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Maternal psychological distress modifies the association between prenatal exposure to per- and polyfluoroalkyl

Shanyu Zhang1, Mingyue Ma2, Yan Zhang3

  • 1MOE-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 200092 Shanghai, China; Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, 230601 Hefei, China.

The Science of the Total Environment
|April 11, 2025
PubMed

Insights

Maternal psychological distress amplifies risks from prenatal per- and polyfluoroalkyl substances (PFAS) exposure, impacting infant gross motor development. Identifying distressed mothers is key for targeted interventions to protect child neurodevelopment.

Area of Science:

  • Environmental Health
  • Neurodevelopmental Toxicology
  • Perinatal Epidemiology

Background:

  • Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and maternal psychological distress are independently linked to adverse child neurodevelopment.
  • Shared biological pathways, including hypothalamic-pituitary-adrenal (HPA) axis disruption and inflammation, may mediate these effects.
  • The modifying role of maternal psychological distress on PFAS-associated neurodevelopmental risks is not well understood.

Purpose of the Study:

  • To investigate whether maternal psychological distress modifies the association between prenatal PFAS exposure and child neurodevelopment at 6 months of age.
  • To examine the impact of individual and mixed PFAS exposures on child neurodevelopment in the context of maternal psychological distress.

Main Methods:

  • A cohort of 1779 mother-child pairs from the Shanghai Birth Cohort was analyzed.
  • Maternal PFAS levels (first trimester) and psychological distress (second trimester: stress, depression, anxiety) were measured.
  • Child neurodevelopment was assessed at 6 months using the Ages & Stages Questionnaires-Third Edition (ASQ-3).
  • Multivariable regression, quantile g-computation, and stratified analyses were employed to assess PFAS-neurodevelopment associations, with stratification by psychological distress status.

Main Results:

  • 41% of pregnant women reported at least one type of psychological distress.
  • Prenatal PFAS exposure was associated with reduced gross motor scores in children overall.
  • Maternal psychological distress significantly modified the PFAS-neurodevelopmental association; adverse effects were evident only in the distressed group.
  • Significant interactions were observed between maternal psychological distress and most PFAS compounds.
  • The negative impact of PFAS on gross motor development intensified with increasing types of maternal psychological stressors.

Conclusions:

  • Maternal psychological distress exacerbates the adverse effects of prenatal PFAS exposure on infant gross motor development.
  • This highlights the critical role of maternal mental health in mediating environmental toxicant risks to child neurodevelopment.
  • Identifying pregnant women experiencing psychological distress is crucial for targeted interventions to mitigate neurodevelopmental risks associated with PFAS exposure.

Keywords:
Modifying effectNeurodevelopmentPFASPrenatal exposurePsychological distress

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