Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark; Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics and Adolescent Medicine, Viborg Regional Hospital, Viborg, Denmark.
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, CT, USA.
Environ Res. 2022 Sep;212(Pt B):113262. doi: 10.1016/j.envres.2022.113262. Epub 2022 Apr 8.
Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are ubiquitous in the environment and accumulate in humans. PFAS are suspected to affect the neuropsychological function of children, but only few studies have evaluated the association with childhood attention and executive function.
To investigate the association between intrauterine exposure to PFAS and offspring attention and executive function.
A total of 1593 children from the Danish National Birth Cohort, born 1996-2003, were included. The levels of 16 PFAS were measured in maternal plasma during pregnancy. At 5 years of age, the Test of Everyday Attention for Children at Five (TEACh-5) and the Behavior Rating Inventory of Executive Function (BRIEF) were performed. TEACh-5 scores were standardized to a mean of 0 and standard deviation (SD) of 1. BRIEF scores were standardized to a mean of 50 and a SD of 10. The associations between levels of seven PFAS and TEACh-5 and BRIEF were examined by multivariable linear regression adjusted for potential confounders.
Perfluorooctane sulfonamide (PFOSA) was associated with poorer selective attention [standardized mean difference (95% confidence interval) -0.5 (-0.7, -0.3), highest versus lowest quartile]. Other PFAS were not clearly associated with selective attention, and we found no clear associations between PFAS exposure and sustained attention. For parent rated executive function, perfluorooctanoate (PFOA) was associated with poorer scores, standardized mean difference 3.8 (95% confidence interval 1.6, 6.0), highest versus lowest quartile. Regarding other PFAS, the associations were less clear. We found no clear associations between any PFAS and executive function rated by preschool teachers.
Intrauterine exposure to PFOSA was associated with poorer selective attention, while PFOA was associated with poorer executive function. Given the widespread nature of PFAS exposure, these findings may have public health implications, warranting further investigation.
全氟烷基和多氟烷基物质（PFAS）在环境中无处不在，并在人体内蓄积。PFAS 被怀疑会影响儿童的神经心理学功能，但只有少数研究评估了其与儿童注意力和执行功能的关系。
研究宫内 PFAS 暴露与后代注意力和执行功能的关系。
共纳入 1996-2003 年出生于丹麦全国出生队列的 1593 名儿童。在妊娠期间测量了母亲血浆中的 16 种 PFAS 水平。在 5 岁时，进行了儿童日常注意力测试（TEACh-5）和行为评定量表的执行功能（BRIEF）。TEACh-5 分数标准化为均值 0 和标准差（SD）1。BRIEF 分数标准化为均值 50 和 SD 10。通过多变量线性回归，在校正了潜在混杂因素后，研究了七种 PFAS 水平与 TEACh-5 和 BRIEF 的关系。
全氟辛烷磺酰胺（PFOSA）与选择性注意力较差相关[标准化均数差（95%置信区间）-0.5（-0.7，-0.3），最高与最低四分位组]。其他 PFAS 与选择性注意力之间的关系不明确，我们未发现 PFAS 暴露与持续注意力之间的明确关联。对于父母评定的执行功能，全氟辛酸（PFOA）与较差的分数相关，标准化均数差 3.8（95%置信区间 1.6，6.0），最高与最低四分位组。关于其他 PFAS，关联不明确。我们未发现任何 PFAS 与幼儿教师评定的执行功能之间的明确关联。
宫内 PFOSA 暴露与选择性注意力较差有关，而 PFOA 与执行功能较差有关。鉴于 PFAS 暴露的广泛性质，这些发现可能具有公共卫生意义，值得进一步研究。
