Prenatal exposure to persistent organic pollutants and associations with child behavior problems at 1-5 years.

Existing studies have found inconclusive associations between prenatal exposure to persistent organic pollutants (POPs), including per- and polyfluoroalkyl substances (PFAS) and polybrominated diphenyl ethers (PBDEs), and offspring neurodevelopment. However, there is a significant gap in research involving African American populations, who face higher levels of exposure to many POPs relative to other groups. In this study, we assessed the joint effects of PFAS and PBDEs on child behavior problems among mother-child pairs in Atlanta, Georgia. Our study population included a subset of mother-child pairs participating in a prospective birth cohort (N = 159) for whom exposure and outcome data were available. Four PFAS and three PBDEs were measured in serum samples obtained during the first trimester of pregnancy. The Child Behavior Checklist was administered annually from ages 1-5 years and used to assess internalizing and externalizing behavior problems (averaged across all timepoints). We used quantile g-computation, Bayesian kernel machine regression (BKMR), and self-organizing maps (SOM) to assess associations between POPs mixtures and internalizing and externalizing behavior problems. Using quantile g-computation, we observed that increasing concentrations of prenatal PBDEs were associated with more internalizing and externalizing behavior problems (e.g., Ѱ = 0.20, 95 % CI = 0.04, 0.36 for externalizing problems). The SOM cluster reflecting high PFAS and high PBDEs was similarly associated with an increase in internalizing and externalizing behavior problems compared to the reference cluster (e.g., β = 0.44 95 % CI = 0.08, 0.81 for internalizing problems). The positive associations were attributable to PBDEs, while PFAS were negatively associated with both outcomes across all three methods. To conclude, among mother-child pairs in Atlanta, we observed that exposure to PFAS and PBDEs was associated with internalizing and externalizing behavior problems between 1 and 5 years of age.