BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are chemical substances spread throughout the environment worldwide. Exposure during pregnancy represents a specific window of vulnerability for child health. OBJECTIVE Our objective was to assess the impact of prenatal exposure to multiple PFAS on emotional and behavioral functions in 12-y-old children. METHOD In the PELAGIE mother-child cohort (France), prenatal exposure to nine PFAS was measured from concentrations in cord serum samples. Behavior was assessed at age 12 y using the parent-reported Strengths and Difficulties Questionnaire (SDQ) and the self-reported Dominic Interactive for Adolescents (DIA) for 444 children. Associations were estimated using negative binomial models for each PFAS. Bayesian kernel machine regression (BKMR) models were performed to assess the exposure mixture effect on children's behavior. RESULTS In our study population, 73% of mothers had spent more than 12 y in education. Higher scores on SDQ externalizing subscale were observed with increasing cord-serum concentration of perfluorooctanoic acid (PFOA) and perfluorononanoic acid (PFNA) [adjusted mean ratio (aMR)=1.18, 95% confidence interval (CI): 1.03, 1.34, and aMR=1.14 (95% CI: 1.00, 1.29) for every doubling of concentration, respectively]. Results for the hyperactivity score were similar [aMR=1.20 (95% CI: 1.04, 1.40) and aMR=1.18 (95% CI: 1.02, 1.36), respectively]. With regard to major depressive disorder and internalizing subscales, perfluorodecanoic acid (PFDA) was associated with higher self-reported DIA scores [aMR=1.14 (95% CI: 1.01, 1.27) and aMR=1.11 (95% CI: 1.02, 1.21), respectively]. In terms of the anxiety subscale, PFDA and PFNA were associated with higher scores [aMR=1.11 (95% CI: 1.02, 1.21) and aMR=1.10 (95% CI: 1.01, 1.19), respectively]. Concurrent increases in the PFAS concentrations included in the BKMR models showed no change in the SDQ externalizing and DIA internalizing subscales scores. CONCLUSION Prenatal exposure to PFNA and PFOA were associated with increasing scores for measures of externalizing behaviors, specifically hyperactivity. We also identified associations between PFNA and PFDA prenatal exposure levels and increasing scores related to internalizing behaviors (general anxiety and major depressive disorder), which adds to the as yet sparse literature examining the links between prenatal exposure to PFAS and internalizing disorders. https://doi.org/10.1289/EHP12540.

中文翻译：

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产前接触全氟烷基物质和 12 岁时儿童行为：一项 PELAGIE 母子队列研究。

背景技术全氟烷基物质和多氟烷基物质(PFAS)是遍布全球环境的化学物质。怀孕期间的暴露是儿童健康脆弱的一个特定时期。目的 我们的目的是评估产前接触多种 PFAS 对 12 岁儿童情绪和行为功能的影响。方法 在 PELAGIE 母子队列（法国）中，根据脐带血清样本中的浓度测量了九种 PFAS 的产前暴露情况。使用家长报告的优势和困难问卷 (SDQ) 和自我报告的 Dominic Interactive for Adolescents (DIA) 对 444 名儿童在 12 岁时进行行为评估。使用负二项式模型估计每种 PFAS 的关联性。贝叶斯核机器回归（BKMR）模型用于评估暴露混合物对儿童行为的影响。结果 在我们的研究人群中，73% 的母亲接受教育的时间超过 12 年。随着全氟辛酸 (PFOA) 和全氟壬酸 (PFNA) 脐带血清浓度的增加，观察到 SDQ 外化子量表得分较高[调整平均比 (aMR)=1.18，95% 置信区间 (CI)：1.03、1.34 和 aMR每增加一倍浓度，分别 =1.14（95% CI：1.00，1.29）]。多动评分的结果相似[分别为 aMR=1.20 (95% CI: 1.04, 1.40) 和 aMR=1.18 (95% CI: 1.02, 1.36)]。对于重度抑郁症和内化分量表，全氟癸酸 (PFDA) 与较高的自我报告 DIA 评分相关 [aMR=1.14 (95% CI: 1.01, 1.27) 和 aMR=1.11 (95% CI: 1.02, 1.21) ， 分别]。就焦虑分量表而言，PFDA 和 PFNA 与较高分数相关[分别为 aMR=1.11 (95% CI: 1.02, 1.21) 和 aMR=1.10 (95% CI: 1.01, 1.19)]。BKMR 模型中包含的 PFAS 浓度的同时增加表明 SDQ 外化和 DIA 内化分量表得分没有变化。结论 产前接触 PFNA 和 PFOA 与外化行为（特别是多动症）评分增加相关。我们还确定了 PFNA 和 PFDA 产前暴露水平与内化行为（一般性焦虑和重度抑郁症）相关评分的增加之间的关联，这增加了迄今为止稀疏的研究 PFAS 产前暴露与内化障碍之间联系的文献。https://doi.org/10.1289/EHP12540。