ArticleEnvironmental research2020
Prenatal exposure to perfluoroalkyl substances and behavioral difficulties in childhood at 7 and 11 years.
Article in Environmental research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- The Association between Prenatal Per- and Polyfluoroalkyl Substances Exposure and Neurobehavioral Problems in Offspring: A Meta-Analysis.International journal of environmental research and public health · 2023Pooled it
- In utero PFAS exposure, inflammation, and behavioral problems in childhood.Environmental research · 2026Article
- Impact of antenatal exposure to a mixture of endocrine disruptors on attentional and executive functions in children.Journal of the Endocrine Society · 2026Article
- Neurotoxicity and Potential Mechanisms of Exposure to Per- and Polyfluoroalkyl Substances (PFASs).Molecular neurobiology · 2025Review
- Paternal and Maternal Exposures to Per- and Polyfluoroalkyl Substances and Child Behavioral Difficulties: A Parental Comparison Study.Environmental science & technology · 2025Article
- Adverse outcome pathway for the neurotoxicity of Per- and polyfluoroalkyl substances: A systematic review.Eco-Environment & Health · 2024Review
- Association between pre- and postnatal exposure to endocrine-disrupting chemicals and birth and neurodevelopmental outcomes: an extensive review.Clinical and experimental pediatrics · 2024Article
- Prenatal exposure to per- and polyfluoroalkyl substances and child behavioral problems.Environmental research · 2024Article
- Prenatal and perinatal exposure to Per- and polyfluoroalkyl substances (PFAS)-contaminated drinking water impacts offspring neurobehavior and development.The Science of the total environment · 2024Article
- Prenatal Exposure to Perfluoroalkyl Substances and Child Behavior at Age 12: A PELAGIE Mother-Child Cohort Study.Environmental health perspectives · 2023Article
- Novel perfluoroalkyl substances (PFAS) discovered in whole blood using automated non-targeted analysis of dried blood spots.The Science of the total environment · 2023Article
- Environmental chemical exposures and mental health outcomes in children: a narrative review of recent literature.Frontiers in toxicology · 2023Review
- Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Facial Features at 5 Years of Age: A Study from the Danish National Birth Cohort.Environmental health perspectives · 2022Article
- Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and neurobehavior in US children through 8 years of age: The HOME study.Environmental research · 2021Article
- Legacy and Emerging Per- and Polyfluoroalkyl Substances: Analytical Techniques, Environmental Fate, and Health Effects.International journal of molecular sciences · 2021Review
- Perfluoroalkyl Substance Exposure and the BDNF Pathway in the Placental Trophoblast.Frontiers in endocrinology · 2021Article
- Exposure to Perfluoroalkyl Substances During Pregnancy and Fetal BDNF Level: A Prospective Cohort Study.Frontiers in endocrinology · 2021Article
- Thyroid Disrupting Effects of Old and New Generation PFAS.Frontiers in endocrinology · 2020Review
- Childhood exposure to per- and polyfluoroalkyl substances (PFAS) and neurobehavioral domains in children at age 8 years.Neurotoxicology and teratologyArticle
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundPerfluoroalkyl substances (PFAS) are suggested to interfere with thyroid hormone during pregnancy and influence fetal neurodevelopment. Epidemiological evidence regarding behavioral difficulties in childhood associated with prenatal PFAS exposure has been inconclusive.
objectiveWe evaluated the association between prenatal PFAS exposure and behavioral difficulties at 7 and 11 years, and investigated the potential mediating role of maternal thyroid hormones.
methodsUsing pooled samples in the Danish National Birth Cohort established between 1996 and 2002, we estimated the associations between concentrations of six types of PFAS in maternal plasma (median, 8 gestational weeks) and child behavioral assessments from the Strength and Difficulties Questionnaire (SDQ), reported by parents at 7 years (n = 2421), and by parents (n = 2070) and children at 11 years (n = 2071). Behavioral difficulties were defined as having a composite SDQ score above the 90th percentile for total difficulties and externalizing or internalizing behaviors. We used logistic regression to estimate the adjusted Odds Ratio (OR) by doubling increase of prenatal PFAS (ng/ml). The possible mediating effect of maternal thyroid function classified based on thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels were evaluated.
resultsPrenatal perfluorononanoic acid (PFNA) was consistently associated with total and externalizing behavioral difficulties in all three SDQ measures reported by parents (OR = 1.40, 95% CI: 1.14-1.73 for age 7; OR = 1.27, 95% CI: 1.05-1.53 for age 11) or children (OR = 1.32, 95% CI: 1.11-1.58) while no consistent associations were observed for other types of PFAS. A small magnitude of natural indirect effects via maternal thyroid dysfunction (ORs ranged from 1.01 to 1.03) of several PFAS were observed for parent-reported total and externalizing behaviors at 7 years only. DISCUSSION: Prenatal PFNA exposure was associated with externalizing behavioral difficulties in childhood in repeated SDQ measures at 7 and 11 years. The slight mediating effects of maternal thyroid hormones in early gestation warrant further evaluation.
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