcomes of patients who underwent surgery for CPAM.
Methods: We retrospectively identified patients aged < 18 years who were hospitalized for CPAM during the neonatal period and underwent surgery between July 2010 and March 2022 using the Diagnosis Procedure Combination database in Japan.