Association between prenatal exposures to per- and polyfluoroalkyl substances and early language development in the ECHO Cohort

Patricia Cintora¹, Lesliam Quirós-Alcalá², Adaeze W Nzegwu³, Sudhi Upadhyaya³, Megan Woodbury⁴, Sarah Dee Geiger⁵, Rachel Morello-Frosch⁶, Anne L Dunlop⁷, Theresa M Bastain⁸, Anne P Starling⁹, Dana Dabelea¹⁰, Carlos A Camargo Jr¹¹, Pi-I Debby Lin¹², Rachel S Kelly¹³, Assiamira Ferrara¹⁴, Lisa A Croen¹⁴, Thomas G O'Connor¹⁵, June-Soo Park¹⁶, Morgan Reynolds¹⁷, Kurunthachalam Kannan¹⁸, Susan L Schantz¹⁹; ECHO Cohort Consortium

Affiliations

¹ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA. Electronic address: cintora2@illinois.edu.
² Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; College of Engineering, Northeastern University, Boston, MA, USA.
⁵ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
⁶ Department of Environmental Science, Policy and Management & School of Public Health, University of California Berkeley, Berkeley, CA, USA.
⁷ Department of Gynecology and Obstetrics, Emory University School of Medicine Atlanta, GA, USA.
⁸ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
¹⁰ Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
¹¹ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹² Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
¹³ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
¹⁴ Kaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.
¹⁵ Department of Psychiatry, University of Rochester, Rochester, NY, USA.
¹⁶ California Department of Toxic Substances Control, Environmental Chemistry Laboratory, Berkeley, CA, USA; University of California, San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, CA, USA.
¹⁷ Division of Environmental Health Sciences, Wadsworth Center, New York State Dept. of Health, Albany, NY, USA.
¹⁸ Division of Environmental Health Sciences, Wadsworth Center, New York State Dept. of Health, Albany, NY, USA; Department of Environmental Health Sciences, School of Public Health, The University at Albany, SUNY, Rensselaer, NY, USA.
¹⁹ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.

PMID: 41015090
DOI: 10.1016/j.neuro.2025.103309

Association between prenatal exposures to per- and polyfluoroalkyl substances and early language development in the ECHO Cohort

Patricia Cintora et al. Neurotoxicology. 2025.

. 2025 Sep 25:103309.

doi: 10.1016/j.neuro.2025.103309. Online ahead of print.

Authors

Affiliations

¹ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA. Electronic address: cintora2@illinois.edu.
² Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; College of Engineering, Northeastern University, Boston, MA, USA.
⁵ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
⁶ Department of Environmental Science, Policy and Management & School of Public Health, University of California Berkeley, Berkeley, CA, USA.
⁷ Department of Gynecology and Obstetrics, Emory University School of Medicine Atlanta, GA, USA.
⁸ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
¹⁰ Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
¹¹ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹² Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
¹³ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
¹⁴ Kaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.
¹⁵ Department of Psychiatry, University of Rochester, Rochester, NY, USA.
¹⁶ California Department of Toxic Substances Control, Environmental Chemistry Laboratory, Berkeley, CA, USA; University of California, San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, CA, USA.
¹⁷ Division of Environmental Health Sciences, Wadsworth Center, New York State Dept. of Health, Albany, NY, USA.
¹⁸ Division of Environmental Health Sciences, Wadsworth Center, New York State Dept. of Health, Albany, NY, USA; Department of Environmental Health Sciences, School of Public Health, The University at Albany, SUNY, Rensselaer, NY, USA.
¹⁹ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.

PMID: 41015090
DOI: 10.1016/j.neuro.2025.103309

Abstract

Background/aim: The relationship between prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and child neurodevelopment remains inconclusive, and few studies have investigated associations of PFAS exposure with language development. This study drew on data from seven U.S.-based Environmental influences on Child Health Outcomes (ECHO) cohorts to investigate associations between prenatal PFAS exposures and language development in early childhood.

Methods: We quantified concentrations of four PFAS in maternal plasma or serum during pregnancy. Language development was assessed using the communication scale from the Ages & Stages Questionnaires, Third Edition (ASQ®-3) in children ages 1.5-5 years (n=1503) and the NIH Toolbox Picture Vocabulary Test (PVT) in children ages 3-5 years (n=399). Associations between single PFAS and language outcomes were examined in multivariable linear and logistic regression models. PFAS mixture was examined using quantile g-computation.

Results: Overall and in sex-specific analyses, we did not observe associations between individual PFAS biomarkers and language development. The PFAS mixture showed no significant associations with ASQ®-3 communication z-scores (ψ = -0.04; 95% CI: -0.86, 0.78) or PVT t-scores (ψ = 0.35; 95% CI: -1.14, 1.83). Sex-specific results showed a small but statistically significant negative association with ASQ®-3 communication scores in females (ψ = -0.46; 95% CI: -0.88, -0.05; p = 0.03) and positive, albeit not statistically significant, associations with PVT t-scores in males (ψ = 0.27; 95% CI: -1.84, 2.38) and females (ψ = 0.55; 95% CI: -1.81, 2.92).

Conclusions: Prenatal concentrations of individual PFAS or their mixture were not associated with ASQ®-3 communication domain scores or PVT t-scores.

Keywords: ECHO; PFAS; development; language; pregnancy.

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Conflict of interest statement

Declaration of Competing Interest The following authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Thomas G O’Connor reports financial support was provided by National Institutes of Health. Carlos A. Camargo, Jr. reports financial support was provided by National Institutes of Health. Patricia Cintora reports financial support was provided by National Institutes of Health. Sarah Geiger reports financial support was provided by University of Illinois Urbana-Champaign and National Institutes of Health. Pi-i Lin reports financial support was provided by Harvard Medical School, Harvard-Pilgrim HealthCare. Rachel Kelly reports financial support was provided by National Heart Lung and Blood Institute. Theresa Bastain reports financial support was provided by National Institutes of Health. The remaining authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Association between prenatal exposures to per- and polyfluoroalkyl substances and early language development in the ECHO Cohort

Affiliations

Association between prenatal exposures to per- and polyfluoroalkyl substances and early language development in the ECHO Cohort

Authors

Affiliations

Abstract

Conflict of interest statement

LinkOut - more resources

Full Text Sources