Evidence map›Paper›PMID 42365676›Full record

ArticleEnvironment international2026

Joint associations between gestational environmental chemical mixtures and child behavioral outcomes.

Jagadeesh Puvvula, Wei-Ting Hwang, Lawrence McCandless, Changchun Xie, Joseph M Braun, Ann M Vuong, Enrique F Schisterman, Russell T Shinohara, Youssef Oulhote, Linda Booij and 14 more

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Article in Environment international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

24 authors.

Jagadeesh PuvvulaDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: Jagadeesh.Puvvula@pennmedicine.upenn.edu.
Wei-Ting HwangDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Lawrence McCandlessFaculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
Changchun XieDepartment of Biostatistics, Health Informatics and Data Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Joseph M BraunDepartment of Epidemiology, Brown University, Providence, RI, USA.
Ann M VuongDepartment of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, USA.
Enrique F SchistermanDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Russell T ShinoharaDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA; Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, PA, USA.
Youssef OulhoteDepartment of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Linda BooijDepartment of Psychiatry, McGill University, Montreal, QC, Canada; Eating Disorders Continuum, Douglas Mental Health University Institute, Montréal West Island Integrated Health and Social Services Centre, Montréal, QC, Canada; Research Centre, Douglas Mental Health University Institute, Montréal, QC, Canada; Azrieli Research Centre of the CHU Sainte-Justine, Montréal, QC, Canada.
Jean R SéguinAzrieli Research Centre of the CHU Sainte-Justine, Montréal, QC, Canada.
Maryse F BouchardAzrieli Research Centre of the CHU Sainte-Justine, Montréal, QC, Canada; Institut national de la recherche scientifique (INRS) - Centre Armand-Frappier Santé Biotechnologie, Laval, Montréal, Canada.
Christine TillPsychology Department, York University, Toronto, ON, Canada.
Angelika ZidekExisting Substances and Risk Assessment Bureau, Health Canada, Ottawa, ON, Canada.
Michael M BorgheseEnvironmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada.
Mandy FisherEnvironmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada.
William D FraserAzrieli Research Centre of the CHU Sainte-Justine, Montréal, QC, Canada; Department of Obstetrics and Gynecology, Centre de Recherche du CHUS, University of Sherbrooke, Sherbrooke, QC, Canada.
Gina MuckleCHU de Québec Research Centre and School of Psychology, Laval University, Québec City, QC, Canada.
Kimberly YoltonDepartment of Biostatistics, Health Informatics and Data Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Kim M CecilDepartment of Biostatistics, Health Informatics and Data Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Jillian Ashley-MartinEnvironmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada.
Tye E ArbuckleEnvironmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada.
Bruce LanphearFaculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada; Child and Family Research Institute, BC Children's Hospital, Vancouver, BC, Canada.
Aimin ChenDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Funding

Study of Prevalent Neurotoxicants in ChildrenP01ES011261 · NIEHS · CINCINNATI CHILDRENS HOSP MED CTR · PI LANPHEAR, BRUCE P · 2001 to 2006
$6.4M
Developmental neurotoxicity of organophosphate and novel brominated flame retardants in childrenR01ES028277 · NIEHS · UNIVERSITY OF PENNSYLVANIA · PI CHEN, AIMIN · 2017 to 2022
$3.4M
Impact of pre- and postnatal chemical mixture exposures on child neurobehavior and neuroimagingR01ES033054 · NIEHS · UNIVERSITY OF PENNSYLVANIA · PI CHEN, AIMIN · 2021 to 2025
$3.3M
Internalizing Behaviors and Neuroimaging Outcomes: Impact of PBDE and PFC ExposuresR01ES027224 · NIEHS · CINCINNATI CHILDRENS HOSP MED CTR · PI CECIL, KIM M, YOLTON, KIMBERLY · 2016 to 2020
$3.0M
A Community-Based Trial to Prevent Lead Poisoning and InjuriesR01ES014575 · NIEHS · CINCINNATI CHILDRENS HOSP MED CTR · PI YOLTON, KIMBERLY · 2007 to 2011
$2.9M
Longitudinal study of exposure to PBDEs and PFCs and child neurobehaviorR01ES020349 · NIEHS · UNIVERSITY OF CINCINNATI · PI CHEN, AIMIN, LANPHEAR, BRUCE P · 2011 to 2015
$2.9M
Gestational and Childhood Exposure to Endocrine Disruptors: Epigenetic and Proteomic Pathways to Adolescent NeurobehaviorK99ES037741 · NIEHS · UNIVERSITY OF PENNSYLVANIA · PI Jagadeesh Puvvula · 2025 to 2026
$249k
NIEHS NIH HHS K99 ES037741NIEHS NIH HHS P01 ES011261NIEHS NIH HHS R01 ES014575NIEHS NIH HHS R01 ES020349NIEHS NIH HHS R01 ES027224NIEHS NIH HHS R01 ES028277NIEHS NIH HHS R01 ES033054
6 · The paper itself

Abstract

backgroundGestational exposure to environmental chemicals contributes to adverse neurodevelopmental outcomes in children. We aim to evaluate the joint associations between gestational chemical biomarkers and behavioral functioning in preschool-aged children.

methodsWe pooled data from 695 mother-child dyads (female, n = 353; male, n = 342) enrolled in the Health Outcomes and Measures of the Environment (HOME) & Maternal-Infant Research on Environmental Chemicals (MIREC) Studies. We assessed concentrations of 29 EDC biomarkers at gestation and assessed the child's behavior and executive functioning at 3 years using the Behavioral Assessment System for Children (BASC-2) and Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Higher scores on these instruments indicate adverse behavioral outcomes. We applied quantile g-computation to estimate joint associations, adjusting for covariates.

findingsEvery quartile increase in chemical biomarker mixture was associated with a 0.84-point higher behavior symptom index score (95% CI: -0.89, 2.57), 1.38-point higher externalizing behavior score (95% CI: -0.65, 3.41), and 1.34-point higher internalizing behavior score (95%CI: -0.97, 3.65); these associations were imprecise with confidence intervals including null. Although the interaction by child sex remained null (p = 0.69) for internalizing behavior scores, gestational chemical mixture was associated with higher internalizing behavior scores in males (Ψ: 3.59; 95%CI: 0.42, 6.75), but not in females. We found evidence of sex-specific trends for working memory scores (interaction p = 0.02), with an imprecise positive trend in males (Ψ: 3.04; 95%CI: -0.46, 6.55) and a negative trend in females.

interpretationGestational exposure to a mixture of environmental chemicals showed suggestive but imprecise associations with internalizing problems and poorer working memory among preschool-age males, but not females. Associations were more pronounced in the HOME Study, which includes participants with higher concentrations for many chemical biomarkers, than in MIREC, raising the possibility that pooled estimates reflect cohort-specific exposure contexts. Sex-specific patterns, particularly for working memory, need further investigation, and our findings should be interpreted cautiously given the imprecision of subgroup estimates.

Indexed as

Child BehaviorEnvironmental PollutantsMaternal ExposurePrenatal Exposure Delayed EffectsBiomarkersChild, PreschoolEndocrine DisruptorsFemaleHumansMalePregnancyBiomarkersEndocrine DisruptorsEnvironmental PollutantsChild behaviorEndocrine disruptorsEnvironmental chemicalsGestational exposures

Identifiers

PMID42365676
PMCPMC13492037

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