Evidence map›Paper›PMID 31653559›Full record

ArticleInternational journal of hygiene and environmental health2020

Prenatal exposure to perfluoroalkyl substances and associations with symptoms of attention-deficit/hyperactivity disorder and cognitive functions in preschool children.

Thea S Skogheim, Gro D Villanger, Kjell Vegard F Weyde, Stephanie M Engel, Pål Surén, Merete G Øie, Annette H Skogan, Guido Biele, Pål Zeiner, Kristin R Øvergaard and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of hygiene and environmental health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 2 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 90 citations in OpenAlex.

  1. Pooled it
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  6. Combined Effects of PFAS and Metals on Cognitive Function.Environments (Basel, Switzerland) · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Thea S SkogheimNorwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway. Electronic address: thea.skogheim@fhi.no.
Gro D VillangerNorwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
Kjell Vegard F WeydeNorwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
Stephanie M EngelGillings School of Global Public Health, University of North Carolina at Chapel Hill, 2104C McGavran-Greenberg Hall CB 7435, Chapel Hill, NC, 27599, USA.
Pål SurénNorwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
Merete G ØieDepartment of Psychology, University of Oslo, PO Box 1094, Blindern, N-0317, Oslo, Norway; Research Department, Innlandet Hospital Trust, PO Box 104, N-2381, Brumunddal, Norway.
Annette H SkoganThe National Centre for Epilepsy, PO Box 4956, Nydalen, N-0424, Oslo, Norway.
Guido BieleNorwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
Pål ZeinerDivision of Mental Health and Addiction, Oslo University Hospital, PO Box 4956, Nydalen, N-0424, Oslo, Norway; Department of Clinical Medicine, University of Oslo, PO Box 1171, N-0318, Oslo, Norway.
Kristin R ØvergaardDivision of Mental Health and Addiction, Oslo University Hospital, PO Box 4956, Nydalen, N-0424, Oslo, Norway.
Line S HaugNorwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
Azemira SabaredzovicNorwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
Heidi AaseNorwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
Norwegian Institute of Public Health · NOUniversity of Oslo · NOOslo University Hospital · NOUniversity of North Carolina at Chapel Hill · US

Funding

UNC-CH CENTER FOR ENVIRONMENTAL HEALTH &SUSCEPTIBILITYP30ES010126 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Melissa A. Troester · 2001 to 2026
$36.3M
Gene-Environment Interactions in an Autism Birth CohortU01NS047537 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI LIPKIN, W. IAN · 2003 to 2013
$27.0M
Prenatal Toxicant Exposure and Risk of Attention-Deficit Hyperactivity DisorderR01ES021777 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ENGEL, STEPHANIE · 2012 to 2016
$2.8M
NIEHS NIH HHS P30 ES010126NIEHS NIH HHS R01 ES021777NINDS NIH HHS U01 NS047537
6 · The paper itself

Abstract

backgroundPerfluoroalkyl substances (PFASs) are persistent organic pollutants that are suspected to be neurodevelopmental toxicants, but epidemiological evidence on neurodevelopmental effects of PFAS exposure is inconsistent. We investigated the associations between prenatal exposure to PFASs and symptoms of attention-deficit/hyperactivity disorder (ADHD) and cognitive functioning (language skills, estimated IQ and working memory) in preschool children, as well as effect modification by child sex. MATERIAL AND

methodsThis study included 944 mother-child pairs enrolled in a longitudinal prospective study of ADHD symptoms (the ADHD Study), with participants recruited from The Norwegian Mother, Father and Child Cohort Study (MoBa). Boys and girls aged three and a half years, participated in extensive clinical assessments using well-validated tools; The Preschool Age Psychiatric Assessment interview, Child Development Inventory and Stanford-Binet (5th revision). Prenatal levels of 19 PFASs were measured in maternal blood at week 17 of gestation. Multivariable adjusted regression models were used to examine exposure-outcome associations with two principal components extracted from the seven detected PFASs. Based on these results, we performed regression analyses of individual PFASs categorized into quintiles.

resultsPFAS component 1 was mainly explained by perfluoroheptane sulfonate (PFHpS), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorooctanoic acid (PFOA). PFAS component 2 was mainly explained by perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA) and perfluorononanoic acid (PFNA). Regression models showed a negative association between PFAS component 1 and nonverbal working memory [β = -0.08 (CI: -0.12, -0.03)] and a positive association between PFAS component 2 and verbal working memory [β = 0.07 (CI: 0.01, 0.12)]. There were no associations with ADHD symptoms, language skills or IQ. For verbal working memory and PFAS component 2, we found evidence for effect modification by child sex, with associations only for boys. The results of quintile models with individual PFASs, showed the same pattern for working memory as the results in the component regression analyses. There were negative associations between nonverbal working memory and quintiles of PFOA, PFNA, PFHxS, PFHpS and PFOS and positive associations between verbal working memory and quintiles of PFOA, PFNA, PFDA and PFUnDA, with significant relationships mainly in the highest concentration groups.

conclusionsBased on our results, we did not find consistent evidence to conclude that prenatal exposure to PFASs are associated with ADHD symptoms or cognitive dysfunctions in preschool children aged three and a half years, which is in line with the majority of studies in this area. Our results showed some associations between PFASs and working memory, particularly negative relationships with nonverbal working memory, but also positive relationships with verbal working memory. The relationships were weak, as well as both positive and negative, which suggest no clear association - and need for replication.

Indexed as

Alkanesulfonic AcidsAttention Deficit Disorder with HyperactivityCaprylatesChild, PreschoolCognitionDecanoic AcidsEnvironmental ExposureEnvironmental PollutantsFatty AcidsFemaleFluorocarbonsHumansMaleMemory, Short-TermNorwayPregnancyAlkanesulfonic AcidsCaprylatesDecanoic AcidsEnvironmental PollutantsFatty AcidsFluorocarbonsperflexaneperfluorodecanoic acidperfluorooctane sulfonic acidperfluorooctanoic acidperfluoroundecanoic acidAttention-deficit/hyperactivity disorder (ADHD)Cognitive functionsFather and Child Cohort Study (MoBa)Perfluoroalkyl substances (PFASs)PrenatalThe Norwegian Mother

Identifiers

PMID31653559
PMCPMC6922090
OpenAlexW2981464001

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.