Jiajun Luo1, Jingyuan Xiao2, Yu Gao3, Cecilia Høst Ramlau-Hansen4, Gunnar Toft5, Jiong Li6, Carsten Obel7, Stine Linding Andersen8, Nicole C Deziel9, Wan-Ling Tseng10, Kosuke Inoue11, Eva Cecilie Bonefeld-Jørgensen12, Jørn Olsen13, Zeyan Liew14. 1. Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA. Electronic address: jiajun.luo@yale.edu. 2. Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA. Electronic address: jingyuan.xiao@yale.edu. 3. Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: gaoyu_ciel@sjtu.edu.cn. 4. Department of Public Health, Aarhus University, Aarhus, Denmark. Electronic address: chrh@ph.au.dk. 5. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: gunnar.toft@clin.au.dk. 6. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: jl@clin.au.dk. 7. Department of Public Health, Aarhus University, Aarhus, Denmark. Electronic address: co@ph.au.dk. 8. Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark. Electronic address: stine.a@rn.dk. 9. Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA. Electronic address: nicole.deziel@yale.edu. 10. Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA. Electronic address: wan-ling.tseng@yale.edu. 11. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA. Electronic address: koinoue@ucla.edu. 12. Department of Public Health, Centre for Arctic Health & Molecular Epidemiology, Aarhus University, Denmark. Electronic address: ebj@ph.au.dk. 13. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: jo@ph.au.dk. 14. Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA. Electronic address: zeyan.liew@yale.edu.
Abstract
BACKGROUND: Perfluoroalkyl substances (PFAS) are suggested to interfere with thyroid hormone during pregnancy and influence fetal neurodevelopment. Epidemiological evidence regarding behavioral difficulties in childhood associated with prenatal PFAS exposure has been inconclusive. OBJECTIVE: We evaluated the association between prenatal PFAS exposure and behavioral difficulties at 7 and 11 years, and investigated the potential mediating role of maternal thyroid hormones. METHODS: Using pooled samples in the Danish National Birth Cohort established between 1996 and 2002, we estimated the associations between concentrations of six types of PFAS in maternal plasma (median, 8 gestational weeks) and child behavioral assessments from the Strength and Difficulties Questionnaire (SDQ), reported by parents at 7 years (n = 2421), and by parents (n = 2070) and children at 11 years (n = 2071). Behavioral difficulties were defined as having a composite SDQ score above the 90th percentile for total difficulties and externalizing or internalizing behaviors. We used logistic regression to estimate the adjusted Odds Ratio (OR) by doubling increase of prenatal PFAS (ng/ml). The possible mediating effect of maternal thyroid function classified based on thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels were evaluated. RESULTS: Prenatal perfluorononanoic acid (PFNA) was consistently associated with total and externalizing behavioral difficulties in all three SDQ measures reported by parents (OR = 1.40, 95% CI: 1.14-1.73 for age 7; OR = 1.27, 95% CI: 1.05-1.53 for age 11) or children (OR = 1.32, 95% CI: 1.11-1.58) while no consistent associations were observed for other types of PFAS. A small magnitude of natural indirect effects via maternal thyroid dysfunction (ORs ranged from 1.01 to 1.03) of several PFAS were observed for parent-reported total and externalizing behaviors at 7 years only. DISCUSSION: Prenatal PFNA exposure was associated with externalizing behavioral difficulties in childhood in repeated SDQ measures at 7 and 11 years. The slight mediating effects of maternal thyroid hormones in early gestation warrant further evaluation.
BACKGROUND:Perfluoroalkyl substances (PFAS) are suggested to interfere with thyroid hormone during pregnancy and influence fetal neurodevelopment. Epidemiological evidence regarding behavioral difficulties in childhood associated with prenatal PFAS exposure has been inconclusive. OBJECTIVE: We evaluated the association between prenatal PFAS exposure and behavioral difficulties at 7 and 11 years, and investigated the potential mediating role of maternal thyroid hormones. METHODS: Using pooled samples in the Danish National Birth Cohort established between 1996 and 2002, we estimated the associations between concentrations of six types of PFAS in maternal plasma (median, 8 gestational weeks) and child behavioral assessments from the Strength and Difficulties Questionnaire (SDQ), reported by parents at 7 years (n = 2421), and by parents (n = 2070) and children at 11 years (n = 2071). Behavioral difficulties were defined as having a composite SDQ score above the 90th percentile for total difficulties and externalizing or internalizing behaviors. We used logistic regression to estimate the adjusted Odds Ratio (OR) by doubling increase of prenatal PFAS (ng/ml). The possible mediating effect of maternal thyroid function classified based on thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels were evaluated. RESULTS: Prenatal perfluorononanoic acid (PFNA) was consistently associated with total and externalizing behavioral difficulties in all three SDQ measures reported by parents (OR = 1.40, 95% CI: 1.14-1.73 for age 7; OR = 1.27, 95% CI: 1.05-1.53 for age 11) or children (OR = 1.32, 95% CI: 1.11-1.58) while no consistent associations were observed for other types of PFAS. A small magnitude of natural indirect effects via maternal thyroid dysfunction (ORs ranged from 1.01 to 1.03) of several PFAS were observed for parent-reported total and externalizing behaviors at 7 years only. DISCUSSION: Prenatal PFNA exposure was associated with externalizing behavioral difficulties in childhood in repeated SDQ measures at 7 and 11 years. The slight mediating effects of maternal thyroid hormones in early gestation warrant further evaluation.
Authors: Ann M Vuong; Kimberly Yolton; Changchun Xie; Kim N Dietrich; Joseph M Braun; Glenys M Webster; Antonia M Calafat; Bruce P Lanphear; Aimin Chen Journal: Neurotoxicol Teratol Date: 2021-08-24 Impact factor: 3.763
Authors: Ann M Vuong; Glenys M Webster; Kimberly Yolton; Antonia M Calafat; Gina Muckle; Bruce P Lanphear; Aimin Chen Journal: Environ Res Date: 2021-02-02 Impact factor: 6.498