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. 2025 Jul 12;24(1):48.
doi: 10.1186/s12940-025-01199-y.

Paternal and maternal exposures to per- and polyfluoroalkyl substances (PFAS) and birth outcomes: a multi-country cohort study

Pengfei Guo  1   2 , Jiajun Luo  3   4 , Jie Zhang  5 , Jens Peter Bonde  6 , Paweł Struciński  7 , Viktor Ohniev  8 , Onyebuchi A Arah  9   10   11   12 , Nicole C Deziel  1   2 , Joshua L Warren  2   13 , Gunnar Toft  5 , Zeyan Liew  14   15
Affiliations

Paternal and maternal exposures to per- and polyfluoroalkyl substances (PFAS) and birth outcomes: a multi-country cohort study

Pengfei Guo et al. Environ Health. .

Abstract

Background: Maternal prenatal exposures to per- and polyfluoroalkyl substances (PFAS) have been linked to adverse birth outcomes. However, few investigations have considered paternal PFAS exposure. We estimated the parent-specific associations of prenatal PFAS exposures with adverse birth outcomes.

Methods: This study included 498 couples from the INUENDO cohort recruited at antenatal care visits in Greenland, Poland, and Ukraine during 2002-2004. We measured five major types of PFAS in parental serum during pregnancy. We analyzed three birth outcomes ascertained from medical records, including gestational age, birth weight, and birth length. We used weighted least squares linear regression to evaluate parent-specific associations of serum PFAS with the birth outcomes, adjusting for parental co-exposures and covariates. We also used quantile g-computation for mixture modeling of the birth outcomes of paternal and/or maternal exposures to multiple PFAS.

Results: No associations were found between maternal and paternal PFAS exposures and gestational age. However, after adjusting for paternal PFOA, a higher level of maternal serum perfluorooctanoate (PFOA) was linked to a tendency towards lower birth weight and shorter birth length. Paternal exposure to several PFAS was also associated with a tendency for shorter birth length, but the estimated effect sizes were small. We found no joint exposure effects in the mixture analyses.

Conclusions: While the evidence was inconclusive, maternal PFOA and paternal PFAS exposures seemed to be associated with lower offspring birth weight and shorter birth length, respectively. Parent-specific effects of PFAS exposures on offspring growth and development warrant further research.

Keywords: Birth outcome; Endocrine disruptors; Environmental pollutants; PFAS; Paternal exposure; Pregnancy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by local ethical committees; Ethical Committee for Human Research in Greenland (approval no. 2010–13), Polish Bioethical Committee (approval no. 6/2002 of 3.07.2002), and the Commission on Ethics, Bioethics Kharkiv National Medical University in Ukraine (protocol number 7, October 7, 2009). All participating parents signed informed consent. Consent for publication: The authors declare that they agree with the publication of this paper in this journal. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Paternal and maternal serum-PFAS concentrations (ng/mL) in the INUENDO cohort (N = 498). Abbreviations: GR, Greenland; PL, Poland; UA, Ukraine. In this study population, blood samples were collected during mid to late pregnancy
Fig. 2
Fig. 2
Associations of parental serum-PFAS concentrations with gestational age, birth weight, and birth length. Mean differences and 95% confidence intervals are presented. Chemical-specific associations were estimated by weighted least squares linear regression for per one interquartile range (IQR) increase in serum-PFAS concentrations (ng/mL), with IQR for each PFAS provided in parentheses. The chemical-specific associations were adjusted for study region, maternal age, parental age difference, paternal and maternal pre-pregnancy BMI, maternal education level, parity, newborn sex, and spousal exposure to the same type of PFAS. Joint associations were estimated by quantile g-computation, adjusted for the same set of covariates and spousal exposure to the same types of PFAS; PFAS mixture modeled as per one quartile increase of individual PFAS exposures of this parent
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