1
|
Choi JW, Oh J, Bennett DH, Calafat AM, Schmidt RJ, Shin HM. Prenatal exposure to per- and polyfluoroalkyl substances and child behavioral problems. ENVIRONMENTAL RESEARCH 2024; 251:118511. [PMID: 38387490 PMCID: PMC11144101 DOI: 10.1016/j.envres.2024.118511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may adversely affect child behaviors; however, findings of epidemiologic studies are inconsistent. We examined prenatal PFAS exposure in association with child behavioral problems. METHODS Participants were 177 mother-child pairs from MARBLES (Markers of Autism Risk in Babies - Learning Early Signs), a cohort with elevated familial likelihood of autism spectrum disorder (ASD). We quantified nine PFAS in maternal serum (1-3 samples per mother) collected from the 1st to 3rd trimesters of pregnancy. Child behavioral problems were assessed at 3 years of age using the Child Behavior Checklist (CBCL), developed to test for various behavioral problems of children. We examined associations of the CBCL scores with individual PFAS concentrations and with their mixture using negative binomial regression and weighted quantile sum regression models. RESULTS Higher prenatal perfluorononanoate (PFNA) concentrations were associated with higher scores of externalizing problems [β = 0.16, 95% CI (0.01, 0.32)] and aggressive behavior [β = 0.17 (0.01, 0.32)]. Higher PFNA, perfluorooctane sulfonate (PFOS), and perfluorodecanoate (PFDA) were associated with higher scores of sleep problems [β = 0.34 (0.15, 0.54) for PFNA, β = 0.20 (0.02, 0.37) for PFOS, and β = 0.19 (0.00, 0.37) for PFDA]. No significant associations observed for typically developing children, whereas PFOS, PFNA, and PFDA were associated with several behavioral problems among children diagnosed with ASD or other neurodevelopmental concerns. Exposure to a mixture of PFAS was associated with higher scores of sleep problems and aggressive behavior, mostly contributed by PFNA and PFDA. CONCLUSIONS Our study showed that prenatal exposure to some PFAS could increase child behavioral problems at 3 years of age. However, our results should be interpreted with caution because we relied on data from a cohort with increased familial likelihood of ASD and thereby had more behavioral problems.
Collapse
Affiliation(s)
- Jeong Weon Choi
- Department of Environmental Science, Baylor University, Waco, TX, USA.
| | - Jiwon Oh
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | | | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California, Davis, CA, USA; MIND Institute, Sacramento, CA, USA
| | - Hyeong-Moo Shin
- Department of Environmental Science, Baylor University, Waco, TX, USA
| |
Collapse
|
2
|
Zhang B, Wang Z, Zhang J, Dai Y, Ding J, Guo J, Qi X, Wu C, Zhou Z. Prenatal exposure to per- and polyfluoroalkyl substances, fetal thyroid function, and intelligence quotient at 7 years of age: Findings from the Sheyang Mini Birth Cohort Study. ENVIRONMENT INTERNATIONAL 2024; 187:108720. [PMID: 38718676 DOI: 10.1016/j.envint.2024.108720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/24/2024] [Accepted: 05/03/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Prenatal exposure to per- and polyfluoroalkyl substances (PFASs) influences neurodevelopment. Thyroid homeostasis disruption is thought to be a possible underlying mechanism. However, current epidemiological evidence remains inconclusive. OBJECTIVES This study aimed to explore the effects of prenatal PFAS exposure on the intelligence quotient (IQ) of school-aged children and assess the potential mediating role of fetal thyroid function. METHODS The study included 327 7-year-old children from the Sheyang Mini Birth Cohort Study (SMBCS). Cord serum samples were analyzed for 12 PFAS concentrations and 5 thyroid hormone (TH) levels. IQ was assessed using the Wechsler Intelligence Scale for Children-Chinese Revised (WISC-CR). Generalized linear models (GLM) and Bayesian Kernel Machine Regression (BKMR) were used to evaluate the individual and combined effects of prenatal PFAS exposure on IQ. Additionally, the impact on fetal thyroid function was examined using a GLM, and a mediation analysis was conducted to explore the potential mediating roles of this function. RESULTS The molar sum concentration of perfluorinated carboxylic acids (ΣPFCA) in cord serum was significantly negatively associated with the performance IQ (PIQ) of 7-year-old children (β = -6.21, 95 % confidence interval [CI]: -12.21, -0.21), with more pronounced associations observed among girls (β = -9.57, 95 % CI: -18.33, -0.81) than in boys. Negative, albeit non-significant, cumulative effects were noted when considering PFAS mixture exposure. Prenatal exposure to perfluorooctanoic acid, perfluorononanoic acid, and perfluorooctanesulfonic acid was positively associated with the total thyroxine/triiodothyronine ratio. However, no evidence supported the mediating role of thyroid function in the link between PFAS exposure and IQ. CONCLUSIONS Increased prenatal exposure to PFASs negatively affected the IQ of school-aged children, whereas fetal thyroid function did not serve as a mediator in this relationship.
Collapse
Affiliation(s)
- Boya Zhang
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China
| | - Zheng Wang
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China
| | - Jiming Zhang
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China.
| | - Yiming Dai
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China
| | - Jiayun Ding
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China
| | - Jianqiu Guo
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China
| | - Xiaojuan Qi
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China; Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Road, Hangzhou 310051, China
| | - Chunhua Wu
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China
| | - Zhijun Zhou
- School of Public Health/MOE Key Laboratory of Public Health Safety, Fudan University, No.130 Dong'an Road, Shanghai 200032, China.
| |
Collapse
|
3
|
Liu D, Yan S, Liu Y, Chen Q, Ren S. Association of prenatal exposure to perfluorinated and polyfluoroalkyl substances with childhood neurodevelopment: A systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 271:115939. [PMID: 38211513 DOI: 10.1016/j.ecoenv.2024.115939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Although previous studies have shown an association between prenatal exposure to perfluorinated and polyfluoroalkyl substances (PFAS) and neurodevelopmental disorders in children, the results have been inconsistent. We summarize studies on the association between prenatal PFAS exposure and neurodevelopment in children in order to better understand the relationship. OBJECTIVE We conducted a meta-analysis of prenatal PFAS exposure and developmental outcomes associated with intellectual, executive function and behavioral difficulty in children to explore the relationship between prenatal exposure to perfluorinated and polyfluoroalkyl substances (PFAS) and neurodevelopmental disorders in children. METHODS We searched for articles published up to August 3, 2023, included and quantified original studies on PFAS and child Intelligence Quotient (IQ), executive function and behavioral difficulty during pregnancy, and systematically summarized articles that could not be quantified. CONCLUSION There is evidence of sex-specific relationship between PFAS exposure and children's PIQ. We found that PFOS [β = -1.56, 95% CI = -2.96, - 0.07; exposure = per 1 ln (ng/ml) increase], PFOA [β = -1.87, 95% CI = -3.29, - 0.46; exposure = per 1 ln (ng/ml) increase], PFHxS [β = -2.02, 95% CI = -3.23, - 0.81; exposure = per 1 ln (ng/ml) increase] decreased performance IQ in boys, but PFOS [β = 1.56, 95% CI = 0.06, 3.06; exposure = per 1 ln (ng/ml) increase] increased performance IQ in girls. PFAS are associated with executive function impairments in children, but not related to behavioral difficulty in children.
Collapse
Affiliation(s)
- Dongge Liu
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Shuqi Yan
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Yanping Liu
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Qianqian Chen
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Shuping Ren
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China.
| |
Collapse
|
4
|
Stübner C, Nielsen C, Jakobsson K, Gillberg C, Miniscalco C. Early-Life Exposure to Perfluoroalkyl Substances (PFAS) and Child Language and Communication Development: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7170. [PMID: 38131721 PMCID: PMC10742458 DOI: 10.3390/ijerph20247170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/27/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
Language development starts during the fetal period when the brain is sensitive to endocrine disruptions from environmental contaminants. This systematic review aims to systematically summarize the existing literature on early-life exposure to PFAS and children's language and communication development, which is an indicator of neurocognitive development. A structured literature search was conducted using three databases, PubMed, Scopus, and CINAHL, last updated in April 2023. The population was defined as children and young adults. PFAS exposure was assessed pre- or postnatally. The outcome was defined as a language and communication ability assessed with validated instruments, parental self-reports, or clinical language disorder diagnoses. In total, 15 studies were identified for subsequent analyses. Thirteen were performed in background-exposed populations and two in highly exposed populations. There were some indications of potential adverse effects; however, these were not consistent across child sex, age of assessment, or PFAS exposure levels. No systematic effect of early-life PFAS exposure on language and communication development was found. These inconclusive findings may partly be explained by the use of general test instruments with limited validity as to children's language and communication development. Further studies over a wider exposure range using specific language test instruments are needed.
Collapse
Affiliation(s)
- Charlotte Stübner
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden; (C.G.); (C.M.)
- Department of Pediatric Speech and Language Pathology, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, 416 50 Gothenburg, Sweden
| | - Christel Nielsen
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, 223 81 Lund, Sweden;
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden;
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, 413 90 Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden; (C.G.); (C.M.)
- Department of Child and Adolescent Neuropsychiatry Unit, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, 416 50 Gothenburg, Sweden
| | - Carmela Miniscalco
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden; (C.G.); (C.M.)
- Department of Pediatric Speech and Language Pathology, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, 416 50 Gothenburg, Sweden
- Department of Child and Adolescent Neuropsychiatry Unit, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, 416 50 Gothenburg, Sweden
| |
Collapse
|
5
|
Gao XX, Zuo QL, Fu XH, Song LL, Cen MQ, Wu J. Association between prenatal exposure to per- and polyfluoroalkyl substances and neurodevelopment in children: Evidence based on birth cohort. ENVIRONMENTAL RESEARCH 2023; 236:116812. [PMID: 37536558 DOI: 10.1016/j.envres.2023.116812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/16/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Although numerous studies have examined the effect of prenatal per- and polyfluoroalkyl substances (PFAS) exposure on neurodevelopment in children, findings have been inconsistent. OBJECTIVE To better understand the effects of PFAS exposure during pregnancy on offspring neurodevelopment, we conducted a systematic review of prenatal exposure to different types of PFAS and neurodevelopment in children. METHODS A comprehensive search was conducted in the PubMed, Web of Science, and EMBASE electronic databases up to March 2023. Only birth cohort studies that report a specific association between PFAS exposure during pregnancy and neurodevelopment were included in this review. RESULTS 31 birth cohort studies that met the inclusion criteria were qualitatively integrated. Among these, 14 studies investigated the impact of PFAS exposure during pregnancy on cognition, 13 on neurobehavior, and 4 on both cognition and neurobehavior. Additionally, 4 studies explored the influence of PFAS on children's comprehensive development. CONCLUSION Prenatal PFAS exposure was associated with poor neurodevelopment in children, including psychomotor development, externalizing behavior, and comprehensive development. However, conclusive evidence regarding its effects on other neurological outcomes remains limited. In addition, sex-specific effects on social behavior and sleep problems were identified.
Collapse
Affiliation(s)
- Xin-Xin Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qian-Lin Zuo
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xi-Hang Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ling-Ling Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Man-Qiu Cen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
6
|
Xie Z, Liang H, Miao M, Wang Z, Chen Y, Yang L, Zhou Y, Cao W, Yuan W. Prenatal Exposure to Perfluoroalkyl Substances and Cognitive and Neurobehavioral Development in Children at 6 Years of Age. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023. [PMID: 37216669 DOI: 10.1021/acs.est.2c06535] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Epidemiological evidence regarding the effects of prenatal exposure to perfluoroalkyl substances (PFASs) on neurodevelopment in children is inconclusive. In 449 mother-child pairs from the Shanghai-Minhang Birth Cohort Study, we measured the concentrations of 11 PFASs in maternal plasma samples obtained at 12-16 weeks of gestation. We assessed children's neurodevelopment at 6 years of age by the fourth edition of the Chinese Wechsler Intelligence Scale for Children and Child Behavior Checklist for ages 6-18. We evaluated the association between prenatal exposure to PFASs and children's neurodevelopment and the effect modification of maternal dietary factors during pregnancy and the child's sex. We found that prenatal exposure to multiple PFASs was associated with increased scores for attention problems, and the individual effect of perfluorooctanoic acid (PFOA) was statistically significant. However, no statistically significant association between PFASs and cognitive development was observed. Additionally, we found the effect modification of maternal nut intake and child's sex. In conclusion, this study suggests that prenatal exposure to PFASs was associated with more attention problems, and maternal nut intake during pregnancy may alter the potential effect of PFASs. However, these findings were exploratory because of multiple testing and the relatively small sample size.
Collapse
Affiliation(s)
- Zhenzhen Xie
- NHC Key Laboratory of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai 200237, China
| | - Hong Liang
- NHC Key Laboratory of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai 200237, China
| | - Maohua Miao
- NHC Key Laboratory of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai 200237, China
| | - Ziliang Wang
- NHC Key Laboratory of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai 200237, China
| | - Yao Chen
- NHC Key Laboratory of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai 200237, China
| | - Lan Yang
- NHC Key Laboratory of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai 200237, China
| | - Yan Zhou
- Hubei Provincial Key Laboratory of Applied Toxicology, National Reference Laboratory of Dioxin, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China
| | - Wencheng Cao
- Hubei Provincial Key Laboratory of Applied Toxicology, National Reference Laboratory of Dioxin, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China
| | - Wei Yuan
- NHC Key Laboratory of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai 200237, China
| |
Collapse
|