Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 2, Odense, 5000, Denmark.
Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.
Environ Health. 2023 May 30;22(1):46. doi: 10.1186/s12940-023-00993-w.
Perfluoroalkyl substances (PFAS) are persistent chemicals used in everyday consumer products leading to ubiquitous human exposure. Findings of impaired neurodevelopment after prenatal exposure to PFAS are contradictory and few studies have assessed the impact of postnatal PFAS exposure. Language development is a good early marker of neurodevelopment but only few studies have investigated this outcome separately. We therefore investigated the association between prenatal and early postnatal PFAS exposure and delayed language development in 18 to 36-month-old Danish children.
The Odense Child Cohort is a large prospective cohort. From 2010 to 2012 all newly pregnant women residing in the Municipality of Odense, Denmark was invited to participate. Concentration of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) were assessed in maternal serum collected in the 1st trimester of pregnancy and in child serum at 18 months. Parents responded to the Danish adaption of the MacArthur-Bates Communicative Development Inventories (MB-CDI) when their child was between 18 and 36 months. Language scores were converted into sex and age specific percentile scores and dichotomized to represent language scores above or below the 15th percentile. We applied Multiple Imputation by Chained Equation and conducted logistic regressions investigating the association between prenatal and early postnatal PFAS exposure and language development adjusting for maternal age, pre-pregnancy BMI, education and respectively fish intake in pregnancy or childhood and duration of breastfeeding in early postnatal PFAS exposure models.
We found no significant associations between neither prenatal nor early postnatal PFAS exposure and language development among 999 mother-child pairs.
In this low-exposed cohort the finding of no association between early postnatal PFAS exposure and language development should be interpreted with caution as we were unable to separate the potential adverse effect of PFAS exposure from the well documented positive effect of breastfeeding on neurodevelopment. We, therefore, recommend assessment of child serum PFAS at an older age as development of the brain proceeds through childhood and even a small impact of PFAS on neurodevelopment would be of public health concern at population level due to the ubiquitous human exposure.
全氟烷基物质（PFAS）是一种用于日常消费品的持久性化学物质，导致人类普遍接触。在产前接触 PFAS 后神经发育受损的发现存在矛盾，并且很少有研究评估产后 PFAS 暴露的影响。语言发展是神经发育的良好早期标志物，但只有少数研究单独研究了这一结果。因此，我们调查了 18 至 36 个月大的丹麦儿童产前和产后早期 PFAS 暴露与语言发育延迟之间的关系。
奥登塞儿童队列是一个大型前瞻性队列。2010 年至 2012 年，丹麦奥登塞市的所有新孕妇都受邀参加。在妊娠 1 期采集母体血清，在 18 个月时采集儿童血清，以评估全氟辛烷磺酸（PFOS）、全氟辛酸（PFOA）、全氟己烷磺酸（PFHxS）、全氟壬酸（PFNA）和全氟癸酸（PFDA）的浓度。当孩子在 18 至 36 个月之间时，父母会回答丹麦改编的麦克阿瑟-贝茨沟通发展量表（MB-CDI）。语言分数转换为性别和年龄特定的百分位数分数，并分为高于或低于第 15 百分位数的二分法。我们应用链方程的多重插补，并进行逻辑回归，调查产前和产后早期 PFAS 暴露与语言发展之间的关系，调整母亲年龄、孕前 BMI、教育以及怀孕期间或儿童时期的鱼摄入量和产后早期 PFAS 暴露模型中的母乳喂养持续时间。
我们在 999 对母婴对中没有发现产前和产后早期 PFAS 暴露与语言发展之间的显著关联。
在这个低暴露队列中，产后早期 PFAS 暴露与语言发展之间没有关联的发现应该谨慎解释，因为我们无法将 PFAS 暴露的潜在不利影响与母乳喂养对神经发育的已有记载的积极影响区分开来。因此，我们建议在儿童年龄较大时评估儿童血清 PFAS，因为大脑的发育贯穿儿童期，即使 PFAS 对神经发育的影响很小，由于人类普遍接触，也会引起公共卫生关注。
