OBJECTIVE Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are persistent pollutants and have endocrine disruptive and neurotoxic effects. The association between maternal PFAS concentrations and neuropsychological development in children is inconclusive. The present study aimed to examine the effect of maternal PFAS concentrations on neuropsychological development in 4-years-old children. METHODS We used data from Shanghai-Minhang Birth Cohort, which recruited pregnant women at 12-16 gestational weeks. Among 981 women having PFAS measurement, 533 mother-child pairs were included in the study. A total of eight PFASs were measured, including perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUdA), perfluorododecanoic acid (PFDoA), and perfluorotridecanoic acid (PFTrDA). When infants turned 4 years old, mothers were asked to complete the Ages and Stages Questionnaires® (ASQ) to assess neuropsychological development of their children. Poisson regression model with robust variance estimates was used to examine the association between maternal PFAS concentrations and each developmental subscale of the ASQ. RESULTS Prenatal plasma concentrations of most PFASs tended to be associated with increased risk of development problem in personal-social skills, including PFHxS, PFOS, PFOA, PFNA, PFDA, and PDUdA, and the associations for PFNA and PFDA were significant (per natural log unit increase: RRPFNA = 1.92, 95% CI: 1.21, 3.05; RR PFDA = 1.66, 95% CI: 1.17, 2.37). In stratified analyses by child' sex, the consistent pattern of higher risk of developmental problems in personal-social skills associated with most PFASs was mainly observed among girls (RRPFOS = 2.56, 95% CI: 1.20, 5.45; RRPFOA = 9.00, 95% CI: 3.82, 21.21; RRPFNA = 3.11, 95% CI: 1.36, 7.13; RRPFDA = 2.20, 95% CI: 1.21, 4.00; RRPFUdA = 2.44, 95% CI: 1.14, 5.20; RRPFDoA = 1.62, 95% CI: 1.04, 2.54). Boys with higher maternal PFOA concentrations had a decreased risk of developmental problems in gross motor skills (RR = 0.47, 95% CI: 0.25, 0.89). CONCLUSION Prenatal plasma PFAS concentrations were associated with neuropsychological development in girls at 4 years of age, mainly in the subset of personal-social skills.

中文翻译：

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四岁儿童的全氟烷基和多氟烷基物质的产前血浆浓度和儿童的神经心理发育。

目的全氟烷基和多氟烷基物质（PFAS）是持久性污染物，对内分泌具有破坏性和神经毒性作用。孕妇PFAS浓度与儿童神经心理发育之间的关系尚无定论。本研究旨在检查母体PFAS浓度对4岁儿童神经心理发育的影响。方法我们使用了上海闵行出生队列的数据，该队列在妊娠12-16周时招募了孕妇。在981名进行PFAS测量的妇女中，有533对母子被纳入研究。总共测量了8种PFAS，包括全氟辛烷磺酸（PFOS），全氟辛酸（PFOA），全氟己磺酸（PFHxS），全氟壬酸（PFNA），全氟癸酸（PFDA），全氟十一烷酸（PFUdA），全氟十二烷酸（PFDoA）和全氟十三烷酸（PFTrDA）。当婴儿满4岁时，母亲被要求填写年龄和阶段问卷（ASQ）以评估其孩子的神经心理发育。具有稳健方差估计的Poisson回归模型用于检验母体PFAS浓度与ASQ的每个发育子量表之间的关联。结果大多数PFAS的产前血浆浓度往往与个人社交技能发展问题风险增加相关，包括PFHxS，PFOS，PFOA，PFNA，PFDA和PDUdA，并且PFNA和PFDA的关联显着（按自然对数）单位增加：RRPFNA = 1.92，95％CI：1.21，3.05； RR PFDA = 1.66，95％CI：1.17，2.37）。在按儿童性别进行的分层分析中，主要在女孩中观察到与大多数PFAS相关的个人社交技能中出现发展问题的较高风险的一致模式（RRPFOS = 2.56，95％CI：1.20，5.45; RRPFOA = 9.00，95％CI：3.82，21.21; RRPFNA = 3.11，95％CI：1.36，7.13； RRPFDA = 2.20，95％CI：1.21，4.00； RRPFUdA = 2.44，95％CI：1.14，5.20； RRPFDoA = 1.62，95％CI：1.04，2.54）。孕产妇PFOA浓度较高的男孩的总体运动技能发展问题的风险降低（RR = 0.47，95％CI：0.25，0.89）。结论产前血浆PFAS浓度与4岁女孩的神经心理发育有关，主要是在个人社交技能中。21.21; RRPFNA = 3.11，95％CI：1.36，7.13; RRPFDA = 2.20，95％CI：1.21，4.00; RRPFUdA = 2.44，95％CI：1.14，5.20；RRPFDoA = 1.62，95％CI：1.04，2.54）。孕产妇PFOA浓度较高的男孩的总体运动技能发展问题的风险降低（RR = 0.47，95％CI：0.25，0.89）。结论产前血浆PFAS浓度与4岁女孩的神经心理发育有关，主要是在个人社交技能中。21.21; RRPFNA = 3.11，95％CI：1.36，7.13; RRPFDA = 2.20，95％CI：1.21，4.00; RRPFUdA = 2.44，95％CI：1.14，5.20；RRPFDoA = 1.62，95％CI：1.04，2.54）。孕产妇PFOA浓度较高的男孩的总体运动技能发展问题的风险降低（RR = 0.47，95％CI：0.25，0.89）。结论产前血浆PFAS浓度与4岁女孩的神经心理发育有关，主要是在个人社交技能中。