Impact of prenatal triclosan exposure on ADHD-like symptoms in school-aged children

BackgroundAttention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental and behavioral disorder in children, often diagnosed during school age. The etiology of ADHD remains unclear; however, existing studies suggest that environmental factors, such as exposure to triclosan (TCS), ma...

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Main Authors: Jingjing LI, Xiaomeng CHENG, Yan ZHANG, Luanluan LI, Xiaodan YU, Ying TIAN, Yu GAO
Format: Article
Language:English
Published: Editorial Committee of Journal of Environmental and Occupational Medicine 2025-06-01
Series:环境与职业医学
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Online Access:http://www.jeom.org/article/cn/10.11836/JEOM24624
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author Jingjing LI
Xiaomeng CHENG
Yan ZHANG
Luanluan LI
Xiaodan YU
Ying TIAN
Yu GAO
author_facet Jingjing LI
Xiaomeng CHENG
Yan ZHANG
Luanluan LI
Xiaodan YU
Ying TIAN
Yu GAO
author_sort Jingjing LI
collection DOAJ
description BackgroundAttention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental and behavioral disorder in children, often diagnosed during school age. The etiology of ADHD remains unclear; however, existing studies suggest that environmental factors, such as exposure to triclosan (TCS), may be associated with the occurrence of ADHD-like symptoms in offspring. Nevertheless, relevant research in China remains limited.ObjectiveTo investigate the impact of early pregnancy TCS exposure on ADHD-like symptoms in 7-year-old children.MethodsThis study was based on the Shanghai Birth Cohort (SBC) and included 662 mother-child pairs. TCS concentrations in early pregnancy urine samples were measured using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Demographic information was collected via questionnaires and medical record abstraction. ADHD-like symptoms in 7-year-old children were first assessed using the Strengths and Difficulties Questionnaire (SDQ). Further differentiation of ADHD-like symptom subtypes (inattentive and hyperactive/impulsive) was conducted using the SNAP-IV, a clinically validated ADHD screening tool. Negative binomial regression models were applied to evaluate the associations between prenatal TCS exposure and hyperactive behavior (SDQ assessment) as well as ADHD-like symptom subtypes (SNAP-IV assessment) in 7-year-old children.ResultsThe positive rate of TCS in early pregnancy urine samples was 91.39%, with median concentrations of 0.69 μg·L−1 and 0.63 μg·g−1 before and after the creatinine adjustment, respectively. The modeling results indicated that prenatal TCS exposure was associated with an increased risk of hyperactive symptoms (SDQ assessment) in 7-year-old children (RR=1.04, 95%CI: 1.02, 1.06); the stratified analyses by children sex revealed similar effects for both boys (RR=1.04, 95%CI: 1.02, 1.07) and girls (RR=1.04, 95%CI: 1.01, 1.07). Further analysis of ADHD-like symptom subtypes showed that prenatal TCS exposure increased the risk of inattentive symptoms (RR=1.03, 95%CI: 1.00, 1.05); the sex-stratified analyses indicated associations between TCS exposure and inattentive symptoms (RR=1.03, 95%CI: 1.00, 1.07) as well as hyperactive/impulsive symptoms (RR=1.04, 95%CI: 1.01, 1.08) in girls.ConclusionPrenatal TCS exposure is associated with an increased risk of ADHD-like symptoms in 7-year-old children, primarily contributing to the risk of the inattention subtype. The impact is more pronounced in girls.
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spelling doaj-art-e7e8de58911c4949879b205885a6070c2025-08-20T03:28:48ZengEditorial Committee of Journal of Environmental and Occupational Medicine环境与职业医学2095-99822025-06-0142664565110.11836/JEOM2462424624Impact of prenatal triclosan exposure on ADHD-like symptoms in school-aged childrenJingjing LI0Xiaomeng CHENG1Yan ZHANG2Luanluan LI3Xiaodan YU4Ying TIAN5Yu GAO6Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaDepartment of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaDepartment of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaDepartment of Developmental Behavioral Pediatrics, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, ChinaDepartment of Developmental Behavioral Pediatrics, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, ChinaDepartment of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaDepartment of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaBackgroundAttention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental and behavioral disorder in children, often diagnosed during school age. The etiology of ADHD remains unclear; however, existing studies suggest that environmental factors, such as exposure to triclosan (TCS), may be associated with the occurrence of ADHD-like symptoms in offspring. Nevertheless, relevant research in China remains limited.ObjectiveTo investigate the impact of early pregnancy TCS exposure on ADHD-like symptoms in 7-year-old children.MethodsThis study was based on the Shanghai Birth Cohort (SBC) and included 662 mother-child pairs. TCS concentrations in early pregnancy urine samples were measured using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Demographic information was collected via questionnaires and medical record abstraction. ADHD-like symptoms in 7-year-old children were first assessed using the Strengths and Difficulties Questionnaire (SDQ). Further differentiation of ADHD-like symptom subtypes (inattentive and hyperactive/impulsive) was conducted using the SNAP-IV, a clinically validated ADHD screening tool. Negative binomial regression models were applied to evaluate the associations between prenatal TCS exposure and hyperactive behavior (SDQ assessment) as well as ADHD-like symptom subtypes (SNAP-IV assessment) in 7-year-old children.ResultsThe positive rate of TCS in early pregnancy urine samples was 91.39%, with median concentrations of 0.69 μg·L−1 and 0.63 μg·g−1 before and after the creatinine adjustment, respectively. The modeling results indicated that prenatal TCS exposure was associated with an increased risk of hyperactive symptoms (SDQ assessment) in 7-year-old children (RR=1.04, 95%CI: 1.02, 1.06); the stratified analyses by children sex revealed similar effects for both boys (RR=1.04, 95%CI: 1.02, 1.07) and girls (RR=1.04, 95%CI: 1.01, 1.07). Further analysis of ADHD-like symptom subtypes showed that prenatal TCS exposure increased the risk of inattentive symptoms (RR=1.03, 95%CI: 1.00, 1.05); the sex-stratified analyses indicated associations between TCS exposure and inattentive symptoms (RR=1.03, 95%CI: 1.00, 1.07) as well as hyperactive/impulsive symptoms (RR=1.04, 95%CI: 1.01, 1.08) in girls.ConclusionPrenatal TCS exposure is associated with an increased risk of ADHD-like symptoms in 7-year-old children, primarily contributing to the risk of the inattention subtype. The impact is more pronounced in girls.http://www.jeom.org/article/cn/10.11836/JEOM24624triclosanattention-deficit hyperactivity disorder like symptombirth cohortschool-age childstrengths and difficulties questionnairesnap-iv
spellingShingle Jingjing LI
Xiaomeng CHENG
Yan ZHANG
Luanluan LI
Xiaodan YU
Ying TIAN
Yu GAO
Impact of prenatal triclosan exposure on ADHD-like symptoms in school-aged children
环境与职业医学
triclosan
attention-deficit hyperactivity disorder like symptom
birth cohort
school-age child
strengths and difficulties questionnaire
snap-iv
title Impact of prenatal triclosan exposure on ADHD-like symptoms in school-aged children
title_full Impact of prenatal triclosan exposure on ADHD-like symptoms in school-aged children
title_fullStr Impact of prenatal triclosan exposure on ADHD-like symptoms in school-aged children
title_full_unstemmed Impact of prenatal triclosan exposure on ADHD-like symptoms in school-aged children
title_short Impact of prenatal triclosan exposure on ADHD-like symptoms in school-aged children
title_sort impact of prenatal triclosan exposure on adhd like symptoms in school aged children
topic triclosan
attention-deficit hyperactivity disorder like symptom
birth cohort
school-age child
strengths and difficulties questionnaire
snap-iv
url http://www.jeom.org/article/cn/10.11836/JEOM24624
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