title: Pregnancy serum concentrations of perfluorinated alkyl substances and offspring behaviour and motor development at age 5-9 years--a prospective study.
abstract: BACKGROUND
  In animal studies, perfluorinated alkyl substances affect growth and neuro-behavioural outcomes. Human epidemiological studies are sparse. The aim was to investigate the association between pregnancy serum concentrations of perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) and offspring behaviour and motor development at 5-9 years of age.
  
  
  METHODS
  Maternal sera from the INUENDO cohort (2002-2004) comprising 1,106 mother-child pairs from Greenland, Kharkiv (Ukraine) and Warsaw (Poland) were analysed for PFOS and PFOA, using liquid-chromatography-tandem-mass-spectrometry. Exposures were grouped into country specific as well as pooled tertiles as well as being used as continuous variables for statistical analyses. Child motor development and behaviour at follow-up (2010-2012) were measured by the Developmental Coordination Disorder Questionnaire 2007 (DCDQ) and Strength and Difficulties Questionnaire (SDQ), respectively. Exposure-outcome associations were analysed by multiple logistic and linear regression analyses.
  
  
  RESULTS
  In the pooled analysis, odds ratio (OR) (95% confidence interval (CI)) for hyperactivity was 3.1 (1.3, 7.2) comparing children prenatally exposed to the highest PFOA tertile with those exposed to the lowest PFOA tertile. Comparing children in the highest PFOS tertile with those in the lowest PFOS tertile showed elevated but statistically non-significant OR of hyperactivity (OR (95% CI) 1.7 (0.9, 3.2)). In Greenland, elevated PFOS was associated with higher SDQ-total scores indicating more behavioural problems (β (95% CI)=1.0 (0.1, 2.0)) and elevated PFOA was associated with higher hyperactivity sub-scale scores indicating more hyperactive behaviour (β (95% CI)=0.5 (0.1, 0.9)). Prenatal PFOS and PFOA exposures were not associated with motor difficulties.
  
  
  CONCLUSIONS
  Prenatal exposure to PFOS and PFOA may have a small to moderate effect on children's neuro-behavioural development, specifically in terms of hyperactive behaviour. The associations were strongest in Greenland where exposure contrast is largest.
authors.affiliation: Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Nørrebrogade 44, building 2c, 8000 Aarhus, Denmark. birghoey@rm.dk.
authors.forename: Birgit Bjerre
authors.initials: BB
authors.lastname: Høyer
authors.forename: Cecilia Høst
authors.initials: CH
authors.lastname: Ramlau-Hansen
authors.forename: Carsten
authors.initials: C
authors.lastname: Obel
authors.forename: Henning Sloth
authors.initials: HS
authors.lastname: Pedersen
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Hernik
authors.forename: Victor
authors.initials: V
authors.lastname: Ogniev
authors.forename: Bo A G
authors.initials: BA
authors.lastname: Jönsson
authors.forename: Christian H
authors.initials: CH
authors.lastname: Lindh
authors.forename: Lars
authors.initials: L
authors.lastname: Rylander
authors.forename: Anna
authors.initials: A
authors.lastname: Rignell-Hydbom
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Bonde
authors.forename: Gunnar
authors.initials: G
authors.lastname: Toft
mesh_terms: D017738:Alkanesulfonic Acids / Q000097:blood*; D002210:Caprylates / Q000097:blood*; D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D002853:Chromatography, Liquid; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006116:Greenland / Q000453:epidemiology; D006801:Humans; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D009043:Motor Activity / Q000187:drug effects*; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D011446:Prospective Studies; D053719:Tandem Mass Spectrometry; D014455:Ukraine / Q000453:epidemiology
chemical_list: D017738:Alkanesulfonic Acids; D002210:Caprylates; D005466:Fluorocarbons; C023036:perfluorooctanoic acid; C076994:perfluorooctane sulfonic acid