产前暴露于全氟和多氟烷基物质与7岁儿童的执行功能及行为问题：来自上海出生队列研究的证据
Prenatal exposure to per- and polyfluoroalkyl substances and childhood executive function and behavioral difficulties at age 7: evidence from the Shanghai birth cohort study.
作者信息
He Xiaoqing, Wu Ruisi, Jiang Wen, Tian Ying, Zhang Jun, Huang Yun
机构信息
Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Embryo-originated Diseases, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
出版信息
Environ Int. 2025 Aug;202:109687. doi: 10.1016/j.envint.2025.109687. Epub 2025 Jul 17.
BACKGROUND
Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants. Prenatal exposure during critical developmental windows may adversely affect fetal brain development. However, evidence on the impact of prenatal PFAS exposure on early school-age behavioral and executive function remains inconsistent, with particularly limited data available from high-exposure regions. This study investigated prenatal PFAS exposure and neurodevelopmental outcomes in 7-year-old children within a prospective birth cohort.
METHODS
This study analyzed data from the Shanghai Birth Cohort, which included 1,543 mother-child pairs. Maternal plasma collected during early pregnancy was tested for ten PFAS compounds. Neurodevelopmental outcomes at age 7 were assessed using the Behavior Rating Inventory of Executive Function and the Strengths and Difficulties Questionnaire. Multivariable linear regression, quantile-based g-computation, and weighted quantile sum regression evaluated individual and joint effects. Stratified analyses by sex and sensitivity analyses were conducted.
RESULTS
Prenatal PFOA exposure was associated with increased executive dysfunction (BRI: β = 0.80, 95 % CI [0.16, 1.43]) and behavioral problems (total difficulties: β = 0.56, 95 % CI [0.19, 0.93]). Conversely, PFUA and PFDA were associated with decreased neurodevelopmental scores. Sex-stratified analyses linked PFOA and PFHpA exposure to poorer outcomes in females, while PFNA, PFDA, and PFUA were associated with better outcomes in males. Mixture analyses found no significant joint effects. Sensitivity analyses confirmed the robustness of the findings.
CONCLUSION
Our study revealed that prenatal PFAS exposure in 7-year-old Chinese children had compound-specific and sex-dependent impacts on executive function and behavioral outcomes. PFOA was associated with poorer performance, while PFUA and PFDA demonstrated inverse relationships, particularly in males.
背景
全氟和多氟烷基物质（PFAS）是持久性环境污染物。在关键发育窗口期的产前暴露可能会对胎儿大脑发育产生不利影响。然而，关于产前PFAS暴露对学龄早期行为和执行功能影响的证据仍然不一致，来自高暴露地区的数据尤其有限。本研究调查了一个前瞻性出生队列中7岁儿童的产前PFAS暴露情况及其神经发育结局。
方法
本研究分析了上海出生队列的数据，该队列包括1543对母婴。检测了孕早期采集的母体血浆中的十种PFAS化合物。使用执行功能行为评定量表和长处与困难问卷评估7岁时的神经发育结局。多变量线性回归、基于分位数的g计算和加权分位数和回归评估了个体和联合效应。进行了按性别分层分析和敏感性分析。
结果
产前全氟辛酸（PFOA）暴露与执行功能障碍增加（执行功能行为评定量表：β = 0.80，95%置信区间[0.16，1.43]）和行为问题（总困难：β = 0.56，95%置信区间[0.19，0.93]）相关。相反，全氟十一酸（PFUA）和全氟癸二酸（PFDA）与神经发育评分降低相关。按性别分层分析表明，PFOA和全氟庚酸（PFHpA）暴露与女性较差的结局相关，而全氟壬酸（PFNA）、PFDA和PFUA与男性较好的结局相关。混合分析未发现显著的联合效应。敏感性分析证实了研究结果的稳健性。
结论
我们的研究表明，中国7岁儿童的产前PFAS暴露对执行功能和行为结局具有化合物特异性和性别依赖性影响。PFOA与较差的表现相关，而PFUA和PFDA则呈现相反关系，尤其是在男性中。
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