Prenatal exposure to perfluoroalkyl substances and associations with symptoms of attention-deficit/hyperactivity disorder and cognitive functions in preschool children
Perfluoroalkyl substances (PFASs) are persistent organic pollutants that are suspected to be neurodevelopmental toxicants, but epidemiological evidence on neurodevelopmental effects of PFAS exposure is inconsistent. We investigated the associations between prenatal exposure to PFASs and symptoms of...
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| Veröffentlicht in: | International journal of hygiene and environmental health 2020-01, Vol.223 (1), p.80-92 |
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| creator | Skogheim, Thea S. Villanger, Gro D. Weyde, Kjell Vegard F. Engel, Stephanie M. Surén, Pål Øie, Merete G. Skogan, Annette H. Biele, Guido Zeiner, Pål Øvergaard, Kristin R. Haug, Line S. Sabaredzovic, Azemira Aase, Heidi |
| description | Perfluoroalkyl substances (PFASs) are persistent organic pollutants that are suspected to be neurodevelopmental toxicants, but epidemiological evidence on neurodevelopmental effects of PFAS exposure is inconsistent. We investigated the associations between prenatal exposure to PFASs and symptoms of attention-deficit/hyperactivity disorder (ADHD) and cognitive functioning (language skills, estimated IQ and working memory) in preschool children, as well as effect modification by child sex.
This study included 944 mother-child pairs enrolled in a longitudinal prospective study of ADHD symptoms (the ADHD Study), with participants recruited from The Norwegian Mother, Father and Child Cohort Study (MoBa). Boys and girls aged three and a half years, participated in extensive clinical assessments using well-validated tools; The Preschool Age Psychiatric Assessment interview, Child Development Inventory and Stanford-Binet (5th revision). Prenatal levels of 19 PFASs were measured in maternal blood at week 17 of gestation. Multivariable adjusted regression models were used to examine exposure-outcome associations with two principal components extracted from the seven detected PFASs. Based on these results, we performed regression analyses of individual PFASs categorized into quintiles.
PFAS component 1 was mainly explained by perfluoroheptane sulfonate (PFHpS), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorooctanoic acid (PFOA). PFAS component 2 was mainly explained by perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA) and perfluorononanoic acid (PFNA). Regression models showed a negative association between PFAS component 1 and nonverbal working memory [β = -0.08 (CI: -0.12, -0.03)] and a positive association between PFAS component 2 and verbal working memory [β = 0.07 (CI: 0.01, 0.12)]. There were no associations with ADHD symptoms, language skills or IQ. For verbal working memory and PFAS component 2, we found evidence for effect modification by child sex, with associations only for boys. The results of quintile models with individual PFASs, showed the same pattern for working memory as the results in the component regression analyses. There were negative associations between nonverbal working memory and quintiles of PFOA, PFNA, PFHxS, PFHpS and PFOS and positive associations between verbal working memory and quintiles of PFOA, PFNA, PFDA and PFUnDA, with significant relationships mainly in the highest concentration |
| doi_str_mv | 10.1016/j.ijheh.2019.10.003 |
| format | Article |
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This study included 944 mother-child pairs enrolled in a longitudinal prospective study of ADHD symptoms (the ADHD Study), with participants recruited from The Norwegian Mother, Father and Child Cohort Study (MoBa). Boys and girls aged three and a half years, participated in extensive clinical assessments using well-validated tools; The Preschool Age Psychiatric Assessment interview, Child Development Inventory and Stanford-Binet (5th revision). Prenatal levels of 19 PFASs were measured in maternal blood at week 17 of gestation. Multivariable adjusted regression models were used to examine exposure-outcome associations with two principal components extracted from the seven detected PFASs. Based on these results, we performed regression analyses of individual PFASs categorized into quintiles.
PFAS component 1 was mainly explained by perfluoroheptane sulfonate (PFHpS), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorooctanoic acid (PFOA). PFAS component 2 was mainly explained by perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA) and perfluorononanoic acid (PFNA). Regression models showed a negative association between PFAS component 1 and nonverbal working memory [β = -0.08 (CI: -0.12, -0.03)] and a positive association between PFAS component 2 and verbal working memory [β = 0.07 (CI: 0.01, 0.12)]. There were no associations with ADHD symptoms, language skills or IQ. For verbal working memory and PFAS component 2, we found evidence for effect modification by child sex, with associations only for boys. The results of quintile models with individual PFASs, showed the same pattern for working memory as the results in the component regression analyses. There were negative associations between nonverbal working memory and quintiles of PFOA, PFNA, PFHxS, PFHpS and PFOS and positive associations between verbal working memory and quintiles of PFOA, PFNA, PFDA and PFUnDA, with significant relationships mainly in the highest concentration groups.
Based on our results, we did not find consistent evidence to conclude that prenatal exposure to PFASs are associated with ADHD symptoms or cognitive dysfunctions in preschool children aged three and a half years, which is in line with the majority of studies in this area. Our results showed some associations between PFASs and working memory, particularly negative relationships with nonverbal working memory, but also positive relationships with verbal working memory. The relationships were weak, as well as both positive and negative, which suggest no clear association – and need for replication.</description><identifier>ISSN: 1438-4639</identifier><identifier>EISSN: 1618-131X</identifier><identifier>DOI: 10.1016/j.ijheh.2019.10.003</identifier><identifier>PMID: 31653559</identifier><language>eng</language><publisher>Germany: Elsevier GmbH</publisher><subject>Alkanesulfonic Acids - blood ; Attention Deficit Disorder with Hyperactivity - epidemiology ; Attention-deficit/hyperactivity disorder (ADHD) ; Caprylates - blood ; Child, Preschool ; Cognition - drug effects ; Cognitive functions ; Decanoic Acids - blood ; Environmental Exposure - statistics & numerical data ; Environmental Pollutants - blood ; Environmental Pollutants - toxicity ; Father and Child Cohort Study (MoBa) ; Fatty Acids - blood ; Female ; Fluorocarbons - blood ; Fluorocarbons - toxicity ; Humans ; Male ; Memory, Short-Term ; Norway - epidemiology ; Perfluoroalkyl substances (PFASs) ; Pregnancy ; Prenatal ; Prenatal Exposure Delayed Effects - epidemiology ; The Norwegian Mother</subject><ispartof>International journal of hygiene and environmental health, 2020-01, Vol.223 (1), p.80-92</ispartof><rights>2019 Elsevier GmbH</rights><rights>Copyright © 2019 Elsevier GmbH. All rights reserved.</rights><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-64441e38599887925e36be93d7743b7e0cdcd2d81a190096bb4930206f0d7fda3</citedby><cites>FETCH-LOGICAL-c483t-64441e38599887925e36be93d7743b7e0cdcd2d81a190096bb4930206f0d7fda3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S143846391930570X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,3537,26546,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31653559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Skogheim, Thea S.</creatorcontrib><creatorcontrib>Villanger, Gro D.</creatorcontrib><creatorcontrib>Weyde, Kjell Vegard F.</creatorcontrib><creatorcontrib>Engel, Stephanie M.</creatorcontrib><creatorcontrib>Surén, Pål</creatorcontrib><creatorcontrib>Øie, Merete G.</creatorcontrib><creatorcontrib>Skogan, Annette H.</creatorcontrib><creatorcontrib>Biele, Guido</creatorcontrib><creatorcontrib>Zeiner, Pål</creatorcontrib><creatorcontrib>Øvergaard, Kristin R.</creatorcontrib><creatorcontrib>Haug, Line S.</creatorcontrib><creatorcontrib>Sabaredzovic, Azemira</creatorcontrib><creatorcontrib>Aase, Heidi</creatorcontrib><title>Prenatal exposure to perfluoroalkyl substances and associations with symptoms of attention-deficit/hyperactivity disorder and cognitive functions in preschool children</title><title>International journal of hygiene and environmental health</title><addtitle>Int J Hyg Environ Health</addtitle><description>Perfluoroalkyl substances (PFASs) are persistent organic pollutants that are suspected to be neurodevelopmental toxicants, but epidemiological evidence on neurodevelopmental effects of PFAS exposure is inconsistent. We investigated the associations between prenatal exposure to PFASs and symptoms of attention-deficit/hyperactivity disorder (ADHD) and cognitive functioning (language skills, estimated IQ and working memory) in preschool children, as well as effect modification by child sex.
This study included 944 mother-child pairs enrolled in a longitudinal prospective study of ADHD symptoms (the ADHD Study), with participants recruited from The Norwegian Mother, Father and Child Cohort Study (MoBa). Boys and girls aged three and a half years, participated in extensive clinical assessments using well-validated tools; The Preschool Age Psychiatric Assessment interview, Child Development Inventory and Stanford-Binet (5th revision). Prenatal levels of 19 PFASs were measured in maternal blood at week 17 of gestation. Multivariable adjusted regression models were used to examine exposure-outcome associations with two principal components extracted from the seven detected PFASs. Based on these results, we performed regression analyses of individual PFASs categorized into quintiles.
PFAS component 1 was mainly explained by perfluoroheptane sulfonate (PFHpS), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorooctanoic acid (PFOA). PFAS component 2 was mainly explained by perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA) and perfluorononanoic acid (PFNA). Regression models showed a negative association between PFAS component 1 and nonverbal working memory [β = -0.08 (CI: -0.12, -0.03)] and a positive association between PFAS component 2 and verbal working memory [β = 0.07 (CI: 0.01, 0.12)]. There were no associations with ADHD symptoms, language skills or IQ. For verbal working memory and PFAS component 2, we found evidence for effect modification by child sex, with associations only for boys. The results of quintile models with individual PFASs, showed the same pattern for working memory as the results in the component regression analyses. There were negative associations between nonverbal working memory and quintiles of PFOA, PFNA, PFHxS, PFHpS and PFOS and positive associations between verbal working memory and quintiles of PFOA, PFNA, PFDA and PFUnDA, with significant relationships mainly in the highest concentration groups.
Based on our results, we did not find consistent evidence to conclude that prenatal exposure to PFASs are associated with ADHD symptoms or cognitive dysfunctions in preschool children aged three and a half years, which is in line with the majority of studies in this area. Our results showed some associations between PFASs and working memory, particularly negative relationships with nonverbal working memory, but also positive relationships with verbal working memory. The relationships were weak, as well as both positive and negative, which suggest no clear association – and need for replication.</description><subject>Alkanesulfonic Acids - blood</subject><subject>Attention Deficit Disorder with Hyperactivity - epidemiology</subject><subject>Attention-deficit/hyperactivity disorder (ADHD)</subject><subject>Caprylates - blood</subject><subject>Child, Preschool</subject><subject>Cognition - drug effects</subject><subject>Cognitive functions</subject><subject>Decanoic Acids - blood</subject><subject>Environmental Exposure - statistics & numerical data</subject><subject>Environmental Pollutants - blood</subject><subject>Environmental Pollutants - toxicity</subject><subject>Father and Child Cohort Study (MoBa)</subject><subject>Fatty Acids - blood</subject><subject>Female</subject><subject>Fluorocarbons - blood</subject><subject>Fluorocarbons - toxicity</subject><subject>Humans</subject><subject>Male</subject><subject>Memory, Short-Term</subject><subject>Norway - epidemiology</subject><subject>Perfluoroalkyl substances (PFASs)</subject><subject>Pregnancy</subject><subject>Prenatal</subject><subject>Prenatal Exposure Delayed Effects - epidemiology</subject><subject>The Norwegian Mother</subject><issn>1438-4639</issn><issn>1618-131X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>3HK</sourceid><recordid>eNp9kdtu1DAQhiNERUvhCZDAL5CtDzn5AiRUcZIqtRcgcWc59qSZJWtHtrOQJ-I18XZpRW-4sjX_P5_H8xfFK0Y3jLLmYrvB7QjjhlMmc2VDqXhSnLGGdSUT7PvTfK9EV1aNkKfF8xi3lHJGO_msOBWsqUVdy7Pi900Ap5OeCPyafVwCkOTJDGGYFh-8nn6sE4lLH5N2BiLRzhIdozeoE3oXyU9MI4nrbk5-F4kfiE4J3EErLQxoMF2Ma-Zpk3CPaSUWow8Wwh3K-FuHWQAyLM4ciejIHCCa0fuJmBEnm0d8UZwMeorw8u95Xnz7-OHr5efy6vrTl8v3V6WpOpHKpqoqBqKrpey6VvIaRNODFLZtK9G3QI01ltuOaSYplU3fV1JQTpuB2nawWpwX747ceel3YE3-StCTmgPudFiV16geKw5Hdev3qpGcU0kz4M0RYALGhE45H7TKe6-5amvW8uwQ9w4fY4Dhgc6oOiSrtuouWXVI9lDMyeau1_8O9tBzH2U2vD0aIK9njxBUNAg5NIsBTFLW438f-AOUU7v7</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Skogheim, Thea S.</creator><creator>Villanger, Gro D.</creator><creator>Weyde, Kjell Vegard F.</creator><creator>Engel, Stephanie M.</creator><creator>Surén, Pål</creator><creator>Øie, Merete G.</creator><creator>Skogan, Annette H.</creator><creator>Biele, Guido</creator><creator>Zeiner, Pål</creator><creator>Øvergaard, Kristin R.</creator><creator>Haug, Line S.</creator><creator>Sabaredzovic, Azemira</creator><creator>Aase, Heidi</creator><general>Elsevier GmbH</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3HK</scope><scope>5PM</scope></search><sort><creationdate>20200101</creationdate><title>Prenatal exposure to perfluoroalkyl substances and associations with symptoms of attention-deficit/hyperactivity disorder and cognitive functions in preschool children</title><author>Skogheim, Thea S. ; Villanger, Gro D. ; Weyde, Kjell Vegard F. ; Engel, Stephanie M. ; Surén, Pål ; Øie, Merete G. ; Skogan, Annette H. ; Biele, Guido ; Zeiner, Pål ; Øvergaard, Kristin R. ; Haug, Line S. ; Sabaredzovic, Azemira ; Aase, Heidi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-64441e38599887925e36be93d7743b7e0cdcd2d81a190096bb4930206f0d7fda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Alkanesulfonic Acids - blood</topic><topic>Attention Deficit Disorder with Hyperactivity - epidemiology</topic><topic>Attention-deficit/hyperactivity disorder (ADHD)</topic><topic>Caprylates - blood</topic><topic>Child, Preschool</topic><topic>Cognition - drug effects</topic><topic>Cognitive functions</topic><topic>Decanoic Acids - blood</topic><topic>Environmental Exposure - statistics & numerical data</topic><topic>Environmental Pollutants - blood</topic><topic>Environmental Pollutants - toxicity</topic><topic>Father and Child Cohort Study (MoBa)</topic><topic>Fatty Acids - blood</topic><topic>Female</topic><topic>Fluorocarbons - blood</topic><topic>Fluorocarbons - toxicity</topic><topic>Humans</topic><topic>Male</topic><topic>Memory, Short-Term</topic><topic>Norway - epidemiology</topic><topic>Perfluoroalkyl substances (PFASs)</topic><topic>Pregnancy</topic><topic>Prenatal</topic><topic>Prenatal Exposure Delayed Effects - epidemiology</topic><topic>The Norwegian Mother</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Skogheim, Thea S.</creatorcontrib><creatorcontrib>Villanger, Gro D.</creatorcontrib><creatorcontrib>Weyde, Kjell Vegard F.</creatorcontrib><creatorcontrib>Engel, Stephanie M.</creatorcontrib><creatorcontrib>Surén, Pål</creatorcontrib><creatorcontrib>Øie, Merete G.</creatorcontrib><creatorcontrib>Skogan, Annette H.</creatorcontrib><creatorcontrib>Biele, Guido</creatorcontrib><creatorcontrib>Zeiner, Pål</creatorcontrib><creatorcontrib>Øvergaard, Kristin R.</creatorcontrib><creatorcontrib>Haug, Line S.</creatorcontrib><creatorcontrib>Sabaredzovic, Azemira</creatorcontrib><creatorcontrib>Aase, Heidi</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>NORA - Norwegian Open Research Archives</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of hygiene and environmental health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Skogheim, Thea S.</au><au>Villanger, Gro D.</au><au>Weyde, Kjell Vegard F.</au><au>Engel, Stephanie M.</au><au>Surén, Pål</au><au>Øie, Merete G.</au><au>Skogan, Annette H.</au><au>Biele, Guido</au><au>Zeiner, Pål</au><au>Øvergaard, Kristin R.</au><au>Haug, Line S.</au><au>Sabaredzovic, Azemira</au><au>Aase, Heidi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prenatal exposure to perfluoroalkyl substances and associations with symptoms of attention-deficit/hyperactivity disorder and cognitive functions in preschool children</atitle><jtitle>International journal of hygiene and environmental health</jtitle><addtitle>Int J Hyg Environ Health</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>223</volume><issue>1</issue><spage>80</spage><epage>92</epage><pages>80-92</pages><issn>1438-4639</issn><eissn>1618-131X</eissn><abstract>Perfluoroalkyl substances (PFASs) are persistent organic pollutants that are suspected to be neurodevelopmental toxicants, but epidemiological evidence on neurodevelopmental effects of PFAS exposure is inconsistent. We investigated the associations between prenatal exposure to PFASs and symptoms of attention-deficit/hyperactivity disorder (ADHD) and cognitive functioning (language skills, estimated IQ and working memory) in preschool children, as well as effect modification by child sex.
This study included 944 mother-child pairs enrolled in a longitudinal prospective study of ADHD symptoms (the ADHD Study), with participants recruited from The Norwegian Mother, Father and Child Cohort Study (MoBa). Boys and girls aged three and a half years, participated in extensive clinical assessments using well-validated tools; The Preschool Age Psychiatric Assessment interview, Child Development Inventory and Stanford-Binet (5th revision). Prenatal levels of 19 PFASs were measured in maternal blood at week 17 of gestation. Multivariable adjusted regression models were used to examine exposure-outcome associations with two principal components extracted from the seven detected PFASs. Based on these results, we performed regression analyses of individual PFASs categorized into quintiles.
PFAS component 1 was mainly explained by perfluoroheptane sulfonate (PFHpS), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorooctanoic acid (PFOA). PFAS component 2 was mainly explained by perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA) and perfluorononanoic acid (PFNA). Regression models showed a negative association between PFAS component 1 and nonverbal working memory [β = -0.08 (CI: -0.12, -0.03)] and a positive association between PFAS component 2 and verbal working memory [β = 0.07 (CI: 0.01, 0.12)]. There were no associations with ADHD symptoms, language skills or IQ. For verbal working memory and PFAS component 2, we found evidence for effect modification by child sex, with associations only for boys. The results of quintile models with individual PFASs, showed the same pattern for working memory as the results in the component regression analyses. There were negative associations between nonverbal working memory and quintiles of PFOA, PFNA, PFHxS, PFHpS and PFOS and positive associations between verbal working memory and quintiles of PFOA, PFNA, PFDA and PFUnDA, with significant relationships mainly in the highest concentration groups.
Based on our results, we did not find consistent evidence to conclude that prenatal exposure to PFASs are associated with ADHD symptoms or cognitive dysfunctions in preschool children aged three and a half years, which is in line with the majority of studies in this area. Our results showed some associations between PFASs and working memory, particularly negative relationships with nonverbal working memory, but also positive relationships with verbal working memory. The relationships were weak, as well as both positive and negative, which suggest no clear association – and need for replication.</abstract><cop>Germany</cop><pub>Elsevier GmbH</pub><pmid>31653559</pmid><doi>10.1016/j.ijheh.2019.10.003</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; NORA - Norwegian Open Research Archives; Elsevier ScienceDirect Journals |
| subjects | Alkanesulfonic Acids - blood Attention Deficit Disorder with Hyperactivity - epidemiology Attention-deficit/hyperactivity disorder (ADHD) Caprylates - blood Child, Preschool Cognition - drug effects Cognitive functions Decanoic Acids - blood Environmental Exposure - statistics & numerical data Environmental Pollutants - blood Environmental Pollutants - toxicity Father and Child Cohort Study (MoBa) Fatty Acids - blood Female Fluorocarbons - blood Fluorocarbons - toxicity Humans Male Memory, Short-Term Norway - epidemiology Perfluoroalkyl substances (PFASs) Pregnancy Prenatal Prenatal Exposure Delayed Effects - epidemiology The Norwegian Mother |
| title | Prenatal exposure to perfluoroalkyl substances and associations with symptoms of attention-deficit/hyperactivity disorder and cognitive functions in preschool children |
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