Exposure to Poly- and Perfluoroalkyl Substances During Pregnancy and Asthma in Childhood: A Systematic Review.

Asthma is a chronic respiratory disease that has been increasing in prevalence among children globally. While genetic factors contribute to asthma risk, there are growing concerns about environmental exposures, such as poly- and perfluoroalkyl substances (PFAS), which may disrupt respiratory and immune development in the prenatal period. This systematic review aimed to assess the association between prenatal PFAS exposure and the development of asthma in childhood, integrating findings from epidemiological studies. A comprehensive literature search was conducted on Scopus, PubMed, and Google Scholar using predefined keywords. The review included prospective cohort studies examining prenatal PFAS exposure and asthma outcomes in children. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). A total of 13 studies were included in the final analysis. The studies involved diverse countries/populations with over 21,000 mother-child pairs. Although some studies reported associations between specific PFAS compounds and asthma, most found no significant relationship between prenatal PFAS exposure and doctor-diagnosed asthma. The findings were inconsistent, with null or mixed results across studies. Despite mechanistic evidence suggesting that PFAS could contribute to asthma development, epidemiological data do not consistently support a link between prenatal exposure and childhood asthma. Further research with standardized exposure measurements and larger cohort studies is needed to clarify these associations.