Prenatal exposure to per- and polyfluoroalkyl substances and infant sleep disturbance: A prospective cohort study
Yun Huang1, Fang Fang2, Yan Chen3
1Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) is linked to infant sleep problems. This study found associations between PFAS and increased risks of severe sleep disturbances, snoring, and nighttime awakenings in infants.
Area of Science:
- Environmental Health
- Developmental Pediatrics
- Toxicology
Background:
- Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may impact fetal brain development.
- Limited research exists on the association between prenatal PFAS exposure and infant sleep patterns.
Purpose of the Study:
- To investigate the relationship between prenatal exposure to PFAS and infant sleep disturbances in the first year of life.
- To analyze both individual and mixture effects of PFAS on infant sleep outcomes.
Main Methods:
- A prospective cohort study of 4127 pregnant women (Shanghai Birth Cohort).
- Quantification of ten PFAS in maternal serum during the first trimester.
- Sleep quality assessed using the Brief Infant Sleep Questionnaire at 6 and 12 months.
- Statistical analyses included multiple linear regression, multinomial logistic regression, quantile-based g-computation, and generalized estimating equation (GEE) models.
Main Results:
- Specific PFAS (PFOS, PFOA) were linked to severe sleep problems in 6-month-olds.
- PFDA exposure was associated with increased snoring risk in 12-month-olds.
- PFAS mixtures correlated with more nighttime awakenings at both 6 and 12 months.
- GEE models indicated prenatal PFAS exposure was associated with longer sleep latency, increased awakenings, longer wakefulness, snoring, and earlier sleep onset.
Conclusions:
- Prenatal exposure to PFAS is associated with an increased risk of sleep disturbances in infants.
- Findings highlight potential adverse effects of environmental contaminants on infant sleep development.
Background:
Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may adversely affect fetal brain development, yet no study has investigated the potential association between prenatal PFAS exposure and infant sleep.
Objectives:
To explore the associations of prenatal PFAS exposure with infant sleep disturbances during the first year of life in a prospective cohort study.
Methods:
We recruited 4127 pregnant women from the Shanghai Birth Cohort (SBC) and followed their children from birth to 12 months old. A total of 2366 infants were included in the 6-month analyses, and 2466 infants in the 12-month analyses. Ten PFAS were quantified in blood serum collected in the first trimester. Sleep quality was measured using the Brief Infant Sleep Questionnaire. We used multiple linear regression and multinomial logistic regression to estimate the individual effects of PFAS on sleep outcomes. We utilized a quantile-based g-computation model to determine the joint effects of the PFAS mixture on infant sleep outcomes. Additionally, generalized estimating equation (GEE) models were performed to examine the longitudinal effects of PFAS exposure during pregnancy.
Results:
In infants aged 6 months, perfluorooctane sulfonate and perfluoroheptanoic acid were associated with a more than 2-fold risk of parent-reported sleep problems as severe. Perfluorodecanoic acid was associated with an increased risk of often or almost always snoring in one-year-old infants (relative risk ratios, 1.79; 95% CI, 1.12-2.86). PFAS mixtures were positively associated with nighttime awakenings both among infants aged 6 months (β, 0.11; 95% CI, 0.04-0.19) and 12 months (β, 0.11; 95% CI, 0.05-0.18). Prenatal exposure to PFAS were associated with longer sleep latency, increased nighttime awakenings, longer nocturnal wakefulness hours, snoring, and earlier sleep-onset time in infants aged 6-12 months, according to GEE models.
Conclusions:
Our study suggests that prenatal exposure to PFAS may increase the risk of sleep disturbance in infants.
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