OBJECTIVES: Cadmium is known to be a significant health hazard, but most information comes from studies of adults. The effects of exposure to cadmium during fetal life on early growth and development remain uncertain. In this study we investigated the placental transport of cadmium and the effects of prenatal cadmium exposure on fetal and child growth in Taiwan. METHODS: The data in this study were from a birth cohort study in Taiwan which started in 2004. Pregnant women were recruited from four hospitals and interviewed after delivery to collect information on themselves and their infants. Children were followed up to obtain information on growth up to 3years of age. Whole blood cadmium concentrations in maternal and cord blood samples were measured and the relationship with birth size and growth assessed using linear regression and mixed models. RESULTS: 321 maternal blood samples and 402 cord blood samples were eligible for analysis. Among 289 pairs with maternal and cord blood suitable for measurement, the median cadmium concentration in cord blood (0.31μg/l) was less than that in maternal blood (1.05μg/l), with low correlation between the two (r=0.04). An increase in cord blood cadmium was found to be associated with newborn decreased head circumference and to be significantly and consistently associated with a decrease in height, weight and head circumference up to 3 years of age. CONCLUSIONS: Placental transport of cadmium is limited. However, prenatal cadmium exposure may have a detrimental effect on head circumference at birth and child growth in the first 3years of life.