Work

Prenatal exposure to per- and polyfluoroalkyl substances and neurodevelopmental trajectories in the first two years of life

Year: 2025

Type: article

Abstract: BACKGROUND: Prenatal exposure to perfluoroalkyl substances (PFAS) has been suggested to impact offspring neurodevelopment. However, epidemiological evidence remains limited and inconclusive, particularly as few studies have considered the longitudinal course of neurodevelopment. OBJECTIVES: We aimed to identify neurodevelopmental trajectories in children aged 6 to 24 months and to assess the individual and mixture effects of PFAS exposure on these trajectories. METHODS: In the Shanghai Birth Cohort, ten PFAS were measured in maternal serum during early pregnancy. Child neurodevelopment at 6, 12, and 24 months was assessed using standardized scales. Latent class mixed models and linear mixed-effects models were used to derive neurodevelopmental trajectory groups and individual slopes, respectively. Associations of individual PFAS and PFAS mixtures with slopes were evaluated using linear regression, Bayesian kernel machine regression (BKMR), and quantile g-computation (qgcomp), overall and by child sex. RESULTS: We analyzed 2,181 mother-child pairs with prenatal PFAS exposure and neurodevelopmental assessments. In the communication, motor, and cognition domains, children showed three distinct neurodevelopmental trajectories from 6 to 24 months: stable, increasing, and catch-up groups. Using neurodevelopmental trajectories, we quantified each individual's slope in each domain. PFUnDA, PFDA, and PFNA were consistently associated with reduced developmental slopes across all three domains, with PFUnDA showing the highest effects: -0.082 (-0.124, -0.041) for communication, -0.064 (-0.106, -0.022) for motor, and -0.132 (-0.173, -0.091) for cognition. Both the BKMR and qgcomp models revealed significant mixture effects of PFAS mixtures on developmental slopes of communication and cognition, highlighting the predominant contribution of PFUnDA, with posterior inclusion probabilities of 0.810 and 0.975, respectively. Associations were evident among girls but not among boys. CONCLUSIONS: Prenatal exposure to PFAS was significantly associated with slower neurodevelopmental progression from 6 to 24 months, particularly in girls, highlighting a potential public health concern.

Source: Environment International

DOI: 10.1016/j.envint.2025.110011