Using semiparametric-mixed model and functional linear model to detect vulnerable prenatal window to carcinogenic...

Prenatal exposure to carcinogenic polycyclic aromatic hydrocarbons (c-PAHs) through maternal inhalation induces higher risk for a wide range of fetotoxic effects. However, the most health-relevant dose function from chronic gestational exposure remains unclear. Whether there is a gestational window during which the human embryo/fetus is particularly vulnerable to PAHs has not been examined thoroughly. We consider a longitudinal semiparametric-mixed effect model to characterize the individual prenatal PAH exposure trajectory, where a nonparametric cyclic smooth function plus a linear function are used to model the time effect and random effects are used to account for the within-subject correlation. We propose a penalized least squares approach to estimate the parametric regression coefficients and the nonparametric function of time. The smoothing parameter and variance components are selected using the generalized cross-validation (GCV) criteria. The estimated subject-specific trajectory of prenatal exposure is linked to the birth outcomes through a set of functional linear models, where the coefficient of log PAH exposure is a fully nonparametric function of gestational age. This allows the effect of PAH exposure on each birth outcome to vary at different gestational ages, and the window associated with significant adverse effect is identified as a vulnerable prenatal window to PAHs on fetal growth. We minimize the penalized sum of squared errors using a spline-based expansion of the nonparametric coefficient function to draw statistical inferences, and the smoothing parameter is chosen through GCV.