Pregnancy serum concentrations of perfluorinated alkyl substances and offspring behaviour and motor development at age 5–9 years – a prospective studyReport as inadecuate

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Environmental Health

, 14:2

Children-s Environmental Health


BackgroundIn animal studies, perfluorinated alkyl substances affect growth and neuro-behavioural outcomes. Human epidemiological studies are sparse. The aim was to investigate the association between pregnancy serum concentrations of perfluorooctanoate PFOA and perfluorooctane sulfonate PFOS and offspring behaviour and motor development at 5–9 years of age.

MethodsMaternal sera from the INUENDO cohort 2002–2004 comprising 1,106 mother-child pairs from Greenland, Kharkiv Ukraine and Warsaw Poland were analysed for PFOS and PFOA, using liquid-chromatography-tandem-mass-spectrometry. Exposures were grouped into country specific as well as pooled tertiles as well as being used as continuous variables for statistical analyses. Child motor development and behaviour at follow-up 2010–2012 were measured by the Developmental Coordination Disorder Questionnaire 2007 DCDQ and Strength and Difficulties Questionnaire SDQ, respectively. Exposure-outcome associations were analysed by multiple logistic and linear regression analyses.

ResultsIn the pooled analysis, odds ratio OR 95% confidence interval CI for hyperactivity was 3.1 1.3, 7.2 comparing children prenatally exposed to the highest PFOA tertile with those exposed to the lowest PFOA tertile. Comparing children in the highest PFOS tertile with those in the lowest PFOS tertile showed elevated but statistically non-significant OR of hyperactivity OR 95% CI 1.7 0.9, 3.2. In Greenland, elevated PFOS was associated with higher SDQ-total scores indicating more behavioural problems β 95% CI =1.0 0.1, 2.0 and elevated PFOA was associated with higher hyperactivity sub-scale scores indicating more hyperactive behaviour β 95% CI = 0.5 0.1, 0.9. Prenatal PFOS and PFOA exposures were not associated with motor difficulties.

ConclusionsPrenatal exposure to PFOS and PFOA may have a small to moderate effect on children’s neuro-behavioural development, specifically in terms of hyperactive behaviour. The associations were strongest in Greenland where exposure contrast is largest.

KeywordsBehaviour Child Child development Cohort study Motor development Perfluorooctanoate PFOA Perfluorooctane sulfonate PFOS Prenatal exposure, Delayed effects AbbreviationsADHDattention deficit hyperactivity disorder

CIconfidence interval

DCDQDevelopmental Coordination Disorder Questionnaire 2007

ORodds ratio

PFASPerfluorinated alkyl substances

PFDoDAperfluorododecanoic acid

PFNAperfluorononanoic acid


PFOSperfluorooctane sulfonate

PFUnDAperfluoroundecanoic acid

SDQStrength and Difficulties Questionnaire


T4total free thyroxine

TSHthyroid-stimulating hormone.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-069X-14-2 contains supplementary material, which is available to authorized users.

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Author: Birgit Bjerre Høyer - Cecilia Høst Ramlau-Hansen - Carsten Obel - Henning Sloth Pedersen - Agnieszka Hernik - Victor Og


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