Prenatal Exposure to PFAS and Evaluation of Child Attentional Function at 4-6 Years of Age: The INMA Study, Spain

摘要

Background. Few studies have assessed the possible association between prenatal exposure to perfluoroalkyl substances (PFAS) and attentional function. We aimed to study such an association during preschool years. Methods. The study population was 921 mother-child pairs (recruitment period: 2003-08), from the Gipuzkoa, Sabadell, and Valencia-INMA cohorts (Spain). PFAS were analyzed in the first-trimester maternal plasma. Attentional function was assessed using the Conners' Kiddie Continuous Performance Test (K-CPT) at 4-6 years of age. We studied three indicators: omission errors (assesses inattention), commission errors (assesses impulsivity), and hit reaction time standard error (HRT-SE, assesses sustained attention). We conducted multivariate regression analyses between log2-transformed PFAS and the outcomes in each cohort and subsequent meta-analysis. We assessed sex effect modification, conducted multi-pollutant analysis, and excluded preterm and small for gestational age newborns. Results. PFHxS, PFOA, PFOS, and PFNA median levels were 0.55, 2.32, 5.91, and 0.63 ng/mL, respectively. We did not find any association between PFAS and child attentional function for the whole population. Although a non-clear differential effect between sexes (p-interaction>0.05) was found, higher estimates of the association between commission errors and the four PFAS were shown in girls, reaching statistical significance for PFNA (Beta: 1.3 [95%CI: 0.02, 2.05] associated with a 2-fold increase in PFNA levels). Estimates did not differ markedly in other sensitivity analyses. Conclusions. Results did not suggest an association between maternal PFAS and attention in preschool children. However, more research is needed to analyze this relationship in other populations at the same or older ages, and to assess a possible association in girls. Funding. ISCIII-FEDER (PI12/01890, PI13/1944, PI14/00891, PI17/00663, MS11/0178, MSII16/00051, MS16/00128), and Alicia Koplowitz Foundation 2017.