Associations of maternal PFAS exposure with offspring growth trajectories from birth to age 2 years

Evidence regarding maternal per- and polyfluoroalkyl substances (PFAS) exposure on offspring physical development is inconsistent. This study included 937 mother-infant pairs from the Jiashan Birth Cohort. Thirteen PFAS congeners were quantified in maternal peripheral blood at the first prenatal visit (< 16 weeks of gestation). Data on offspring weight and length from birth to 24 months of age were extracted, and Z-scores for weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) were calculated. Group-based trajectory modeling (GBTM) was applied to fit growth trajectories. Maternal PFTrDA exposure was associated with higher likelihood of offspring in WAZ "rising" groups, specifically the "Low-start rapid-rise" (OR: 1.37, 95% CI: 1.09, 1.71), "High-start slow-rise" (OR: 1.29, 95% CI: 1.07, 1.56), and "High-start rapid-rise" (OR: 1.46, 95% CI: 1.10, 1.96) groups. PFHxS and PFNA were linked to the LAZ-"Low-start rapid-rise" group (OR: 1.48, 95% CI: 1.07, 2.05; OR: 1.24, 95% CI: 1.02, 1.51, respectively), while PFTrDA was associated with the LAZ-"High-start rapid-rise" group (OR: 1.23, 95% CI: 1.01, 1.51). Most PFAS were associated with elevated likelihood of offspring in the WLZ-"Medium-start rapid-rise" group (ORs: 1.26-1.43). Bayesian kernel machine regression further confirmed the joint effects of the PFAS mixture on rising WAZ/WLZ trajectories and PFTrDA as the key chemical driving the association with the WAZ-"High-start rapid-rise" group. These findings provide evidence for associations between maternal PFAS exposure and offspring growth trajectories during early life.