Impact of antenatal exposure to a mixture of endocrine disruptors on attentional and executive functions in children.

Context: Numerous studies indicate negative associations between early life exposure to endocrine-disrupting chemicals and various aspects of neurodevelopment. However, few have focused on specific cognitive processes. Additionally, toxicants are often analyzed individually, without accounting for their combined effects. Objective: This study aimed at investigating the impact of prenatal exposure to a mixture of endocrine disruptors on attention and executive functions in young children and comparing their effects with those reported in the literature. Methods: Two polychlorinated biphenyls (PCBs) and 4 perfluoroalkyl substances (PFASs) were measured in the cord blood from 55 children enrolled in a longitudinal Belgian cohort study. At 6 years of age, attentional and executive functions were assessed using specific neuropsychological tests. Associations between a mixture of toxicants and cognitive performance were analyzed using the principal components approach and weighted quantile sum regression, while accounting for sex differences. Results: Higher prenatal exposure to PCB mixtures was significantly associated with an increased number of omissions in the Divided Attention test. In sex-stratified analyses, this association remained significant but was observed only in boys. Additionally, boys exhibited reduced working memory and planning abilities following exposure to a mixture of PCBs and PFASs. In contrast, antenatal exposure to a mixture of PCBs and PFASs in girls was associated with reduced behavioral regulation, including inhibition control, as assessed by parent-reported questionnaires screening executive functioning in daily life. Conclusion: These results support associations between antenatal exposure to a mixture of endocrine disruptors and attention and executive development, emphasizing a sex-specific effect.