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Benjamin J. Apelberg,¹ Frank R. Witter,² Julie B. Herbstman,³ Antonia M. Calafat,⁴ Rolf U. Halden,⁵ Larry L. Needham,⁴ and Lynn R. Goldman⁵

¹Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; ²Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; ³Columbia Children's Center for Environmental Health, Columbia Mailman School of Public Health, New York, New York, USA; ⁴Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ⁵Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

Abstract
Background: Recent studies have reported developmental toxicity among rodents dosed with perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) .

Objectives: We examined the relationship between concentrations of PFOS and PFOA in cord serum (surrogates for in utero exposures) and gestational age, birth weight, and birth size in humans.

Methods: We conducted a hospital-based cross-sectional epidemiologic study of singleton deliveries in Baltimore, Maryland. Cord serum samples (n = 293) were analyzed for PFOS and PFOA by online solid-phase extraction, coupled with reversed-phase high-performance liquid chromatography–isotope dilution tandem mass spectrometry. Maternal characteristics and anthropometric measures were obtained from medical charts.

Results: After adjusting for potential confounders, both PFOS and PFOA were negatively associated with birth weight [per ln-unit: β = –69 g, 95% confidence interval (CI) , –149 to 10 for PFOS ; β= –104 g, 95% CI, –213 to 5 for PFOA], ponderal index (per ln-unit: β = –0.074 g/cm³ 100, 95% CI, –0.123 to –0.025 for PFOS ; β = –0.070 g/cm³ 100, 95% CI, –0.138 to –0.001 for PFOA) , and head circumference (per ln-unit: β = –0.32 cm, 95% CI, –0.56 to –0.07 for PFOS ; β = –0.41 cm, 95% CI, –0.76 to –0.07 for PFOA) . No associations were observed between either PFOS or PFOA concentrations and newborn length or gestational age. All associations were independent of cord serum lipid concentrations.

Conclusions: Despite relatively low cord serum concentrations, we observed small negative associations between both PFOS and PFOA concentrations and birth weight and size. Future studies should attempt to replicate these findings in other populations.

Key words: Birth weight, cord blood, epidemiology, fetal exposure, fetal growth, gestational age, head circumference, human, length, perfluorooctane sulfonate, perfluorooctanoate, polyfluoroalkyl compounds, ponderal index. Environ Health Perspect 115:1670–1676 (2007) . doi:10.1289/ehp.10334 available via http://dx.doi.org/ [Online 31 July 2007]

Address correspondence to L.R. Goldman, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Rm. E6636, Baltimore, MD 21205 USA. Telephone: (410) 614-9301. Fax: (443) 287-7375. E-mail: lgoldman@jhsph.edu

Supplemental Material is available online at http://www.ehponline.org/docs/2007/10334/suppl.pdf

We thank the following people whose contributions have been essential to the completion of this work: T. Burke, J. Samet, J. Heidler, E. Wells, C. Sann, R. Quinn, C. Resnick, Z. Kuklenyik, J. Tully, X. Bryant, J. Reidy, T. Bernert, B. Slazyk, and the exceptional cooperation and tireless effort of the nursing staff in the Labor and Delivery Unit of the Johns Hopkins Hospital.

We also thank our funders: the Johns Hopkins Bloomberg School of Public Health (JHSPH) Maryland Mothers and Babies Study ; the Cigarette Restitution Fund, supporting the Program Research Grant given to the Johns Hopkins Medical Institutions ; the JHSPH Center for a Livable Future ; the JHSPH Department of Epidemiology, as well as the Heinz Family Foundation.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC.

The authors declare they have no competing financial interests.

Received 4 April 2007 ; accepted 30 July 2007.