Associations of cord blood concentrations of perfluoroalkyl substances with autistic traits in Singaporean children: The growing up in Singapore towards healthy outcomes study

Michael Mascari; Nathan Cohen; Meizhen Yao; Jonathan Huang; Jamil Lane; Katherine W Reeves; Raji Balasubramanian; Zhenhua Liu; Nasser Laouali; Lourdes Mary Daniel; Chia-Yang Chen; Chong Yap Seng; Chan Shiao-Yng; Michelle Z L Kee; Damaskini Valvi; Youssef Oulhote

doi:10.1016/j.chemosphere.2024.144040

Associations of cord blood concentrations of perfluoroalkyl substances with autistic traits in Singaporean children: The growing up in Singapore towards healthy outcomes study

Chemosphere. 2025 Jan 8:371:144040. doi: 10.1016/j.chemosphere.2024.144040. Online ahead of print.

Authors

Michael Mascari¹, Nathan Cohen², Meizhen Yao³, Jonathan Huang⁴, Jamil Lane⁵, Katherine W Reeves⁶, Raji Balasubramanian⁷, Zhenhua Liu⁸, Nasser Laouali⁹, Lourdes Mary Daniel¹⁰, Chia-Yang Chen¹¹, Chong Yap Seng¹², Chan Shiao-Yng¹³, Michelle Z L Kee¹⁴, Damaskini Valvi¹⁵, Youssef Oulhote¹⁶

Affiliations

¹ Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA. Electronic address: [email protected].
² Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA. Electronic address: [email protected].
³ Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA. Electronic address: [email protected].
⁴ Thompson School of Social Work and Public Health, Office of Public Health Studies, University of Hawaii at Manoa, 2430 Campus Road, Honolulu, HI, 96822, USA. Electronic address: [email protected].
⁵ Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA. Electronic address: [email protected].
⁶ Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA. Electronic address: [email protected].
⁷ Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA. Electronic address: [email protected].
⁸ Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts at Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA. Electronic address: [email protected].
⁹ Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA. Electronic address: [email protected].
¹⁰ Department of Child Development, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899. Electronic address: [email protected].
¹¹ Institute of Food Safety and Health, College of Public Health, National Taiwan University, No. 17, Xuzhou Road, Zhongzheng District, Taipei City, 100, Taiwan. Electronic address: [email protected].
¹² Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597. Electronic address: [email protected].
¹³ Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597; Institute for Human Development and Potential (IHDP), Agency for Science, Technology, and Research (A∗STAR), 1, #20-10 Fusionopolis Wy, Connexis, North Tower, 138632, Singapore. Electronic address: [email protected].
¹⁴ Institute for Human Development and Potential (IHDP), Agency for Science, Technology, and Research (A∗STAR), 1, #20-10 Fusionopolis Wy, Connexis, North Tower, 138632, Singapore; Brain-Body Initiative, Agency for Science, Technology, and Research (A∗STAR), 1, #20-10 Fusionopolis Wy, Connexis, North Tower, 138632, Singapore. Electronic address: [email protected].
¹⁵ Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA. Electronic address: [email protected].
¹⁶ Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA. Electronic address: [email protected].

PMID: 39733956
DOI: 10.1016/j.chemosphere.2024.144040

Abstract

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by social deficits and repetitive behaviors. Environmental pollutants may contribute to the etiology of ASD, but studies of perfluoroalkyl substances (PFAS) have shown conflicting results.

Objectives: We assessed associations between cord blood concentrations of PFAS with autistic traits at age seven years in a Singaporean birth cohort.

Methods: We measured cord blood concentrations of eight PFAS in a sample of 430 mother-child pairs from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort. We assessed autistic traits using the Social Responsiveness Scale Second Edition (SRS-2) and its sub-scores, in which higher scores indicate more autistic traits. We estimated covariate-adjusted associations between the PFAS and SRS-2 scores using Bayesian weighted quantile sum (BWQS) regression models for the PFAS mixtures and multivariable regressions for single PFAS. We additionally evaluated effect modification by biological sex.

Results: We observed a positive association between the PFAS mixture and SRS-2 cognition sub-scores (β per SD increase = 1.25 points, 95% CI -0.03, 2.40). Perfluorononanoic acid (PFNA) was the strongest contributor to the mixture effect. In single PFAS models, exposure to PFNA was associated with a higher SRS-2 total score (β = 0.93 points, 95% CI 0.29, 1.58), cognition sub-score (β = 1.26 points, 95% CI 0.55, 1.97), communication sub-score (β = 0.88 points, 95% CI 0.20, 1.56), and restrictive and repetitive behaviors sub-score (β = 0.93 points, 95% CI 0.23, 1.63). We also observed evidence of effect modification by sex for perfluoroundecanoic acid (PFUnDA) for the total score (p-effect modification [EM] = 0.03), cognition sub-score (p-EM = 0.03), and communication sub-score (p-EM = 0.04), with negative associations seen in females and null associations in males.

Discussion: Cord blood PFAS concentrations were positively associated with autistic traits measured by SRS-2.

Keywords: Autism; Perfluoroalkyl substances; Singapore; Social responsiveness scale second edition.

Abstract

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