Fig. 5

A directed acyclic graph (DAG) used to identify real and theoretical confounders in the relationship between PFAS exposure and newborn DNA methylation and hydroxymethylation. Rectangles represent variables included as exposures or outcomes. Ovals represent confounding or control variables that were assessed for model inclusion. Thick solid lines show the relationship considered for mediation analysis. Filled ovals represent all precision, confounding, or control variables included in the models. Other maternal variables (unfilled oval on bottom of DAG) were considered for inclusion (age, early pregnancy body mass index (BMI), marital status, and income). Within our dataset, only one variable (self-reported race as a proxy for racism and racist policies) showed evidence as a true confounder (associated with both exposure and outcome); other maternal variables were not included in the models. Infant sex was not considered as true confounder, as only gestational age and Fenton z-scores (already adjusted for age and sex) were assessed as outcomes