Abstract
Background: Perfluoroalkyl substances (PFASs) are ubiquitous, persistent chemicals used in stain and water resistant products. Animal studies suggest that PFASs are neurodevelopmental toxicants, but epidemiologic studies are inconsistent in their findings of exposure-associated changes in children’s cognition and behavior. Objective: To investigate the association of prenatal PFASs with social cognition, a measure of how individuals perceive and respond to social cues, which is impaired in individuals with autism spectrum disorders (ASD). Methods: We collected pilot data from 52 mother-adolescent pairs participating in Project Viva, a longitudinal pre-birth cohort enrolled 1999‒2002, in which we measured perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) in maternal plasma collected in early gestation (median=9.4 weeks). Parents rated their children using the Social Responsiveness Scale Version 2 (SRS-2). Results: Mean (interquartile range [IQR]) PFOA and PFOS concentrations were 6.6 ng/ml (3.4) and 30.7 ng/mL (16.6), respectively; mean (range) child age was 14 years (12-15) and mean (SD) SRS-2 score was 23.2 (19.4). In multivariable linear regression adjusted for maternal education and household income, for each IQR increment of prenatal PFOA and PFOS SRS-2 score was higher (poorer social cognition) by 5.2 points (95% CI: 0.9, 9.5) and 5.7 points (1.2, 10.4), respectively. We observed similar associations with the two SRS-derived DSM-V compatible subscales, Social Communication & Interaction and Restricted Interests & Repetitive Behavior. Discussion: Prenatal exposure to PFOA and PFOS was associated with poorer social cognition in a pilot sample of adolescents; estimating associations in the larger cohort will increase precision. Examining quantitative traits like social cognition rather than dichotomous diagnosis offers a statistically powerful and perhaps more valid approach to studying modifiable environmental risk factors for ASD.
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