Per- and polyfluoroalkyl substances (PFAS) in early life is associated with childhood intestinal inflammation: analyses of three birth cohorts
By Vishal Midya, Amith S Maroli, Mellissa Picker, Georgia Dolios, Damaskini Valvi, Isabella Nguyen, Taegyu Kim, Alexa Rendon, Rosemary Chen, Kaitlyn Weinstein, Haibin Guan, Gary Joseph, Joseph Eggers, Libni A Torres-Olascoaga, Rohitha Ravisekar, Bhargavi Srinath, Romana Ranchadiya, Syam S Andra, David Achaintre, Chris Gennings, Martha M Téllez-Rojo, Robert O Wright, Manish Arora, Maria José Rosa, Megan Niedzwiecki, Joana Torres, Cecilia S Alcala, Jamil M Lane, Shoshannah Eggers, Jean-Frederic Colombel, Inga Peter, Lauren Petrick, and Manasi Agrawal
Clin Gastroenterol Hepatol
July 10, 2026
DOI: 10.1016/j.cgh.2026.07.001
Background And Aims
Early life exposures shape intestinal and immune development and later risk of inflammatory bowel disease (IBD). Per- and polyfluoroalkyl substances (PFAS), or forever chemicals, are associated with intestinal inflammation and IBD. However, the impact of early life PFAS exposure on later intestinal inflammation is not known.
Methods
We conducted untargeted PFAS analyses in early life samples from mother-offspring dyads across three cohorts. These included dried blood spots from offspring (n=84) and cord blood (n=93) from two prospective birth cohorts of mothers with and without IBD in New York, United States, and maternal serum during pregnancy (n=14) from a birth cohort in Mexico City, Mexico. Fecal calprotectin (FC), a biomarker of intestinal inflammation, was measured longitudinally in offspring stool. Covariate-adjusted weighted quantile sum regression models were used to estimate associations between PFAS and FC.
Results
PFAS metabolites were detected across all sample types. Higher levels of PFAS mixtures were associated with higher FC between 1 and 6 years of age in both dried blood spot and cord blood analyses (covariate-adjusted β estimates for change in log-transformed fecal calprotectin at age 6 years per decile increase in the PFAS mixture was 0.44, 95% CI 0.18, 0.70 and 0.69, 95% CI 0.53, 0.85, respectively) Similarly, higher levels of PFAS mixtures in maternal serum were associated with higher FC in late childhood (β 0.19, 95% CI 0.05, 0.33). Compared to mothers-offspring dyads without maternal IBD, those with maternal IBD were more likely to have higher perfluoro-1-octane sulfonamide acetic acid and 3-perfluorohexyl-2-hydroxypropyl acrylate levels in dried blood spots and cord blood, respectively; these PFAS metabolites were also the top contributors to offspring FC.
Conclusion
PFAS chemicals are detectable in early life samples, indicating exposure during this period of vulnerability, and are associated with higher FC in childhood across three birth cohorts.
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