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. 2023 Jan 1;216(Pt 4):114759.
doi: 10.1016/j.envres.2022.114759. Epub 2022 Nov 9.

Prenatal exposure to polycyclic aromatic hydrocarbons is not associated with behavior problems in preschool and early school-aged children: A prospective multi-cohort study

Erin R Wallace  1 , Erin Buth  2 , Adam A Szpiro  3 , Yu Ni  2 , Christine T Loftus  2 , Erin Masterson  2 , Drew B Day  4 , Bob Z Sun  5 , Alexis Sullivan  6 , Emily Barrett  7 , Ruby Hn Nguyen  8 , Morgan Robinson  9 , Kurunthachalam Kannan  9 , Alex Mason  10 , Sheela Sathyanarayana  11 , Kaja Z LeWinn  6 , Nicole R Bush  12 , Catherine J Karr  13
Affiliations

Prenatal exposure to polycyclic aromatic hydrocarbons is not associated with behavior problems in preschool and early school-aged children: A prospective multi-cohort study

Erin R Wallace et al. Environ Res. .

Abstract

Background: Epidemiological study findings are inconsistent regarding associations between prenatal polycyclic aromatic hydrocarbon (PAH) exposures and childhood behavior. This study examined associations of prenatal PAH exposure with behavior at age 4-6 years in a large, diverse, multi-region prospective cohort. Secondary aims included examination of PAH mixtures and effect modification by child sex, breastfeeding, and child neighborhood opportunity.

Methods: The ECHO PATHWAYS Consortium pooled 1118 mother-child dyads from three prospective pregnancy cohorts in six U.S. cities. Seven PAH metabolites were measured in prenatal urine. Child behavior was assessed at age 4-6 using the Total Problems score from the Child Behavior Checklist (CBCL). Neighborhood opportunity was assessed using the socioeconomic and educational scales of the Child Opportunity Index. Multivariable linear regression was used to estimate associations per 2-fold increase in each PAH metabolite, adjusted for demographic, prenatal, and maternal factors and using interaction terms for effect modifiers. Associations with PAH mixtures were estimated using Weighted Quantile Sum Regression (WQSR).

Results: The sample was racially and sociodemographically diverse (38% Black, 49% White, 7% Other; household-adjusted income range $2651-$221,102). In fully adjusted models, each 2-fold increase in 2-hydroxynaphthalene was associated with a lower Total Problems score, contrary to hypotheses (b = -0.80, 95% CI = -1.51, -0.08). Associations were notable in boys (b = -1.10, 95% CI = -2.11, -0.08) and among children breastfed 6+ months (b = -1.31, 95% CI = -2.25, -0.37), although there was no statistically significant evidence for interaction by child sex, breastfeeding, or neighborhood child opportunity. Associations were null for other PAH metabolites; there was no evidence of associations with PAH mixtures from WQSR.

Conclusion: In this large, well-characterized, prospective study of mother-child pairs, prenatal PAH exposure was not associated with child behavior problems. Future studies characterizing the magnitude of prenatal PAH exposure and studies in older childhood are needed.

Keywords: Behavioral development; Neurodevelopment; Polycyclic aromatic hydrocarbons; Prenatal.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Directed acyclic graph (DAG) showing conceptual model for confounding Abbreviations: BMI=Body mass index, CBCL=Child Behavior Checklist, PAH=Polycyclic aromatic hydrocarbon, SES=Socioeconomic status
Figure 2.
Figure 2.
Flowchart for inclusion of study participants from enrollment to age 4–6 child visit and final analytic study sample, by ECHO-PATHWAYS cohort
Figure 3.
Figure 3.
Associations between prenatal OH-PAH metabolites and age 4–6 Total Problems, by metabolite and model. Models represent effect estimates (symbols) and 95% confidence intervals (bars) from linear regressions. The minimally adjusted model includes child age at assessment (continuous year, to two decimal places), child sex (binary), CBCL form version (binary), OH-PAH analysis batch, and urinary specific gravity (continuous). The fully adjusted model includes terms in the minimally adjusted model plus maternal education (categorical), adjusted income by household count (continuous, natural log transformed), household count (categorical), interaction between adjusted income by family household size (i.e. log income X household count), maternal age at child’s birth (continuous), marital status (married or living with partner vs. not), child birth order (binary, first born vs. not), study site (categorical, 7, with Seattle GAPPS and Seattle TIDES modeled separately), maternal depression (PROMIS score, continuous), maternal stress (Perceived Stress scale, continuous), Child Opportunity Index Social and Economic domain (continuous), Child Opportunity Index Education, pre- and post-natal secondhand smoke exposure (self-reported; any vs. none), and postnatal maternal smoking (self-reported; any vs. none). The expanded adjusted model includes terms in the fully adjusted model plus pre-pregnancy BMI (continuous), gestational age (continuous), prenatal alcohol use (continuous), breastfeeding status (categorical; None, <6 months., ≥ 6 months), as well as self-identified race (categorical; White, Black, Asian, American Indian/Alaska Native, Other, Multiple race). All estimates represent effect per 2-fold increase in log OH-PAH. Abbreviations: 1-NAP= 1-hydroxynaphthalene, 2-NAP=2-hydroxynaphthalene, 2-PHEN=2-hydroxyphenanthrene, 3-PHEN=3-hydroxyphenanthrene, 1/9-PHEN=1/9-hydroxyphenanthrene, 2/3/9-FLUO=2/3/9-hydroxyfluorene, 1-PYR=1-hydroxypyrene, 95% CI = 95% Confidence Interval.
Figure 4.
Figure 4.
Associations between OH-PAH metabolites and age 4–6 Total Problems, by child sex. Models represent effect estimates (symbols) and 95% confidence intervals (bars) from linear regressions. Adjusted for child age at assessment (continuous year, to two decimal places), child sex (binary), CBCL form version (binary), OH-PAH analysis batch, and urinary specific gravity (continuous). maternal education (categorical), adjusted income by household count (continuous, natural log transformed), household count (categorical), interaction between adjusted income by family household size (i.e. log income X household count), maternal age at child’s birth (continuous), marital status (married or living with partner vs. not), child birth order (binary, first born vs. not), study site (categorical, 7, with Seattle GAPPS and Seattle TIDES modeled separately), maternal depression (PROMIS score, continuous), maternal stress (Perceived Stress scale, continuous), Child Opportunity Index Social and Economic domain (continuous), Child Opportunity Index Education, pre- and post-natal secondhand smoke exposure (self-reported; any vs. none), and postnatal maternal smoking (self-reported; any vs. none). All estimates represent effect per 2-fold increase in log OH-PAH. Abbreviations: 1-NAP= 1-hydroxynaphthalene, 2-NAP=2-hydroxynaphthalene, 2-PHEN=2-hydroxyphenanthrene, 3-PHEN=3-hydroxyphenanthrene, 1/9-PHEN=1/9-hydroxyphenanthrene, 2/3/9-FLUO=2/3/9-hydroxyfluorene, 1-PYR=1-hydroxypyrene, 95% CI = 95% Confidence Interval.
Figure 5.
Figure 5.
Associations between OH-PAH metabolites and age 4–6 Total Problems, by length of breastfeeding. Models represent effect estimates (symbols) and 95% confidence intervals (bars) from linear regressions. Adjusted for child age at assessment (continuous year, to two decimal places), child sex (binary), CBCL form version (binary), OH-PAH analysis batch, and urinary specific gravity (continuous). maternal education (categorical), adjusted income by household count (continuous, natural log transformed), household count (categorical), interaction between adjusted income by family household size (i.e. log income X household count), maternal age at child’s birth (continuous), marital status (married or living with partner vs. not), child birth order (binary, first born vs. not), study site (categorical, 7, with Seattle GAPPS and Seattle TIDES modeled separately), maternal depression (PROMIS score, continuous), maternal stress (Perceived Stress scale, continuous), Child Opportunity Index Social and Economic domain (continuous), Child Opportunity Index Education, pre- and post-natal secondhand smoke exposure (self-reported; any vs. none), and postnatal maternal smoking (self-reported; any vs. none). All estimates represent effect per 2-fold increase in log OH-PAH. Abbreviations: 1-NAP= 1-hydroxynaphthalene, 2-NAP=2-hydroxynaphthalene, 2-PHEN=2-hydroxyphenanthrene, 3-PHEN=3-hydroxyphenanthrene, 1/9-PHEN=1/9-hydroxyphenanthrene, 2/3/9-FLUO=2/3/9-hydroxyfluorene, 1-PYR=1-hydroxypyrene, 95% CI = 95% Confidence Interval.
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References

    1. Abid Z, Roy A, Herbstman JB, Ettinger AS, 2014. Urinary polycyclic aromatic hydrocarbon metabolites and attention/deficit hyperactivity disorder, learning disability, and special education in U.S. children aged 6 to 15. J Environ Public Health 2014, 628508. 10.1155/2014/628508 - DOI - PMC - PubMed
    1. Acevedo-Garcia D, McArdle N, Hardy EF, Crisan UI, Romano B, Norris D, Baek M, Reece J, 2014. The child opportunity index: improving collaboration between community development and public health. Health Aff (Millwood) 33, 1948–1957. 10.1377/hlthaff.2014.0679 - DOI - PubMed
    1. Achenbach TM, Rescorla LA, 2001. Manual for the ASEBA School-Age Forms & Profiles. University of Vermont, Research Center for Children, Youth, & Families, Burlington, VT.
    1. Achenbach TM, Rescorla LA, 2000. Manual for the ASEBA Preschool Forms & Profiles. University of Vermont, Research Center for Children, Youth, & Families, Burlington, VT.
    1. Agency for Toxic Substances and Disease Registry (ATSDR), 1995. Toxicological profile for polycyclic aromatic hydrocarbons, U.S. Department of Health and Human Services.

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