Association between prenatal exposure to bisphenol a and birth outcomes A systematic review with meta-analysis

Background: Previous studies investigated the relation of prenatal exposure to bisphenol A (BPA) and birth outcomes, but these results were inconsistent. The aim of this study was to investigate the relation of prenatal exposure to BPA and birth outcomes, provide comprehensive results based on current studies. Methods: The PubMed, Cochrane databases, and Web of Science databases were searched systematically by two researchers respectively from their inceptions to Oct. 2018, using the following keywords "bisphenol A, birth weight, birth length, head circumference, gestational age, birth outcomes". We extracted beta coefficient and 95% confidence interval (CI) or beta coefficient and standard deviation (SD) from included study. The subgroup analysis was performed to evaluate the potential heterogeneity between studies. We conducted sensitivity analysis by excluding the each individual study to assess the results whether were stable. Finally, the publication bias was performed by accumulative forest plot. Results: Seven studies with 3004 participants met the inclusion criteria. BPA had significant positively association with birth weight (beta = 21.92, 95%CI: 1.50-42.35, P=.04). No significant associations were found between BPA and birth length, head circumference and gestational age (All of P>.05). Conclusion: This meta-analysis demonstrated that the BPA was positively associated with birth weight. Therefore, further studies are needed to investigate the critical sensitive period of influencing fetal development and to investigate the difference on gender.