Prenatal and childhood exposure to per-/polyfluoroalkyl substances (PFASs) and its associations with childhood overweight and/or obesity: a systematic review with meta-analyses

Frigerio, Gianfranco; Ferrari, Chiara Matilde; Fustinoni, Silvia

doi:10.1186/s12940-023-01006-6

Environmental Health

Table 3 Results of the meta-analyses performed on a subset of the studies included in the systematic review. For each combination of exposure and outcome, and for each sex category (boys and girls combined, only boys, and only girls) a meta-analysis was performed only if suitable information was reported from at least 3 studies. In this table, the pooled estimated of the random effects models (with the 95% confidence interval) from the generic invariance method, the I² of the heterogeneity test, the p-value of the Egger’s test, and the pooled estimated of the random effects models (with the 95% confidence interval) by weighting per sample size are reported. The complete forest and funnel plots are reported in the supplementary figures

From: Prenatal and childhood exposure to per-/polyfluoroalkyl substances (PFASs) and its associations with childhood overweight and/or obesity: a systematic review with meta-analyses

Conditions assessed	Studies included	Random effects model [95% CI] Generic invariance method	Heterogeneity (I²)	Egger’s test p-value	Random effects model [95% CI] Weighted per sample size
Prenatal PFOA and BMI
Both sexes	[64, 69, 70, 74,75,76, 79, 81, 83, 86,87,88,89,90,91,92, 94]	-0.0015 [-0.0112; 0.0081]	0.58	0.743	0.0099 [-0.0031; 0.0228]
Boys	[68,69,70, 76, 81,82,83, 86,87,88, 91, 92]	-0.0003 [-0.0010; 0.0005]	0.00	0.027	-0.0081 [-0.0229; 0.0068]
Girls	[68,69,70, 76, 78, 81,82,83, 86,87,88, 91, 92]	0.0000 [-0.0001; 0.0002]	0.66	0.814	0.0015 [-0.0104; 0.0134]
Prenatal PFOS and BMI
Both sexes	[64, 69, 70, 74,75,76, 79, 81, 83, 86,87,88,89,90,91,92, 94]	-0.0002 [-0.0014; 0.0010]	0.57	0.973	-0.0035 [-0.0096; 0.0025]
Boys	[68,69,70, 76, 81,82,83, 86,87,88, 91, 92]	-0.0001 [-0.0010; 0.0009]	0.00	0.299	-0.0044 [-0.0103; 0.0014]
Girls	[68,69,70, 76, 78, 81,82,83, 86,87,88, 91, 92]	-0.0012 [-0.0043; 0.0019]	0.63	0.588	-0.0009 [-0.0064; 0.0045]
Prenatal PFHxS and BMI
Both sexes	[64, 69, 70, 75, 76, 81, 83, 86, 87, 90, 92]	0.0000 [-0.007; 0.0069]	0.00	0.389	-0.0008 [-0.0524; 0.0509]
Boys	[68,69,70, 76, 81, 83, 86, 87, 92]	-0.0020 [-0.0050; 0.0011]	0.00	0.601	-0.0268 [-0.0983; 0.0447]
Girls	[68,69,70, 76, 78, 81, 83, 86, 87, 92]	-0.0010 [-0.0046; 0.0025]	0.00	0.080	0.0486 [-0.0013; 0.0986]
Prenatal PFNA and BMI
Both sexes	[64, 69, 70, 75, 76, 81, 83, 86, 87, 90, 92]	-0.0002 [-0.0034; 0.0029]	0.21	0.112	0.0481 [-0.013; 0.1091]
Boys	[68,69,70, 76, 81, 83, 86, 87, 92]	-0.0024 [-0.0111; 0.0063]	0.22	0.232	0.0931 [0.0108; 0.1753]
Girls	[68,69,70, 76, 78, 81, 83, 86, 87, 92]	0.0040 [-0.0052; 0.0131]	0.33	0.040	0.0800 [0.0036; 0.1564]
Prenatal PFDA and BMI
Both sexes	[69, 70, 76, 86, 87, 90]	-0.0008 [-0.0045; 0.0029]	0.03	0.855	0.0201 [-0.0644; 0.1046]
Boys	[68,69,70, 76, 86, 87]	0.0011 [-0.0041; 0.0064]	0.00	0.753	0.0235 [-0.1035; 0.1504]
Girls	[68,69,70, 76, 86, 87]	-0.0015 [-0.0065; 0.0034]	0.1	0.362	0.0329 [-0.0815; 0.1473]
Prenatal PFUA and BMI
Both sexes	[64, 69, 70, 76, 87]	-0.0016 [-0.0048; 0.0017]	0.00	0.618	-0.2062 [-0.6457; 0.2333]
Boys	[68,69,70, 76, 87]	0.0019 [-0.0055; 0.0092]	0.00	0.343	0.0860 [-0.0910; 0.2630]
Girls	[68,69,70, 76, 87]	-0.0041 [-0.0094; 0.0012]	0.00	0.994	-0.0082 [-0.1418; 0.1254]
Prenatal PFDoA and BMI
Both sexes	[69, 76, 87]	0.0154 [-0.0306; 0.0614]	0.50	0.680	0.0433 [-0.0221; 0.1088]
Boys	[69, 76, 87]	0.0223 [-0.0244; 0.0690]	0.34	0.677	0.0442 [-0.0187; 0.1070]
Girls	[69, 76, 87]	0.0054 [-0.0250; 0.0357]	0.34	0.732	0.0284 [-0.0188; 0.0757]
Prenatal PFBS and BMI
Both sexes	[69, 76, 87]	0.0011 [-0.0073; 0.0096]	0.52	0.576	-0.0555 [-0.1196; 0.0086]
Boys	[69, 76, 87]	-0.0135 [-0.0533; 0.0262]	0.47	0.757	-0.0552 [-0.1256; 0.0153]
Girls	[69, 76, 87]	0.0023 [-0.0026; 0.0073]	0.52	0.561	-0.0557 [-0.1178; 0.0065]
Prenatal PFOA and risk of overweight
Both sexes	[70, 71, 74, 83, 84, 90, 92, 94]	0.0084 [-0.0003; 0.0171]	0.02	0.063	0.0142 [-0.0006; 0.0289]
Prenatal PFOS and risk of overweight
Both sexes	[70, 71, 74, 83, 84, 90, 92, 94]	0.0007 [-0.0012; 0.0026]	0.19	0.504	0.0016 [-0.0018; 0.0050]
Prenatal PFHxS and risk of overweight
Both sexes	[70, 71, 83, 84, 90, 92]	-0.0035 [-0.0235; 0.0166]	0.41	0.312	-0.0627 [-0.1201; -0.0052]
Prenatal PFNA and risk of overweight
Both sexes	[70, 71, 83, 84, 90, 92]	0.0250 [-0.0116; 0.0616]	0.02	0.338	-0.0633 [-0.1611; 0.0344]
Prenatal PFOA and WC
Both sexes	[65, 69, 70, 81, 83, 86, 87, 92]	0.0000 [-0.0001; 0.0000]	0.00	0.168	0.0017 [-0.0152; 0.0186]
Boys	[69, 70, 81,82,83, 86, 87, 92]	-0.0001 [-0.0002; 0.0001]	0.00	0.467	0.0019 [-0.0177; 0.0214]
Girls	[69, 70, 78, 81,82,83, 86, 87, 92]	0.0000 [-0.0001; 0.0001]	0.35	0.884	-0.0046 [-0.0207; 0.0114]
Prenatal PFOS and WC
Both sexes	[65, 69, 70, 81, 83, 86, 87, 92]	0.0000 [0.0000; 0.0001]	0.00	0.405	-0.0045 [-0.0117; 0.0027]
Boys	[69, 70, 81,82,83, 86, 87, 92]	0.0000 [-0.0001; 0.0001]	0.00	0.987	-0.0024 [-0.0101; 0.0054]
Girls	[69, 70, 78, 81,82,83, 86, 87, 92]	-0.0001 [-0.0004; 0.0003]	0.46	0.500	0.0003 [-0.0063; 0.0070]
Prenatal PFHxS and WC
Both sexes	[65, 69, 70, 81, 83, 86, 87, 92]	0.0001 [-0.0001; 0.0003]	0.00	0.589	-0.0050 [-0.0426; 0.0326]
Boys	[69, 70, 81, 83, 86, 87, 92]	-0.0001 [-0.0005; 0.0002]	0.04	0.661	-0.0516 [-0.1332; 0.0300]
Girls	[69, 70, 78, 81, 83, 86, 87, 92]	0.0000 [-0.0004; 0.0005]	0.00	0.620	0.0151 [-0.0300; 0.0601]
Prenatal PFNA and WC
Both sexes	[65, 69, 70, 81, 83, 86, 87, 92]	0.0004 [-0.0006; 0.0015]	0.16	0.019	0.0467 [0.0063; 0.0872]
Boys	[69, 70, 81, 83, 86, 87, 92]	-0.0001 [-0.0006; 0.0003]	0.00	0.042	0.0465 [-0.0123; 0.1053]
Girls	[69, 70, 78, 81, 83, 86, 87, 92]	0.0010 [-0.0002; 0.0023]	0.00	0.592	0.0137 [-0.0353; 0.0628]
Prenatal PFDA and WC
Both sexes	[69, 70, 86, 87]	0.0003 [-0.0002; 0.0008]	0.00	0.607	0.0538 [-0.1353; 0.2429]
Boys	[69, 70, 86, 87]	-0.0001 [-0.0004; 0.0003]	0.00	0.833	0.0632 [-0.2203; 0.3468]
Girls	[69, 70, 86, 87]	0.0010 [-0.0001; 0.0021]	0.00	0.728	0.0444 [-0.2168; 0.3056]
Prenatal PFUA and WC
Both sexes	[69, 70, 87]	0.0005 [-0.0010; 0.0020]	0.67	0.345	0.3729 [0.0703; 0.6755]
Boys	[69, 70, 87]	0.0002 [-0.0044; 0.0049]	0.38	0.195	0.5132 [-0.1139; 1.1404]
Girls	[69, 70, 87]	0.0015 [-0.0015; 0.0045]	0.00	0.242	0.2805 [-0.1624; 0.7234]
Childhood PFOA and BMI
Both sexes	[64, 79, 81, 90, 98, 104, 105, 111]	-0.0525 [-0.1039; -0.0012]	0.84	0.023	-0.0445 [-0.0604; -0.0286]
Boys	[81, 98, 111]	-0.0910 [-0.2488; 0.0668]	0.89	0.394	-0.0410 [-0.2285; 0.1464]
Girls	[81, 98, 111, 112]	-0.0150 [-0.0401; 0.0100]	0.74	0.256	-0.0134 [-0.0456; 0.0187]
Childhood PFOS and BMI
Both sexes	[64, 79, 81, 90, 98, 104, 105, 111]	-0.0166 [-0.0283; -0.0049]	0.82	0.011	-0.0226 [-0.0412; -0.0039]
Boys	[81, 98, 111]	-0.0229 [-0.0338; -0.0120]	0.00	0.359	-0.0235 [-0.0354; -0.0116]
Girls	[81, 98, 111]	-0.0162 [-0.0531; 0.0207]	0.84	0.972	-0.0278 [-0.0719; 0.0164]
Childhood PFHxS and BMI
Both sexes	[64, 81, 90, 98, 104, 111]	-0.0247 [-0.0814; 0.0320]	0.35	0.260	-0.0334 [-0.1157; 0.0489]
Boys	[81, 98, 111]	-0.0547 [-0.2558; 0.1464]	0.18	0.444	-0.0331 [-0.1620; 0.0957]
Girls	[81, 98, 111]	0.0667 [-0.1136; 0.2469]	0.35	0.079	0.0399 [-0.1249; 0.2047]
Childhood PFNA and BMI
Both sexes	[64, 81, 90, 104, 111]	-0.2162 [-0.4883; 0.0558]	0.81	0.383	-0.3279 [-0.6121; -0.0438]
Childhood PFOA and risk of overweight
Both sexes	[64, 90, 96, 108]	-0.0101 [-0.0497; 0.0295]	0.84	0.413	-0.0074 [-0.0554; 0.0407]
Childhood PFOS and risk of overweight
Both sexes	[90, 96, 108]	0.0016 [-0.0081; 0.0113]	0.78	0.231	-0.0007 [-0.0137; 0.0123]

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