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Exposure to per- and polyfluoroalkyl substances in early pregnancy and risk of cerebral palsy in children

Vilhelmsson, Andreas LU orcid ; Rylander, Lars LU orcid ; Jöud, Anna LU orcid ; Lindh, Christian H LU orcid ; Mattsson, Kristina LU ; Liew, Zeyan ; Guo, Pengfei LU ; Ritz, Beate ; Källén, Karin LU and Thacher, Jesse D LU (2023) In Science of the Total Environment 899.
Abstract

BACKGROUND: Most cerebral palsy (CP) cases have an unexplained etiology, but a role for environmental exposures has been suggested. One purported environmental risk factor is exposure to endocrine-disrupting pollutants specifically per- and polyfluoroalkyl substances (PFAS).

OBJECTIVES: We investigated the association between prenatal PFAS exposures and CP in Swedish children.

METHODS: In this case-control study, 322 CP cases, 343 population controls, and 258 preterm controls were identified from a birth registry in combination with a CP follow-up program from 1995 to 2014 and linked to a biobank which contains serum samples from week 10-14 of pregnancy. Maternal serum concentrations of four PFAS compounds: perfluorohexane... (More)

BACKGROUND: Most cerebral palsy (CP) cases have an unexplained etiology, but a role for environmental exposures has been suggested. One purported environmental risk factor is exposure to endocrine-disrupting pollutants specifically per- and polyfluoroalkyl substances (PFAS).

OBJECTIVES: We investigated the association between prenatal PFAS exposures and CP in Swedish children.

METHODS: In this case-control study, 322 CP cases, 343 population controls, and 258 preterm controls were identified from a birth registry in combination with a CP follow-up program from 1995 to 2014 and linked to a biobank which contains serum samples from week 10-14 of pregnancy. Maternal serum concentrations of four PFAS compounds: perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorooctane sulfonate (PFOS) were analyzed using liquid chromatography-tandem-mass-spectrometry. We estimated odds ratios (ORs) and 95 % confidence intervals (CIs) for CP and each PFAS in quartiles and as continuous variables controlling for various sociodemographic and lifestyle factors.

RESULTS: In crude and adjusted analyses, we did not find consistent evidence of associations between serum PFHxS, PFOA, PFNA, PFOS and concentrations in early pregnancy and CP, except in preterm infants. The ORs comparing the highest PFAS quartiles to the lowest were 1.05 (95 % CI: 0.63-1.76), 0.96 (95 % CI: 0.55-1.68), 0.71 (95 % CI: 0.41-1.25), and 1.17 (95 % CI: 0.61-2.26), for PFHxS, PFOA, PFNA, and PFOS, respectively. Some positive associations were observed for preterm infants, but the results were imprecise. Similar patterns were observed in analyses treating PFAS as continuous variables.

CONCLUSIONS: In this study, we found little evidence that early pregnancy prenatal exposure to PFHxS, PFOA, PFNA, or PFOS increases the risk of CP. However, some positive associations were observed for preterm cases and warrant further investigation.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Science of the Total Environment
volume
899
article number
165622
publisher
Elsevier
external identifiers
  • scopus:85165311090
  • pmid:37474063
ISSN
1879-1026
DOI
10.1016/j.scitotenv.2023.165622
language
English
LU publication?
yes
additional info
Copyright © 2023. Published by Elsevier B.V.
id
c5909b1b-02c6-4a86-b7ef-bce35c3f07c0
date added to LUP
2023-07-22 20:56:29
date last changed
2024-04-19 23:55:29
@article{c5909b1b-02c6-4a86-b7ef-bce35c3f07c0,
  abstract     = {{<p>BACKGROUND: Most cerebral palsy (CP) cases have an unexplained etiology, but a role for environmental exposures has been suggested. One purported environmental risk factor is exposure to endocrine-disrupting pollutants specifically per- and polyfluoroalkyl substances (PFAS).</p><p>OBJECTIVES: We investigated the association between prenatal PFAS exposures and CP in Swedish children.</p><p>METHODS: In this case-control study, 322 CP cases, 343 population controls, and 258 preterm controls were identified from a birth registry in combination with a CP follow-up program from 1995 to 2014 and linked to a biobank which contains serum samples from week 10-14 of pregnancy. Maternal serum concentrations of four PFAS compounds: perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorooctane sulfonate (PFOS) were analyzed using liquid chromatography-tandem-mass-spectrometry. We estimated odds ratios (ORs) and 95 % confidence intervals (CIs) for CP and each PFAS in quartiles and as continuous variables controlling for various sociodemographic and lifestyle factors.</p><p>RESULTS: In crude and adjusted analyses, we did not find consistent evidence of associations between serum PFHxS, PFOA, PFNA, PFOS and concentrations in early pregnancy and CP, except in preterm infants. The ORs comparing the highest PFAS quartiles to the lowest were 1.05 (95 % CI: 0.63-1.76), 0.96 (95 % CI: 0.55-1.68), 0.71 (95 % CI: 0.41-1.25), and 1.17 (95 % CI: 0.61-2.26), for PFHxS, PFOA, PFNA, and PFOS, respectively. Some positive associations were observed for preterm infants, but the results were imprecise. Similar patterns were observed in analyses treating PFAS as continuous variables.</p><p>CONCLUSIONS: In this study, we found little evidence that early pregnancy prenatal exposure to PFHxS, PFOA, PFNA, or PFOS increases the risk of CP. However, some positive associations were observed for preterm cases and warrant further investigation.</p>}},
  author       = {{Vilhelmsson, Andreas and Rylander, Lars and Jöud, Anna and Lindh, Christian H and Mattsson, Kristina and Liew, Zeyan and Guo, Pengfei and Ritz, Beate and Källén, Karin and Thacher, Jesse D}},
  issn         = {{1879-1026}},
  language     = {{eng}},
  month        = {{07}},
  publisher    = {{Elsevier}},
  series       = {{Science of the Total Environment}},
  title        = {{Exposure to per- and polyfluoroalkyl substances in early pregnancy and risk of cerebral palsy in children}},
  url          = {{http://dx.doi.org/10.1016/j.scitotenv.2023.165622}},
  doi          = {{10.1016/j.scitotenv.2023.165622}},
  volume       = {{899}},
  year         = {{2023}},
}