Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb:147:106328.
doi: 10.1016/j.envint.2020.106328. Epub 2020 Dec 30.

Prenatal exposure to per- and polyfluoroalkyl substances in association with autism spectrum disorder in the MARBLES study

Jiwon Oh  1 , Deborah H Bennett  2 , Antonia M Calafat  3 , Daniel Tancredi  4 , Dorcas L Roa  5 , Rebecca J Schmidt  6 , Irva Hertz-Picciotto  6 , Hyeong-Moo Shin  7
Affiliations

Prenatal exposure to per- and polyfluoroalkyl substances in association with autism spectrum disorder in the MARBLES study

Jiwon Oh et al. Environ Int. 2021 Feb.

Abstract

Background: Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) has shown potential to adversely affect child brain development, but epidemiologic evidence remains inconsistent. We examined whether prenatal exposure to PFAS was associated with increased risk of autism spectrum disorder (ASD).

Methods: Participants were 173 mother-child pairs from MARBLES (Markers of Autism Risk in Babies - Learning Early Signs), a high-risk ASD cohort. At 3 years old, children were clinically confirmed for ASD and classified into ASD (n = 57) and typical development (TD, n = 116). We quantified nine PFAS in maternal serum collected during pregnancy. We examined associations of ASD with individual PFAS as well as the combined effect of PFAS on ASD using scores of the first principal component (PC-1) accounting for the largest variance.

Results: Prenatal perfluorooctanoate (PFOA) and perfluorononanoate (PFNA) showed positive associations (per 2 nanogram per milliliter increase: relative risk (RR) = 1.20, 95% CI: 0.90, 1.61 [PFOA]; RR = 1.24, 95% CI: 0.91, 1.69 [PFNA]), while perfluorohexane sulfonate (PFHxS) showed a negative association (RR = 0.88, 95% CI: 0.77, 1.01) with ASD risk. When examining associations of ASD with untransformed PFAS concentrations, PFOA, PFNA, and PC-1 were associated with increased ASD risk (per nanogram per milliliter increase: RR = 1.31, 95% CI: 1.04, 1.65; RR = 1.79, 95% CI: 1.13, 2.85; RR = 1.10, 95% CI: 0.97, 1.25, respectively), while the RR of PFHxS moved toward the null.

Conclusions: From this high-risk ASD cohort, we observed increased risk of ASD in children exposed to PFOA and PFNA. Further studies should be conducted in the general population because this population may have a larger fraction of cases resulting from genetic sources.

Keywords: Autism spectrum disorder; Per- and polyfluoroalkyl substances; Prenatal exposure.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Study flow and blood sample collection from MARBLES participants.
See this image and copyright information in PMC

References

    1. American Psychiatric Association, 2013. Diagnostic and statistical manual of mental disorders. American Psychiatric Association Fifth Edition, Washington, DC.
    1. Banik A; Kandilya D; Ramya S; Stünkel W; Chong Y; Dheen S Maternal factors that induce epigenetic changes contribute to neurological disorders in offspring. Genes 2017;8:150 - PMC - PubMed
    1. Barrett ES; Mbowe O; Thurston SW; Butts S; Wang C; Nguyen R; Bush N; Redmon JB; Sheshu S; Swan SH Predictors of Steroid Hormone Concentrations in Early Pregnancy: Results from a Multi-Center Cohort. Maternal and child health journal 2019;23:397–407 - PMC - PubMed
    1. Benford D; De Boer J; Carere A; Di Domenico A; Johansson N; Schrenk D; Schoeters G; De Voogt P; Dellatte E Opinion of the scientific panel on contaminants in the food chain on perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA) and their salts. EFSA Journal 2008:1–131
    1. Berg V; Nøst TH; Hansen S; Elverland A; Veyhe A-S; Jorde R; Odland JØ; Sandanger TM Assessing the relationship between perfluoroalkyl substances, thyroid hormones and binding proteins in pregnant women; a longitudinal mixed effects approach. Environment international 2015;77:63–69 - PubMed

Publication types