Attention Deficit/Hyperactivity Disorder and Childhood Autism in Association with Prenatal Exposure to Perfluoroalkyl Substances: A Nested Case-Control Study in the Danish National Birth Cohort

Zeyan Liew, Beate Ritz, Ondine S von Ehrenstein, Bodil H Bech, Ellen A Nohr, Chunyuan Fei, Rossana Bossi, Tine B Henriksen, Eva C Bonefeld-Jørgensen, Jørn Olsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND: Perfluoroalkyl substances (PFASs) are persistent pollutants found to be endocrine disruptive and neurotoxic in animals. Positive correlations between PFASs and neurobehavioral problems in children were reported in cross-sectional data, but findings from prospective studies are limited.

OBJECTIVES: We investigated whether prenatal exposure to PFASs is associated with attention deficit/hyperactivity disorder (ADHD) or childhood autism in children.

METHODS: Among 83,389 mother-child pairs enrolled in the Danish National Birth Cohort during 1996-2002, we identified 890 ADHD cases and 301 childhood autism cases from the Danish National Hospital Registry and the Danish Psychiatric Central Registry. From this cohort, we randomly selected 220 cases of ADHD and autism each, and we also randomly selected 550 controls frequency matched by child's sex. Sixteen PFASs were measured in maternal plasma collected in early or mid-pregnancy. We calculated risk ratios (RR) using generalized linear models taking into account sampling weights.

RESULTS: Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected in all samples; 4 other PFASs were quantified in ≥ 90% of the samples. We did not find consistent evidence of associations between mother's PFAS plasma levels and ADHD (per ln-ng/ml increase: PFOS RR = 0.87; 95%CI: 0.74, 1.02; PFOA RR = 0.98; 95%CI: 0.82, 1.16) or autism (per ln-ng/ml increase: PFOS RR = 0.92; 95%CI: 0.69, 1.22; PFOA RR = 0.98; 95%CI: 0.73, 1.31). We found positive as well as negative associations between higher PFAS quartiles and ADHD in models that simultaneously adjusted for all PFASs, but these estimates were imprecise.

CONCLUSIONS: In this study we found no evidence to suggest that prenatal PFAS exposure increases the risk of ADHD or childhood autism in children.

OriginalsprogEngelsk
TidsskriftEnvironmental Health Perspectives
Vol/bind123
Udgave nummer4
Antal sider7
ISSN0091-6765
DOI
StatusUdgivet - 2015

Fingeraftryk

perfluorooctanoic acid
Case-Control Studies
Odds Ratio
Mothers
Registries
Linear Models
Prospective Studies
Weights and Measures
perfluorooctane sulfonic acid

Citer dette

Liew, Zeyan ; Ritz, Beate ; von Ehrenstein, Ondine S ; Bech, Bodil H ; Nohr, Ellen A ; Fei, Chunyuan ; Bossi, Rossana ; Henriksen, Tine B ; Bonefeld-Jørgensen, Eva C ; Olsen, Jørn. / Attention Deficit/Hyperactivity Disorder and Childhood Autism in Association with Prenatal Exposure to Perfluoroalkyl Substances : A Nested Case-Control Study in the Danish National Birth Cohort. I: Environmental Health Perspectives. 2015 ; Bind 123, Nr. 4.
@article{bb0c5f665e974fcc80d481e86136d373,
title = "Attention Deficit/Hyperactivity Disorder and Childhood Autism in Association with Prenatal Exposure to Perfluoroalkyl Substances: A Nested Case-Control Study in the Danish National Birth Cohort",
abstract = "BACKGROUND: Perfluoroalkyl substances (PFASs) are persistent pollutants found to be endocrine disruptive and neurotoxic in animals. Positive correlations between PFASs and neurobehavioral problems in children were reported in cross-sectional data, but findings from prospective studies are limited.OBJECTIVES: We investigated whether prenatal exposure to PFASs is associated with attention deficit/hyperactivity disorder (ADHD) or childhood autism in children.METHODS: Among 83,389 mother-child pairs enrolled in the Danish National Birth Cohort during 1996-2002, we identified 890 ADHD cases and 301 childhood autism cases from the Danish National Hospital Registry and the Danish Psychiatric Central Registry. From this cohort, we randomly selected 220 cases of ADHD and autism each, and we also randomly selected 550 controls frequency matched by child's sex. Sixteen PFASs were measured in maternal plasma collected in early or mid-pregnancy. We calculated risk ratios (RR) using generalized linear models taking into account sampling weights.RESULTS: Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected in all samples; 4 other PFASs were quantified in ≥ 90{\%} of the samples. We did not find consistent evidence of associations between mother's PFAS plasma levels and ADHD (per ln-ng/ml increase: PFOS RR = 0.87; 95{\%}CI: 0.74, 1.02; PFOA RR = 0.98; 95{\%}CI: 0.82, 1.16) or autism (per ln-ng/ml increase: PFOS RR = 0.92; 95{\%}CI: 0.69, 1.22; PFOA RR = 0.98; 95{\%}CI: 0.73, 1.31). We found positive as well as negative associations between higher PFAS quartiles and ADHD in models that simultaneously adjusted for all PFASs, but these estimates were imprecise.CONCLUSIONS: In this study we found no evidence to suggest that prenatal PFAS exposure increases the risk of ADHD or childhood autism in children.",
author = "Zeyan Liew and Beate Ritz and {von Ehrenstein}, {Ondine S} and Bech, {Bodil H} and Nohr, {Ellen A} and Chunyuan Fei and Rossana Bossi and Henriksen, {Tine B} and Bonefeld-J{\o}rgensen, {Eva C} and J{\o}rn Olsen",
year = "2015",
doi = "10.1289/ehp.1408412",
language = "English",
volume = "123",
journal = "Environmental Health Perspectives",
issn = "0091-6765",
publisher = "National Institute of Environmental Health Sciences",
number = "4",

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Attention Deficit/Hyperactivity Disorder and Childhood Autism in Association with Prenatal Exposure to Perfluoroalkyl Substances : A Nested Case-Control Study in the Danish National Birth Cohort. / Liew, Zeyan; Ritz, Beate; von Ehrenstein, Ondine S; Bech, Bodil H; Nohr, Ellen A; Fei, Chunyuan; Bossi, Rossana; Henriksen, Tine B; Bonefeld-Jørgensen, Eva C; Olsen, Jørn.

I: Environmental Health Perspectives, Bind 123, Nr. 4, 2015.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Attention Deficit/Hyperactivity Disorder and Childhood Autism in Association with Prenatal Exposure to Perfluoroalkyl Substances

T2 - A Nested Case-Control Study in the Danish National Birth Cohort

AU - Liew, Zeyan

AU - Ritz, Beate

AU - von Ehrenstein, Ondine S

AU - Bech, Bodil H

AU - Nohr, Ellen A

AU - Fei, Chunyuan

AU - Bossi, Rossana

AU - Henriksen, Tine B

AU - Bonefeld-Jørgensen, Eva C

AU - Olsen, Jørn

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Perfluoroalkyl substances (PFASs) are persistent pollutants found to be endocrine disruptive and neurotoxic in animals. Positive correlations between PFASs and neurobehavioral problems in children were reported in cross-sectional data, but findings from prospective studies are limited.OBJECTIVES: We investigated whether prenatal exposure to PFASs is associated with attention deficit/hyperactivity disorder (ADHD) or childhood autism in children.METHODS: Among 83,389 mother-child pairs enrolled in the Danish National Birth Cohort during 1996-2002, we identified 890 ADHD cases and 301 childhood autism cases from the Danish National Hospital Registry and the Danish Psychiatric Central Registry. From this cohort, we randomly selected 220 cases of ADHD and autism each, and we also randomly selected 550 controls frequency matched by child's sex. Sixteen PFASs were measured in maternal plasma collected in early or mid-pregnancy. We calculated risk ratios (RR) using generalized linear models taking into account sampling weights.RESULTS: Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected in all samples; 4 other PFASs were quantified in ≥ 90% of the samples. We did not find consistent evidence of associations between mother's PFAS plasma levels and ADHD (per ln-ng/ml increase: PFOS RR = 0.87; 95%CI: 0.74, 1.02; PFOA RR = 0.98; 95%CI: 0.82, 1.16) or autism (per ln-ng/ml increase: PFOS RR = 0.92; 95%CI: 0.69, 1.22; PFOA RR = 0.98; 95%CI: 0.73, 1.31). We found positive as well as negative associations between higher PFAS quartiles and ADHD in models that simultaneously adjusted for all PFASs, but these estimates were imprecise.CONCLUSIONS: In this study we found no evidence to suggest that prenatal PFAS exposure increases the risk of ADHD or childhood autism in children.

AB - BACKGROUND: Perfluoroalkyl substances (PFASs) are persistent pollutants found to be endocrine disruptive and neurotoxic in animals. Positive correlations between PFASs and neurobehavioral problems in children were reported in cross-sectional data, but findings from prospective studies are limited.OBJECTIVES: We investigated whether prenatal exposure to PFASs is associated with attention deficit/hyperactivity disorder (ADHD) or childhood autism in children.METHODS: Among 83,389 mother-child pairs enrolled in the Danish National Birth Cohort during 1996-2002, we identified 890 ADHD cases and 301 childhood autism cases from the Danish National Hospital Registry and the Danish Psychiatric Central Registry. From this cohort, we randomly selected 220 cases of ADHD and autism each, and we also randomly selected 550 controls frequency matched by child's sex. Sixteen PFASs were measured in maternal plasma collected in early or mid-pregnancy. We calculated risk ratios (RR) using generalized linear models taking into account sampling weights.RESULTS: Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected in all samples; 4 other PFASs were quantified in ≥ 90% of the samples. We did not find consistent evidence of associations between mother's PFAS plasma levels and ADHD (per ln-ng/ml increase: PFOS RR = 0.87; 95%CI: 0.74, 1.02; PFOA RR = 0.98; 95%CI: 0.82, 1.16) or autism (per ln-ng/ml increase: PFOS RR = 0.92; 95%CI: 0.69, 1.22; PFOA RR = 0.98; 95%CI: 0.73, 1.31). We found positive as well as negative associations between higher PFAS quartiles and ADHD in models that simultaneously adjusted for all PFASs, but these estimates were imprecise.CONCLUSIONS: In this study we found no evidence to suggest that prenatal PFAS exposure increases the risk of ADHD or childhood autism in children.

U2 - 10.1289/ehp.1408412

DO - 10.1289/ehp.1408412

M3 - Journal article

C2 - 25616253

VL - 123

JO - Environmental Health Perspectives

JF - Environmental Health Perspectives

SN - 0091-6765

IS - 4

ER -