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Table 4 Results of the meta-analyses performed on a subset of the studies included in the systematic review stratifying separately studies that measured the outcomes in children who were 3 or less years from studies that considered children who were more than 3 years. 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 in both sexes

0–3 years

[76, 86, 89, 91]

-0.0140 [-0.0351; 0.0070]

0.77

0.910

-0.0133 [-0.0343; 0.0078]

4–18 years

[64, 69, 70, 74, 75, 79, 81, 83, 87, 88, 90, 92, 94]

0.0000 [-0.0008; 0.0009]

0.24

0.047

0.0275 [0.0059; 0.0491]

Prenatal PFOA and BMI in boys

0–3 years

[68, 76, 86, 91]

-0.0022 [-0.0070; 0.0026]

0.19

0.533

-0.0051 [-0.0182; 0.0079]

4–18 years

[69, 70, 81,82,83, 87, 88, 92]

0.0000 [-0.0009; 0.0008]

0.00

0.039

-0.0115 [-0.0398; 0.0168]

Prenatal PFOA and BMI in girls

0–3 years

[68, 76, 86, 91]

-0.0036 [-0.0413; 0.0341]

0.87

0.673

-0.0087 [-0.0313; 0.0139]

4–18 years

[69, 70, 78, 81,82,83, 87, 88, 92]

0.0000 [-0.0001; 0.0002]

0.23

0.672

0.0115 [-0.0084; 0.0313]

Prenatal PFOS and BMI in both sexes

0–3 years

[76, 86, 89, 91]

-0.0101 [-0.0189; -0.0013]

0.38

0.965

-0.0092 [-0.0210; 0.0026]

4–18 years

[64, 69, 70, 74, 75, 79, 81, 83, 87, 88, 90, 92, 94]

0.0002 [-0.0009; 0.0014]

0.42

0.251

0.0008 [-0.0056; 0.0072]

Prenatal PFOS and BMI in boys

0–3 years

[68, 76, 86, 91]

-0.0024 [-0.0071; 0.0024]

0.21

0.123

-0.0060 [-0.0128; 0.0007]

4–18 years

[69, 70, 81,82,83, 87, 88, 92]

0.0002 [-0.0029; 0.0033]

0.00

0.538

-0.0026 [-0.0128; 0.0077]

Prenatal PFOS and BMI in girls

0–3 years

[68, 76, 86, 91]

-0.0065 [-0.0186; 0.0056]

0.78

0.356

-0.0086 [-0.0198; 0.0026]

4–18 years

[69, 70, 78, 81,82,83, 87, 88, 92]

-0.0006 [-0.0033; 0.0021]

0.56

0.883

0.0065 [-0.0019; 0.0150]

Prenatal PFHxS and BMI in both sexes

4–18 years

[64, 69, 70, 75, 81, 83, 87, 90, 92]

0.0000 [-0.0071; 0.0071]

0.00

0.435

-0.0009 [-0.0600; 0.0582]

Prenatal PFHxS and BMI in boys

0–3 years

[68, 76, 86]

-0.0023 [-0.0054; 0.0009]

0.00

0.659

0.0159 [-0.0998; 0.1317]

4–18 years

[69, 70, 81, 83, 87, 92]

0.0040 [-0.0108; 0.0188]

0.00

0.051

-0.0694 [-0.1534; 0.0146]

Prenatal PFHxS and BMI in girls

0–3 years

[68, 76, 86]

0.0343 [-0.0360; 0.1046]

0.33

0.463

0.0806 [-0.0197; 0.181]

4–18 years

[69, 70, 78, 81, 83, 87, 92]

-0.0014 [-0.0050; 0.0021]

0.00

0.387

0.0221 [-0.0348; 0.0790]

Prenatal PFNA and BMI in both sexes

4–18 years

[64, 69, 70, 75, 81, 83, 87, 90, 92]

-0.0001 [-0.0033; 0.0030]

0.00

0.072

0.0656 [-0.0252; 0.1564]

Prenatal PFNA and BMI in boys

0–3 years

[68, 76, 86]

-0.0083 [-0.0183; 0.0016]

0.00

0.831

0.0009 [-0.0495; 0.0513]

4–18 years

[69, 70, 81, 83, 87, 92]

0.0022 [-0.0052; 0.0097]

0.17

0.120

0.1851 [0.0280; 0.3421]

Prenatal PFNA and BMI in girls

0–3 years

[68, 76, 86]

0.0216 [-0.0031; 0.0463]

0.52

0.119

0.0588 [-0.0023; 0.1198]

4–18 years

[69, 70, 78, 81, 83, 87, 92]

-0.0002 [-0.0027; 0.0023]

0.05

0.290

0.0976 [-0.0355; 0.2307]

Prenatal PFDA and BMI in both sexes

4–18 years

[69, 70, 87, 90]

-0.0007 [-0.003; 0.0015]

0.00

0.001

-0.0816 [-0.2605; 0.0973]

Prenatal PFDA and BMI in boys

0–3 years

[68, 76, 86]

-0.0069 [-0.0286; 0.0147]

0.00

0.196

0.0365 [-0.0673; 0.1402]

4–18 years

[69, 70, 87]

0.0016 [-0.0038; 0.0070]

0.00

0.410

-0.0111 [-0.3852; 0.3630]

Prenatal PFDA and BMI in girls

0–3 years

[68, 76, 86]

0.0111 [-0.0205; 0.0427]

0.41

0.407

0.1055 [-0.0437; 0.2546]

4–18 years

[69, 70, 87]

-0.0017 [-0.0077; 0.0043]

0.00

0.829

-0.1628 [-0.4729; 0.1474]

Prenatal PFUA and BMI in both sexes

4–18 years

[64, 69, 70, 87]

-0.0015 [-0.0048; 0.0017]

0.00

0.749

-0.3931 [-1.2412; 0.4549]

Prenatal PFUA and BMI in boys

4–18 years

[69, 70, 87]

0.0021 [-0.0055; 0.0098]

0.00

0.263

0.2827 [-0.2755; 0.8409]

Prenatal PFUA and BMI in girls

4–18 years

[69, 70, 87]

-0.0045 [-0.0098; 0.0008]

0.00

0.325

-0.0501 [-0.4704; 0.3701]

Prenatal PFOA and risk of overweight

4–18 years

[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

4–18 years

[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

4–18 years

[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

4–18 years

[70, 71, 83, 84, 90, 92]

0.025 [-0.0116; 0.0616]

0.02

0.338

-0.0633 [-0.1611; 0.0344]

Prenatal PFOA and WC in both sexes

4–18 years

[65, 69, 70, 81, 83, 87, 92]

0.0000 [-0.0001; 0.0000]

0.00

0.232

0.0007 [-0.0171; 0.0184]

Prenatal PFOA and WC in boys

4–18 years

[69, 70, 81,82,83, 87, 92]

-0.0001 [-0.0002; 0.0001]

0.00

0.199

-0.0023 [-0.0218; 0.0173]

Prenatal PFOA and WC in girls

4–18 years

[69, 70, 78, 81,82,83, 87, 92]

0.0000 [-0.0001; 0.0001]

0.43

0.939

-0.0040 [-0.0194; 0.0114]

Prenatal PFOS and WC in both sexes

4–18 years

[65, 69, 70, 81, 83, 87, 92]

0.0000 [0.0000; 0.0001]

0.00

0.675

-0.0038 [-0.0115; 0.0039]

Prenatal PFOS and WC in boys

4–18 years

[69, 70, 81,82,83, 87, 92]

0.0000 [-0.0001; 0.0001]

0.00

0.492

-0.0012 [-0.0093; 0.0068]

Prenatal PFOS and WC in girls

4–18 years

[69, 70, 78, 81,82,83, 87, 92]

-0.0001 [-0.0004; 0.0003]

0.51

0.631

0.0015 [-0.0053; 0.0083]

Prenatal PFHxS and WC in both sexes

4–18 years

[65, 69, 70, 81, 83, 87, 92]

0.0003 [-0.0014; 0.0020]

0.13

0.621

-0.0069 [-0.0420; 0.0281]

Prenatal PFHxS and WC in boys

4–18 years

[69, 70, 81, 83, 87, 92]

-0.0001 [-0.0041; 0.0039]

0.19

0.726

-0.0518 [-0.1069; 0.0032]

Prenatal PFHxS and WC in girls

4–18 years

[69, 70, 78, 81, 83, 87, 92]

0.0000 [-0.0004; 0.0005]

0.06

0.675

0.0144 [-0.0285; 0.0572]

Prenatal PFNA and WC in both sexes

4–18 years

[65, 69, 70, 81, 83, 87, 92]

0.0004 [-0.0006; 0.0015]

0.14

0.051

0.0411 [-0.0002; 0.0824]

Prenatal PFNA and WC in boys

4–18 years

[69, 70, 81, 83, 87, 92]

-0.0001 [-0.0006; 0.0003]

0.00

0.070

0.0477 [-0.0105; 0.1059]

Prenatal PFNA and WC in girls

4–18 years

[69, 70, 78, 81, 83, 87, 92]

0.0010 [-0.0002; 0.0023]

0.00

0.779

-0.0035 [-0.0509; 0.0438]

Prenatal PFDA and WC in both sexes

4–18 years

[69, 70, 87]

0.0003 [-0.0002; 0.0008]

0.00

0.956

0.0324 [-0.1791; 0.2438]

Prenatal PFDA and WC in boys

4–18 years

[69, 70, 87]

-0.0001 [-0.0004; 0.0003]

0.00

0.738

0.0312 [-0.3097; 0.3721]

Prenatal PFDA and WC in girls

4–18 years

[69, 70, 87]

0.0010 [-0.0001; 0.0021]

0.00

0.963

0.0329 [-0.2441; 0.3100]

Prenatal PFUA and WC in both sexes

4–18 years

[69, 70, 87]

0.0005 [-0.0010; 0.0020]

0.67

0.345

0.3729 [0.0703; 0.6755]

Prenatal PFUA and WC in boys

4–18 years

[69, 70, 87]

0.0002 [-0.0044; 0.0049]

0.38

0.195

0.5132 [-0.1139; 1.1404]

Prenatal PFUA and WC in girls

4–18 years

[69, 70, 87]

0.0015 [-0.0015; 0.0045]

0.00

0.242

0.2805 [-0.1624; 0.7234]

Childhood PFOA and BMI in both sexes

4–18 years

[64, 79, 81, 90, 98, 104, 105, 111]

-0.0525 [-0.1039; -0.0012]

0.84

0.023

-0.0445 [-0.0604; -0.0286]

Childhood PFOA and BMI in boys

4–18 years

[81, 98, 111]

-0.0910 [-0.2488; 0.0668]

0.89

0.394

-0.0410 [-0.2285; 0.1464]

Childhood PFOA and BMI in girls

4–18 years

[81, 98, 111, 112]

-0.0150 [-0.0401; 0.0100]

0.74

0.256

-0.0134 [-0.0456; 0.0187]

Childhood PFOS and BMI in both sexes

4–18 years

[64, 79, 81, 90, 98, 104, 105, 111]

-0.0166 [-0.0283; -0.0049]

0.82

0.011

-0.0226 [-0.0412; -0.0039]

Childhood PFOS and BMI in boys

4–18 years

[81, 98, 111]

-0.0229 [-0.0338; -0.0120]

0.00

0.359

-0.0235 [-0.0354; -0.0116]

Childhood PFOS and BMI in girls

4–18 years

[81, 98, 111]

-0.0162 [-0.0531; 0.0207]

0.84

0.972

-0.0278 [-0.0719; 0.0164]

Childhood PFHxS and BMI in both sexes

4–18 years

[64, 81, 90, 98, 104, 111]

-0.0247 [-0.0814; 0.0320]

0.35

0.260

-0.0334 [-0.1157; 0.0489]

Childhood PFHxS and BMI in boys

4–18 years

[81, 98, 111]

-0.0547 [-0.2558; 0.1464]

0.18

0.444

-0.0331 [-0.1620; 0.0957]

Childhood PFHxS and BMI in girls

4–18 years

[81, 98, 111]

0.0667 [-0.1136; 0.2469]

0.35

0.079

0.0399 [-0.1249; 0.2047]

Childhood PFNA and BMI in both sexes

4–18 years

[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 in both sexes

4–18 years

[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 in both sexes

4–18 years

[90, 96, 108]

0.0016 [-0.0081; 0.0113]

0.78

0.231

-0.0007 [-0.0137; 0.0123]