Background

Humans are widely exposed to per- and polyfluoroalkyl substances (PFAS). As fetal stage is a critical window for neurodevelopment, it is important to know if in utero exposure to PFAS affects fetal neurodevelopment. However, previous human studies are both limited and inconsistent.

Objectives

To investigate the relationship between PFAS exposure during early pregnancy and the neurodevelopmental status at 2 years of age in a prospective cohort study.

Methods

We measured 10 PFAS in maternal plasma samples collected prior to 16 weeks of gestation in the Shanghai Birth Cohort Study between 2013 and 2016. Childhood neurodevelopment was assessed at 2 years of age using the Bayley Scales of Infant and Toddler Development-Third Edition (BSID-III). Associations with domain specific scores for individual PFAS were assessed by multiple linear regression and binary logistic regression when scores were dichotomized. Quantile-based g-computation was used to estimate the joint effects of PFAS mixture.

Results

A total of 2257 mother–child pairs who had both PFAS and BSID measurements were included in our analyses. The means and standard deviations of comprehensive scores were 115 ± 22, 96 ± 15 and 108 ± 15 for cognition, language, and motor, respectively. In multiple linear regressions, we observed significant negative associations of perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDeA), perfluoroundecanoic acid (PFUnDA) with cognitive scores; PFNA, PFDeA, PFUnDA and perfluorohexanesulfonate (PFHxS) negatively with language scores; and PFNA and PFUnDA negatively with motor scores. Quantile-based g-computation showed that PFAS mixture was significantly associated with decreased cognitive and language scores, with an estimated β of −2.1 [95% confidence interval (CI): −3.5, −0.7)] and −2.0 (95% CI: −2.9, −1.0) per one quartile increase in PFAS mixture for cognitive and language domains, respectively. PFAS mixture was associated with increased odds of low cognition (adjusted odds ratio [OR] = 1.3, 95% CI:1.0, 1.6) and language scores (OR = 1.2, 95% CI: 1.1, 1.3).

Conclusions

PFAS exposure during early pregnancy was significantly associated with the adverse neurodevelopmental status at 2 years of age, which raises a serious public health concern.

中文翻译：

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2 岁儿童接触全氟烷基物质与神经发育：一项前瞻性队列研究

背景

人类广泛接触全氟烷基物质和多氟烷基物质 (PFAS)。由于胎儿阶段是神经发育的关键窗口，因此了解子宫内接触 PFAS 是否会影响胎儿神经发育非常重要。然而，之前的人类研究既有限又不一致。

目标

通过前瞻性队列研究探讨妊娠早期 PFAS 暴露与 2 岁时神经发育状态之间的关系。

方法

我们测量了 2013 年至 2016 年上海出生队列研究中妊娠 16 周前收集的母体血浆样本中的 10 种 PFAS。使用贝利婴幼儿发育量表第三版 (BSID-三）。当分数二分时，通过多元线性回归和二元逻辑回归评估个体 PFAS 与领域特定分数的关联。基于分位数的 g 计算用于估计 PFAS 混合物的联合效应。

结果

我们的分析中总共纳入了 2257 对同时进行 PFAS 和 BSID 测量的母子。认知、语言和运动综合得分的平均值和标准差分别为 115 ± 22、96 ± 15 和 108 ± 15。在多元线性回归中，我们观察到全氟辛烷磺酸（PFOS）、全氟壬酸（PFNA）、全氟癸酸（PFDeA）、全氟十一烷酸（PFUnDA）与认知评分呈显着负相关；PFNA、PFDeA、PFUnDA 和全氟己烷磺酸盐 (PFHxS) 与语言分数呈负相关；PFNA 和 PFUnDA 与运动评分呈负相关。基于分位数的 g 计算表明，PFAS 混合物与认知和语言分数下降显着相关，估计 β 为 -2.1 [95% 置信区间 (CI)：-3.5, -0.7)] 和 -2.0 (95% CI)认知和语言领域的 PFAS 混合物每增加四分位数，分别为 -2.9、-1.0）。PFAS 混合物与低认知（调整后优势比 [OR] = 1.3，95% CI：1.0，1.6）和语言分数（OR = 1.2，95% CI：1.1，1.3）的几率增加相关。

结论

妊娠早期接触 PFAS 与 2 岁时不良神经发育状态显着相关，这引起了严重的公共卫生问题。