Background and objectives: The impact of prenatal exposure to polycyclicaromatic 17 hydrocarbons (PAHs) on birth outcomes as weight, length, head circumference, placenta 18 weight, and Apgar. Materials and Methods: Two cohorts of children born in the years 2013 and 19 2014 in Karvina (Northern Moravia, N=144) and Ceske Budejovice (Southern Bohemia, 20 N=198), were studied for the relationship between the prenatal exposure to PAHs and growth 21 parameters up to two years of age. PAHs exposure was evaluated according to the concentration 22 of benzo[a]pyrene (B[a]P) in polluted air and monohydroxylated PAH metabolites (OH-PAHs) 23 in urine of newborns as well as their mothers. Data of growth parameters were obtained from 24 pediatric questionnaires up to 24 months. 25 Results: Concentrations of B[a]P were significantly higher in Karvina (p<0.001). OH-26 PAH metabolites were significantly higher in the mothers´ as well as in the newborns´ urine in 27 Karvina. The length was shorter in newborns in Karvina at birth (p<0.001), but this difference 28 was straightened out during next 3 to 24 months. Birth weight at the delivery did not differ 29 between newborns in Karvina and Ceske Budejovice. Newborns in both locations significantly 30 decreased their weight gain between birth and 3 months after delivery. OH-PAHs metabolites 31 in mother’s or newborn’s urine did not affect birth weight. Top 25% values of concentrations 32 of 2-OH-FLUO, 1-OH-NAP, 2-OH-NAP, 1-OH-PHEN, 2-OH-PHEN, 3-OH-PHEN, 4-OH-33 PHEN, and the sum of all-OH-PAHs higher than median in the newborns´ urine decreased their 34 length. 2-OH-PHEN top 25% of concentrations in the newborns´ urine decreased their head 35 circumference, 2-OH-FLUO, 1-OH-NAP, 2-OH-NAP, 1-OH-PHEN, 2-OH-PHEN, 3-OH-36 PHEN, 4-OH-PHEN, 9-OH-PHEN, 1-OH-PYR, and all-OH-PAHs decreased placenta weight; 37 2-OH-FLUO, 1-OH-NAP, 2-OH-NAP, 1-OH-PHEN, 2-OH-PHEN, 3-OH-PHEN, 4-OH-38 PHEN, and all-OH-PAHs decreased Apgar 5´. Conclusions: We observed that higher 39 concentration of PAHs determined as OH-PAHs metabolites in newborns´ urine decreased their 40 length, head circumference, placenta weight, and Apgar 5´, but did not affect birth weight.