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Prenatal PFAS exposure and early childhood sleep quality in the ECHO Cohort
Cai Zhang1, Taylor Etzel2, Susan L Schantz3
1Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Champaign, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
Insights
Prenatal exposure to perfluorooctanoic acid (PFOA) was linked to increased sleep problems in young children. Other PFAS chemicals showed no significant associations, suggesting PFOA may impact early childhood sleep quality.
Area of Science:
- Environmental Health
- Pediatric Sleep Medicine
- Endocrinology
Background:
- Per- and polyfluoroalkyl substances (PFAS) are persistent endocrine disruptors.
- PFAS exposure readily crosses the placenta, potentially affecting neurodevelopment and circadian regulation.
- Early childhood sleep quality is crucial for healthy development.
Purpose of the Study:
- To examine associations between prenatal exposure to specific PFAS, including PFOA, PFOS, PFNA, and PFHxS, and early childhood sleep quality.
- To investigate the impact of these persistent chemicals on neurodevelopmental outcomes related to sleep.
Main Methods:
- Analysis of 2,836 mother-child pairs from the ECHO Cohort.
- Measurement of maternal serum PFAS concentrations during pregnancy.
- Assessment of parent-reported sleep problems using the Child Behavior Checklist (CBCL) from ages 1-5 years.
- Statistical analysis using linear mixed-effects models with covariate adjustment.
Main Results:
- Higher prenatal perfluorooctanoic acid (PFOA) concentrations were associated with modestly higher CBCL Sleep Problems T-scores in early childhood (β=0.13; 95% CI: 0.05, 0.21).
- Associations for perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) were small and not statistically significant.
- The findings indicate a potential link between PFOA exposure and sleep disturbances in young children.
Conclusions:
- Prenatal PFOA exposure may be associated with increased parent-reported sleep problems in early childhood.
- The study contributes to the limited evidence on PFAS and early childhood sleep behaviors.
- Further research with objective sleep measures and mixture-based approaches is warranted to confirm these findings.
Abstract:
Per- and polyfluoroalkyl substances (PFAS) are persistent endocrine-disrupting chemicals that readily cross the placenta and may interfere with hormonal systems essential for neurodevelopment and circadian regulation. We examined associations between prenatal exposure to individual PFAS and early childhood sleep quality. The analytic sample included 2836 mother-child pairs from 14 study sites in the Environmental influences on Child Health Outcomes (ECHO) Cohort. We assessed Child Behavior Checklist (CBCL) Sleep Problems T-scores from ages 1-5 years. Maternal serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) were measured during pregnancy. Linear mixed-effects models with random intercepts estimated associations between log2-transformed PFAS concentrations and CBCL scores, with covariate adjustment. The mean maternal age was 29.6 years, and the sample was racially and socioeconomically diverse (43% non-Hispanic White, 24% Black, and 23% Hispanic; 27% holding advanced degrees; and 36% reporting annual incomes <$30,000). In adjusted analyses, higher prenatal PFOA concentrations were associated with higher CBCL sleep problem scores in early childhood (β = 0.13; 95% CI: 0.05, 0.21). Associations for PFOS, PFNA, and PFHxS were small and not statistically significant. Although the magnitude of the observed PFOA association was modest, the findings add to a limited evidence base on prenatal PFAS exposure and parent-reported sleep-related behaviors in early childhood and warrant confirmation in future studies that incorporate harmonized trimester-specific exposure assessment, objective sleep measures, and mixture-based analytic approaches.
