Two INMA Project Studies Analyse the Possible Consequences of Prenatal Exposure to Perfluoroalkyl Substances

No solid evidence found to link exposure to PFAS with birth outcomes or cardiometabolic risk


Per- and polyfluoroalkyl substances (PFAS) are a class of man-made chemicals used in countless industrial and consumer products. The possible toxic effect of these compounds is a cause for concern in public health. The Barcelona Institute for Global Health, a centre supported by the ”la Caixa” Banking Foundation, has led two studies undertaken to provide more information on the possible impact of prenatal exposure to PFAS on the health of newborns and children.

As part of the INMA Project, a framework for research on the effects of environmental pollution on child health, the two studies were undertaken to investigate the consequences of prenatal exposure to PFAS. One studied its impact on the weight, length, gestational age, and head circumference of newborns at birth. The other focused on whether prenatal exposure to PFAS might increase the risk of cardiometabolic syndrome or obesity. The authors, who published the studies in Environment International and Environmental Health Perspectives, respectively, did not find any significant associations.

In total, the two studies recruited over 1,200 mother-child pairs from INMA birth cohorts in three Spanish regions: Gipuzkoa, Sabadell and Valencia. The researchers measured four common PFAS in maternal blood samples extracted during the first trimester of pregnancy: perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA) and perfluorononanoic acid (PFNA) . Anthropometric measurements were recorded at birth, and weight gain was assessed at six months and at four and seven years of age. Blood pressure and blood lipid levels were measured in some of the participants.

Evidence from previous studies suggests that PFAS may have adverse effects on childhood health. Prenatal exposure to PFOA has been associated with low birth weight, which in turn is linked to a higher risk of obesity in childhood and adulthood. “However, most of the work done to date has taken the form of small or cross-sectional studies and this limits its usefulness for the purposes of drawing firm conclusions” explains Cyntia Manzano, ISGlobal researcher and first author of both studies. “We found that a higher concentration of PFAS was associated with reduced birth weight, but the association was not statistically significant in this study. We also observed a link between exposure to PFNA and an increase in cardiometabolic risk at 4 years of age.”

The conclusions of these two studies highlight the need for longitudinal studies with longer follow up periods to provide more data on the effects of PFAS on child health. In the meantime, we should be cautious about the use of these chemical compounds and our exposure to them in the environment.


Manzano-Salgado CB, Casas M, Lopez-Espinosa MJ, et al. Prenatal exposure to perfluoroalkyl substances and birth outcomes in a Spanish birth cohort . Environ Int. 2017 Sep 13;108:278-284.

Manzano-Salgado CB, Casas M, Lopez-Espinosa MJ, et al. Prenatal Exposure to Perfluoroalkyl Substances and Cardiometabolic Risk in Children from the Spanish INMA Birth Cohort Study . Environ Health Perspect. 2017 Sep 20;125(9):097018.