{"doi":"10.1289/ehp11545","title":"Associations of Gestational Perfluoroalkyl Substances Exposure with Early Childhood BMI z-Scores and Risk of Overweight/Obesity: Results from the ECHO Cohorts","abstract":"Background: Gestational per- and polyfluoroalkyl substances (PFAS) exposure may be associated with adiposity and increased risk of obesity among children and adolescents. However, results from epidemiological studies evaluating these associations are inconsistent. Objectives: We estimated the associations of pregnancy PFAS concentrations with child body mass index (BMI) z-scores and risk of overweight/obesity in eight U.S. cohorts. Methods: We used data from 1,391 mother–child pairs who enrolled in eight Environmental influences on Child Health Outcomes (ECHO) cohorts (enrolled: 1999–2019). We quantified concentrations of seven PFAS in maternal plasma or serum in pregnancy. We measured child weight and height between the ages of 2 and 5 y and calculated age- and sex-specific BMI z-scores; 19.6% children had more than one BMI measurement. We estimated covariate-adjusted associations of individual PFAS and their mixture with child BMI z-scores and risk of overweight/obesity using linear mixed models, modified Poisson regression models, and Bayesian approaches for mixtures. We explored whether child sex modified these associations. Results: We observed a pattern of subtle positive associations of PFAS concentrations in pregnancy with BMI z-scores and risk of overweight/obesity. For instance, each doubling in perfluorohexane sulfonic acid concentrations was associated with higher BMI z-scores (β=0.07; 95% CI: 0.01, 0.12). Each doubling in perfluroundecanoic acid [relative risk (RR)=1.10; 95% CI: 1.04, 1.16] and N-methyl perfluorooctane sulfonamido acetic acid (RR=1.06; 95% CI: 1.00, 1.12) was associated with increased risk of overweight/obesity, with some evidence of a monotonic dose–response relation. We observed weaker and more imprecise associations of the PFAS mixture with BMI or risk of overweight/obesity. Associations did not differ by child sex. Discussion: In eight U.S.-based prospective cohorts, gestational exposure to higher levels of PFAS were associated with slightly higher childhood BMI z-score and risk of overweight or obesity. Future studies should examine associations of gestational exposure to PFAS with adiposity and related cardiometabolic consequences in older children. https://doi.org/10.1289/EHP11545","journal":"Environmental Health Perspectives","year":2023,"id":320076,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":51,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9317,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":364003,"name":"Adaeze C. Wosu","orcid":"0000-0003-2216-1211","position":1,"is_corresponding":false},{"id":254531,"name":"Abby F. Fleisch","orcid":"0000-0002-2789-6412","position":2,"is_corresponding":false},{"id":292675,"name":"Anne L. Dunlop","orcid":"0000-0002-5092-8136","position":3,"is_corresponding":false},{"id":282187,"name":"Anne P. Starling","orcid":"0000-0002-6638-8314","position":4,"is_corresponding":false},{"id":381696,"name":"Assiamira Ferrara","orcid":"0000-0002-7505-4826","position":5,"is_corresponding":false},{"id":249641,"name":"Dana Dabelea","orcid":"0000-0001-9514-8929","position":6,"is_corresponding":false},{"id":239883,"name":"Emily Oken","orcid":"0000-0003-2513-3339","position":7,"is_corresponding":false},{"id":105708,"name":"Jessie P. Buckley","orcid":"0000-0001-7976-0157","position":8,"is_corresponding":false},{"id":239089,"name":"Leda Chatzi","orcid":null,"position":9,"is_corresponding":false},{"id":48177,"name":"MARGARET R. KARAGAS","orcid":"0000-0002-6398-7362","position":10,"is_corresponding":false},{"id":301985,"name":"Megan E. Romano","orcid":"0000-0003-4932-2492","position":11,"is_corresponding":false},{"id":332910,"name":"Susan L. Schantz","orcid":null,"position":12,"is_corresponding":false},{"id":498135,"name":"Thomas G. O’Connor","orcid":"0009-0000-4894-9002","position":13,"is_corresponding":false},{"id":298305,"name":"Tracey J. Woodruff","orcid":"0000-0003-3622-1297","position":14,"is_corresponding":false},{"id":322966,"name":"Yeyi Zhu","orcid":"0000-0002-7296-738X","position":15,"is_corresponding":false},{"id":301908,"name":"Ghassan B. Hamra","orcid":"0000-0002-6921-5742","position":16,"is_corresponding":false},{"id":275578,"name":"Joseph M. Braun","orcid":"0000-0002-5239-3235","position":17,"is_corresponding":false},{"id":1030444,"name":"and the program collaborators for Environmental influences on Child Health Outcomes","orcid":null,"position":18,"is_corresponding":false},{"id":718357,"name":"Yun Liu","orcid":"0000-0002-2979-9552","position":0,"is_corresponding":true}],"reference_count":67,"raw_metadata":null,"created_at":"2026-07-19T01:07:17.361058Z","pmid":"37283528","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}