Evidence map›Paper›PMID 40914105›Full record

ArticleEnvironment international2025

Prenatal exposure to per- and polyfluoroalkyl substances: Association with child behavior in the environmental influences on child health outcomes (ECHO) Cohort.

Catherine M Bulka, Lesliam Quiros-Alcala, Xiaoshuang Xun, T Michael O'Shea, Joseph M Braun, Jennifer L Ames, Alison E Hipwell, Vaia Lida Chatzi, Amy M Padula, Dana Dabelea and 11 more

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Article in Environment international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Catherine M BulkaCollege of Public Health, University of South Florida, Tampa, FL, USA.
Lesliam Quiros-AlcalaDepartment of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Xiaoshuang XunEnvironmental influences on Child Health Outcomes Data Analysis Center, Johns Hopkins University, Baltimore, MD, USA.
T Michael O'SheaDepartment of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Joseph M BraunDepartment of Epidemiology, Brown University, Providence, RI, USA; Center for Children's Environmental Health, Brown University, Providence, RI, USA.
Jennifer L AmesKaiser Permanente Division of Research, Oakland, CA, USA.
Alison E HipwellDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Vaia Lida ChatziDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Amy M PadulaProgram on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, USA.
Dana DabeleaLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Anne StarlingLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Anne L DunlopDepartment of Gynecology & Obstetrics, School of Medicine, Emory University, Atlanta, GA, USA.
Donghai LiangDepartment of Environmental Health, Rollins School of Public Health, Emory University Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University Atlanta, GA, USA.
Susan SchantzDepartment of Psychology, College of Liberal Arts & Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA.
Hyeong-Moo ShinDepartment of Environmental Science, College of Arts & Sciences, Baylor University, Waco, TX, USA.
Jiwon OhDepartment of Public Health Sciences, University of California Davis, Davis, CA, USA.
Rebecca J SchmidtDepartment of Public Health Sciences, University of California Davis, Davis, CA, USA.
Kun LuDepartment of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, USA.
Thomas G O'ConnorDepartment of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
Rebecca C FryDepartment of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, USA; Institute for Environmental Health Solutions, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, USA. Electronic address: rfry@unc.edu.
ECHO Cohort Consortium

Funding

Oversight and Project Management ComponentU2COD023375 · DUKE UNIVERSITY · 2025 to 2025
$26.2M
ECHO DAC (Environmental Influences on Child Health Outcomes Data Analysis Center)U24OD023382 · JOHNS HOPKINS UNIVERSITY · 2025 to 2025
$14.2M
The NYU Children’s Health & Environment Study: an ECHO CohortUH3OD023305 · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2025 to 2025
$9.0M
A prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort StudyUH3OD023275 · DARTMOUTH COLLEGE · 2025 to 2025
$8.6M
The ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child HealthU24OD023319 · NORTHWESTERN UNIVERSITY · 2025 to 2025
$6.0M
Mount Sinai ECHO site for Perinatal Environment and Development StudiesUH3OD023337 · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2025 to 2025
$5.7M
Environmental influences on Child Health Outcomes in the Northern Plains PASS-ECHO CohortUH3OD023279 · AVERA MCKENNAN · 2025 to 2025
$5.2M
Enriching ECHO Cohorts with High-risk Pregnancies and Children with Health Challenges (Enriching ECHO)UH3OD035546 · HACKENSACK UNIVERSITY MEDICAL CENTER · 2025 to 2025
$5.0M
Prenatal Exposures and Child Health Outcomes 2: A Statewide Study of Michigan FamiliesUH3OD023285 · HENRY FORD HEALTH + MICHIGAN STATE UNIVERSITY HEALTH SCIENCES · 2025 to 2025
$4.6M
Miami-ECHO: A Cohort of Mothers, Children and Fathers in Miami-Dade CountyUH3OD035542 · UNIVERSITY OF MIAMI CORAL GABLES · 2025 to 2025
$4.3M
Targeted Analysis ResourceU2CES026533 · NIEHS · UNIVERSITY OF MINNESOTA · 2023 to 2025
$4.1M
Untargeted Analysis ResourceU2CES030857 · NIEHS · RESEARCH TRIANGLE INSTITUTE · 2024 to 2025
$4.0M
NHLBI NIH HHS K01 HL138124NICHD NIH HHS UG1 HD104252NIEHS NIH HHS U24 ES026539NIEHS NIH HHS U2C ES026533NIEHS NIH HHS U2C ES026542NIEHS NIH HHS U2C ES026555NIEHS NIH HHS U2C ES026561NIEHS NIH HHS U2C ES030851NIEHS NIH HHS U2C ES030857NIEHS NIH HHS U2C ES030859NIH HHS U24 OD023319NIH HHS U24 OD023382NIH HHS U24 OD035523NIH HHS U2C OD023375NIH HHS UG3 OD023244NIH HHS UG3 OD023248NIH HHS UG3 OD023249NIH HHS UG3 OD023251NIH HHS UG3 OD023253NIH HHS UG3 OD023272NIH HHS UG3 OD023275NIH HHS UG3 OD023279NIH HHS UG3 OD023282NIH HHS UG3 OD023285NIH HHS UG3 OD023288NIH HHS UG3 OD023289NIH HHS UG3 OD023290NIH HHS UG3 OD023305NIH HHS UG3 OD023313NIH HHS UG3 OD023337NIH HHS UG3 OD023342NIH HHS UG3 OD023344NIH HHS UG3 OD023348NIH HHS UG3 OD023349NIH HHS UG3 OD023365NIH HHS UG3 OD023389NIH HHS UG3 OD035508NIH HHS UG3 OD035509NIH HHS UG3 OD035513NIH HHS UG3 OD035516NIH HHS UG3 OD035517NIH HHS UG3 OD035518NIH HHS UG3 OD035519NIH HHS UG3 OD035521NIH HHS UG3 OD035526NIH HHS UG3 OD035527NIH HHS UG3 OD035528NIH HHS UG3 OD035529NIH HHS UG3 OD035532NIH HHS UG3 OD035533NIH HHS UG3 OD035536NIH HHS UG3 OD035537NIH HHS UG3 OD035540NIH HHS UG3 OD035542NIH HHS UG3 OD035543NIH HHS UG3 OD035544NIH HHS UG3 OD035546NIH HHS UG3 OD035550NIH HHS UH3 OD023244NIH HHS UH3 OD023248NIH HHS UH3 OD023249NIH HHS UH3 OD023251NIH HHS UH3 OD023253NIH HHS UH3 OD023268NIH HHS UH3 OD023271NIH HHS UH3 OD023272NIH HHS UH3 OD023275NIH HHS UH3 OD023279NIH HHS UH3 OD023282NIH HHS UH3 OD023285NIH HHS UH3 OD023286NIH HHS UH3 OD023287NIH HHS UH3 OD023288NIH HHS UH3 OD023289NIH HHS UH3 OD023290NIH HHS UH3 OD023305NIH HHS UH3 OD023313NIH HHS UH3 OD023318NIH HHS UH3 OD023320NIH HHS UH3 OD023328NIH HHS UH3 OD023332NIH HHS UH3 OD023337NIH HHS UH3 OD023342NIH HHS UH3 OD023344NIH HHS UH3 OD023347NIH HHS UH3 OD023348NIH HHS UH3 OD023349NIH HHS UH3 OD023365NIH HHS UH3 OD023389NIH HHS UH3 OD035508NIH HHS UH3 OD035518NIH HHS UH3 OD035519NIH HHS UH3 OD035521NIH HHS UH3 OD035526NIH HHS UH3 OD035529NIH HHS UH3 OD035536NIH HHS UH3 OD035542NIH HHS UH3 OD035543NIH HHS UH3 OD035546
6 · The paper itself

Abstract

backgroundPrenatal exposure to per- and polyfluoroalkyl substances (PFAS) may adversely impact child neurodevelopment; however, epidemiologic findings remain inconclusive because of small sample sizes, limited exposure variability, and differing neurodevelopmental measures. We aimed to investigate the relationship between prenatal PFAS exposure and child behavior.

methodsWe pooled data from nine study sites in the nationwide Environmental influences on Child Health Outcomes (ECHO) Cohort. PFAS were quantified in maternal serum samples collected between 2 and 42 weeks' gestation. Behavioral and emotional problems were assessed via the Child Behavior Checklist (CBCL) in preschool-age (n = 1,723) and school-age (n = 627) children. We used age-stratified, covariate-adjusted linear mixed-effects models to estimate differences in CBCL scores by PFAS quartile, focusing on analytes detected at >75 %. We also fit quantile g-computation models to examine associations for PFAS mixtures and tested for effect modification by child sex.

findingsPerfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) were the most frequently detected analytes in maternal prenatal serum, although concentrations were generally low (<5 ng/mL). Associations between PFAS concentrations and CBCL scores were mostly null, except for some suggestive findings for PFHxS in the preschool-age subset. No consistent sex differences were observed, and associations for PFAS mixtures were statistically insignificant.

interpretationWe found little evidence of associations between prenatal PFAS exposures and child behavioral problems in the ECHO Cohort. Future studies should consider PFAS exposure during the postnatal period, which may be a more sensitive window.

Indexed as

Child BehaviorEnvironmental PollutantsFluorocarbonsMaternal ExposurePrenatal Exposure Delayed EffectsAdultAlkanesulfonic AcidsCaprylatesChildChild HealthChild, PreschoolCohort StudiesFemaleHumansMalePregnancyAlkanesulfonic AcidsCaprylatesEnvironmental PollutantsFluorocarbonsperfluorooctanoic acidBehaviorChild developmentPFASPregnancy

Identifiers

PMID40914105
PMCPMC12989968

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.