The relationship between prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure and infant neurodevelopment: Modifying effects of DHA revised
Background: It has been found that prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure can affect infant neurodevelopment. On the other hand, docosahexaenoic acid (DHA) supplementation can improve neurodevelopment, but studies on whether it can improve neurodevelopmental delay caused...
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Elsevier
2025-09-01
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| Series: | Ecotoxicology and Environmental Safety |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651325009030 |
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| author | Ting-ting Jiang Lian-man Lei Xia-yu Zhang Ya-ling Li Lu-ming Yan Zi-shun Lu Zi-yi Liu Bo-lin Liu Lian-jie Dou An-hui Zhang Min Yu Min Zhu Fei Li Ji-an Xie Chao Zhang Jia-hu Hao |
| author_facet | Ting-ting Jiang Lian-man Lei Xia-yu Zhang Ya-ling Li Lu-ming Yan Zi-shun Lu Zi-yi Liu Bo-lin Liu Lian-jie Dou An-hui Zhang Min Yu Min Zhu Fei Li Ji-an Xie Chao Zhang Jia-hu Hao |
| author_sort | Ting-ting Jiang |
| collection | DOAJ |
| description | Background: It has been found that prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure can affect infant neurodevelopment. On the other hand, docosahexaenoic acid (DHA) supplementation can improve neurodevelopment, but studies on whether it can improve neurodevelopmental delay caused by prenatal PFAS exposure are limited. Objective: This study aimed to investigate the relationship between prenatal PFAS exposure and infant neurodevelopmental delay and evaluate the effects of postnatal DHA supplementation on infant neurodevelopment. Methods: From October 2020 to December 2022, 2415 mother–newborn pairs were enrolled in the study from China WuHu Birth Cohort Study (WH-BC). Six PFAS (PFOA, PFOS, PFNA, PFBS, PFHxS and PFHxA) were measured in maternal urine samples using liquid chromatography-mass spectrometry (LC-MS/MS). Infant neurodevelopment was assessed at 6 and 12 months using the Ages and Stages Questionnaire (ASQ-3) score. Generalised linear models (GLMs) and Bayesian kernel machine regression (BKMR) were used to evaluate the associations between single or mixed PFAS exposure and infant neurodevelopment. Generalized estimating equations (GEEs) were used to identify the sensitive time window for the effect of prenatal exposure to PFAS on infant neurodevelopment. Stratified analysis was used to investigate the potential effect of postnatal DHA supplementation on infant neurodevelopment. Results: In the gross motor domain, there was a significant positive association between child development delay at 6 months of age and first-trimester PFOA (1st tri: OR = 1.97, 95 % CI: 1.20, 3.24) as well as second-trimester PFNA (2nd tri: OR = 1.61, 95 % CI: 1.03, 2.52). Similarly, at 12 months of age, there were significantly and positively associated between second-trimester exposure levels of PFNA (OR = 1.98, 95 % CI: 1.14, 3.45), PFBS (OR = 1.63, 95 % CI: 1.04, 2.55) and children's developmental delay. We found significant association between prenatal exposure to PFAS and increased children's developmental delay after adjusting for confounders, and the critical exposure windows of PFAS were the first-trimester and second-trimester of pregnancy. Prenatal PFAS exposure affected neurodevelopmental domains differently in infants of different sexes, with PFAS exposure mainly affecting fine domain development in boys and communication and gross motor domains in girls. The children's developmental delay associated with exposure to PFAS could be attenuated by DHA supplementation during lactation in mother-child pairs with PFAS. Whereas in the DHA unsupplemented group, PFAS exposure increased the risk of neurodevelopment. There was a significant and positive association between PFOA (1st tri: OR = 1.68, 95 % CI: 1.09, 2.60) and PFNA (1st tri: OR = 1.43, 95 % CI: 1.01, 2.03;2nd tri: OR = 1.61, 95 % CI: 1.06, 2.45) with developmental delay at 6 months of age. Conclusions: PFAS exposure was associated with developmental delays, with gender differences observed, and female infants are more vulnerable. Infant neurodevelopmental delay caused by prenatal PFAS exposure can be alleviated by postnatal DHA supplementation. These findings offer important directions for future research and may have implications for public health policy development. |
| format | Article |
| id | doaj-art-1f290e57d85447538019bfe57df8afb0 |
| institution | DOAJ |
| issn | 0147-6513 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ecotoxicology and Environmental Safety |
| spelling | doaj-art-1f290e57d85447538019bfe57df8afb02025-08-20T03:04:06ZengElsevierEcotoxicology and Environmental Safety0147-65132025-09-0130211855810.1016/j.ecoenv.2025.118558The relationship between prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure and infant neurodevelopment: Modifying effects of DHA revisedTing-ting Jiang0Lian-man Lei1Xia-yu Zhang2Ya-ling Li3Lu-ming Yan4Zi-shun Lu5Zi-yi Liu6Bo-lin Liu7Lian-jie Dou8An-hui Zhang9Min Yu10Min Zhu11Fei Li12Ji-an Xie13Chao Zhang14Jia-hu Hao15Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, ChinaAnhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, ChinaAnhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, ChinaWuhu Maternal and Child Health (MCH) Center, Wuhu, Anhui Province, ChinaWuhu Maternal and Child Health (MCH) Center, Wuhu, Anhui Province, ChinaWuhu Maternal and Child Health (MCH) Center, Wuhu, Anhui Province, ChinaAnhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, ChinaAnhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China; Correspondence to: Anhui Centre for Disease Control and Prevention, No. 12569 Fanhua Road, Hefei, Anhui 230601, China.Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University)， Ministry of Education of the People’s Republic of China, Hefei, Anhui Province, China; Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Correspondence to: School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China.Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University)， Ministry of Education of the People’s Republic of China, Hefei, Anhui Province, China; Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui Province, China; Correspondence to: School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China.Background: It has been found that prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure can affect infant neurodevelopment. On the other hand, docosahexaenoic acid (DHA) supplementation can improve neurodevelopment, but studies on whether it can improve neurodevelopmental delay caused by prenatal PFAS exposure are limited. Objective: This study aimed to investigate the relationship between prenatal PFAS exposure and infant neurodevelopmental delay and evaluate the effects of postnatal DHA supplementation on infant neurodevelopment. Methods: From October 2020 to December 2022, 2415 mother–newborn pairs were enrolled in the study from China WuHu Birth Cohort Study (WH-BC). Six PFAS (PFOA, PFOS, PFNA, PFBS, PFHxS and PFHxA) were measured in maternal urine samples using liquid chromatography-mass spectrometry (LC-MS/MS). Infant neurodevelopment was assessed at 6 and 12 months using the Ages and Stages Questionnaire (ASQ-3) score. Generalised linear models (GLMs) and Bayesian kernel machine regression (BKMR) were used to evaluate the associations between single or mixed PFAS exposure and infant neurodevelopment. Generalized estimating equations (GEEs) were used to identify the sensitive time window for the effect of prenatal exposure to PFAS on infant neurodevelopment. Stratified analysis was used to investigate the potential effect of postnatal DHA supplementation on infant neurodevelopment. Results: In the gross motor domain, there was a significant positive association between child development delay at 6 months of age and first-trimester PFOA (1st tri: OR = 1.97, 95 % CI: 1.20, 3.24) as well as second-trimester PFNA (2nd tri: OR = 1.61, 95 % CI: 1.03, 2.52). Similarly, at 12 months of age, there were significantly and positively associated between second-trimester exposure levels of PFNA (OR = 1.98, 95 % CI: 1.14, 3.45), PFBS (OR = 1.63, 95 % CI: 1.04, 2.55) and children's developmental delay. We found significant association between prenatal exposure to PFAS and increased children's developmental delay after adjusting for confounders, and the critical exposure windows of PFAS were the first-trimester and second-trimester of pregnancy. Prenatal PFAS exposure affected neurodevelopmental domains differently in infants of different sexes, with PFAS exposure mainly affecting fine domain development in boys and communication and gross motor domains in girls. The children's developmental delay associated with exposure to PFAS could be attenuated by DHA supplementation during lactation in mother-child pairs with PFAS. Whereas in the DHA unsupplemented group, PFAS exposure increased the risk of neurodevelopment. There was a significant and positive association between PFOA (1st tri: OR = 1.68, 95 % CI: 1.09, 2.60) and PFNA (1st tri: OR = 1.43, 95 % CI: 1.01, 2.03;2nd tri: OR = 1.61, 95 % CI: 1.06, 2.45) with developmental delay at 6 months of age. Conclusions: PFAS exposure was associated with developmental delays, with gender differences observed, and female infants are more vulnerable. Infant neurodevelopmental delay caused by prenatal PFAS exposure can be alleviated by postnatal DHA supplementation. These findings offer important directions for future research and may have implications for public health policy development.http://www.sciencedirect.com/science/article/pii/S0147651325009030InfantsPFASDHANeurodevelopmental |
| spellingShingle | Ting-ting Jiang Lian-man Lei Xia-yu Zhang Ya-ling Li Lu-ming Yan Zi-shun Lu Zi-yi Liu Bo-lin Liu Lian-jie Dou An-hui Zhang Min Yu Min Zhu Fei Li Ji-an Xie Chao Zhang Jia-hu Hao The relationship between prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure and infant neurodevelopment: Modifying effects of DHA revised Ecotoxicology and Environmental Safety Infants PFAS DHA Neurodevelopmental |
| title | The relationship between prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure and infant neurodevelopment: Modifying effects of DHA revised |
| title_full | The relationship between prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure and infant neurodevelopment: Modifying effects of DHA revised |
| title_fullStr | The relationship between prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure and infant neurodevelopment: Modifying effects of DHA revised |
| title_full_unstemmed | The relationship between prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure and infant neurodevelopment: Modifying effects of DHA revised |
| title_short | The relationship between prenatal perfluorine and polyfluoroalkyl substances (PFAS) exposure and infant neurodevelopment: Modifying effects of DHA revised |
| title_sort | relationship between prenatal perfluorine and polyfluoroalkyl substances pfas exposure and infant neurodevelopment modifying effects of dha revised |
| topic | Infants PFAS DHA Neurodevelopmental |
| url | http://www.sciencedirect.com/science/article/pii/S0147651325009030 |
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