The neurotoxic effects of prenatal
exposure to per- and polyfluoroalkyl
substances (PFAS) on offspring animals are well-documented. However,
epidemiological evidence for legacy PFAS is inconclusive, and for
alternative PFAS, it is little known. In this investigation, we selected
718 mother–child pairs from the Chinese Maoming Birth Cohort
Study and measured 17 legacy and alternative PFAS in the third-trimester
serum. Neuropsychological developments (communication, gross motor
function, fine motor function, problem solving ability, and personal–social
skills) were assessed at 3, 6, 12, 18, 24, and 36 months using the
Ages and Stages Questionnaires 3rd edition. Trajectories of each subscale
were classified into persistently low and persistently high groups
via group-based trajectory modeling. Logistic regression and grouped
weighted quantile sum were fitted to assess the potential effects
of individual PFAS and their mixtures, respectively. Higher linear
PFHxS levels were associated with elevated odds for the persistently
low trajectories of communication (OR = 1.73; 95% CI: 1.12, 2.66)
and problem solving ability (OR = 2.11; 95% CI: 1.14, 3.90). Similar
findings were observed for linear PFOS, 1m-PFOS, PFDA, PFDoDA, PFUnDA,
and legacy PFAS mixture. However, no association was observed for
alternative PFAS and their mixture. We provided insights into the
longitudinal links between prenatal legacy/alternative PFAS exposure
and neuropsychological development trajectories over the first 3 years
of life.