Association between prenatal exposure to perfluoroalkyl substances and asthma in 5-year-old children in the Odense Child Cohort

Abstract

BackgroundAsthma is the most common non-communicable disease in children. Prenatal exposure to perfluoroalkyl substances (PFASs), a group of persistent environmental chemicals with endocrine disrupting abilities, has been associated with immunomodulation and may contribute to the aetiology of asthma. We investigated the associations between prenatal exposure to five PFASs and asthma in 5-year-old children.MethodsWe studied 981 mother-child pairs within the Odense Child Cohort (OCC), Denmark. We measured perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) in maternal serum donated in early pregnancy. A standardized questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC) was used to assess wheeze, self-reported asthma and doctor-diagnosed asthma among children at age 5 years. Associations were examined using logistic regression analyses adjusting for parity, maternal educational level, maternal pre-pregnancy BMI, asthma predisposition and child sex.ResultsAmong the 5-year-old children 18.6% reported wheeze and 7.1% reported asthma. We found no association between prenatal exposure to PFAS and doctor-diagnosed asthma or wheeze. Prenatal PFAS exposure was associated with self-reported asthma, although only significant for PFNA (OR = 1.84, 95% CI 1.03,3.23).ConclusionOur findings support the suggested immunomodulatory effects of PFASs, however, additional studies are warranted. In order to verify our findings, it is important to re-examine the children with postnatal measurements of serum PFAS concentrations and additional clinical diagnostic testing at an older age where an asthma diagnosis is more valid.

Perfluoroalkyl substances exposure and immunity, allergic response, infection, and asthma in children: review of epidemiologic studies

“…A lack of significant findings among childhood asthma diagnosis and/or symptoms (e.g., wheeze) and PFAS levels has been reported by numerous other studies ( Impinen et al., 2018 , 2019 ; Jackson-Browne et al., 2020 ; Smit et al., 2015 ). For example, Beck et al. (2019) examined prenatal exposure to PFOS, PFOA, PFHxS, PFNA, and PFDA and child asthma at the age of 5 years.…”

“…(2017) , Faroe Island Cohort, cord blood and maternal serum 2 weeks after parturition, child serum at 18 months and 5 years, Faroe Islands, 2007–2009 Age 18 months and 5 years Maternal (n = 55) Geometric mean ± GSE 9.075 ±0.495 1.47 ±0.100 0.789 ±0.056 0.298 ±0.020 N/A N/A N/A 0.24 ±0.022 N/A 18 months old (n = 41) Geometric mean ± GSE 8.25 ±0.761 3.58 ±0.391 1.244 ±0.135 0.347 ±0.033 N/A N/A N/A 0.247 ±0.045 N/A 5 years old (n = 53) Geometric mean ± GSE 5.058 ±0.261 2.596 ±0.128 1.358 ±0.095 0.357 ±0.024 N/A N/A N/A 0.372 ±0.032 N/A Knudsen et al., 2018 , Greenlandic Birth cohort, maternal serum, Greenland 2010–2011 Age N/A All (N = 189) Median (Range) N/A N/A N/A N/A N/A N/A N/A N/A 18.5 (6.14–96.43) Immune Outcome: Asthma Agier et al. (2019) , European Human Early-Life Exposome (HELIX), maternal and child serum, Europe 2003–2009 Age 6–12 years Prenatal (N = 1,033 child-mother pairs) Mean (SD) 8.2 (6.1) 2.6 (1.8) 0.8 (0.6) N/A N/A N/A N/A 0.8 (1) N/A Postnatal (N = 1,033 child-mother pairs) Mean (SD) 2.6 (2.6) 1.7 (0.7) 0.7 (0.7) N/A N/A N/A N/A 0.5 (1) N/A ...…”

“…(2011) X X X X X Immune Outcome: Asthma Agier et al. (2019) X X X X X X Beck et al. (2019) X X X X Gaylord et al.…”

Serum levels of perfluorooctanoic acid and perfluorooctane sulfonic acid in pregnant women: Maternal predictors and associations with birth outcomes in the PIPA Project

“…Studies have found inverse associations between PFOA or PFOS and birth weight. 17,41,48 However, other studies have reported inconsistent associations. [49][50][51] Other outcomes at birth, such as length, BMI, and head circumference, have been investigated with mixed findings.…”

“…Recent studies have suggested positive associations between maternal exposure to PFAS and low birth weight, 15 dyslipidemia, 16 and asthma in childhood. 17 Age, diet, and maternal characteristics have been identified as maternal predictors of PFOA and PFOS in developed countries. 18 However, there may be different predictors for different populations, and there is limited knowledge about maternal predictors of PFOA and PFOS in developing countries.…”