Prenatal Exposure to Perfluoroalkyl Substances and Cognitive and Neurobehavioral Development in Children at 6 Years of Age

Prenatal exposure to PFASs was associatedwith more attentionproblems in children, which might be counteracted by higher maternalnut intake. Epidemiological evidence regarding the effects of prenatalexposureto perfluoroalkyl substances (PFASs) on neurodevelopment in childrenis inconclusive. In 449 mother-child pairs from the Shanghai-MinhangBirth Cohort Study, we measured the concentrations of 11 PFASs inmaternal plasma samples obtained at 12-16 weeks of gestation.We assessed children's neurodevelopment at 6 years of age bythe fourth edition of the Chinese Wechsler Intelligence Scale forChildren and Child Behavior Checklist for ages 6-18. We evaluatedthe association between prenatal exposure to PFASs and children'sneurodevelopment and the effect modification of maternal dietary factorsduring pregnancy and the child's sex. We found that prenatalexposure to multiple PFASs was associated with increased scores forattention problems, and the individual effect of perfluorooctanoicacid (PFOA) was statistically significant. However, no statisticallysignificant association between PFASs and cognitive development wasobserved. Additionally, we found the effect modification of maternalnut intake and child's sex. In conclusion, this study suggeststhat prenatal exposure to PFASs was associated with more attentionproblems, and maternal nut intake during pregnancy may alter the potentialeffect of PFASs. However, these findings were exploratory becauseof multiple testing and the relatively small sample size.