Concentrations of perfluoroalkyl substances and bisphenol A in newborn dried blood spots and the association with child behavior

Environ Pollut. 2018 Dec;243(Pt B):1629-1636. doi: 10.1016/j.envpol.2018.09.107. Epub 2018 Sep 27.


Experimental studies suggest that prenatal exposure to endocrine disrupting chemicals interferes with developmental processes in the fetal brain. Yet, epidemiological evidence is inconclusive. In a birth cohort (2008-2010, upstate New York), we quantified concentrations of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and bisphenol A (BPA) in stored newborn dried blood spots using liquid chromatography/tandem mass spectrometry. Mothers reported on children's behavior using the Strengths and Difficulties Questionnaire at age 7 (650 singletons and 138 twins). Difficulties in total behavior (i.e., emotional, conduct, hyperactivity, and peer problems) and prosocial behavior were classified using validated cut-offs. We used logistic regression with generalized estimating equations to estimate the odds of having difficulties per exposure category. In total, 111 children (12.1%) had total behavioral difficulties and 60 (6.5%) had difficulties in prosocial behavior. The median (interquartile range) of PFOS, PFOA, and BPA were 1.74 ng/ml (1.33), 1.12 ng/ml (0.96), and 7.93 ng/ml (10.79), respectively. Higher PFOS levels were associated with increased odds of having behavioral difficulties (OR per SD of log PFOS = 1.30, 95%CI: 1.03-1.65). We observed associations between PFOS in the highest relative to the lowest quartile and behavioral difficulties (OR for PFOS1.14-1.74 = 1.65, 95%CI: 0.84-3.34; PFOS1.75-2.47 = 1.73, 95%CI: 0.87-3.43; and PFOS>2.47 = 2.47, 95%CI: 1.29-4.72 compared to PFOS<1.41). The associations between higher concentrations of PFOS and behavioral difficulties at age 7 years were driven by problems in conduct and emotional symptoms. Higher PFOA levels were associated with difficulties in prosocial behavior (OR = 1.35, 95%CI: 1.03-1.75). There was an inverse association between BPA concentrations and difficulties in prosocial behavior but only in the 2nd and 4th quartiles. We found no interactions between sex and chemical concentrations. Increasing prenatal exposure to PFOS and PFOA, as reflected in neonatal concentrations, may pose risk for child behavioral difficulties.

Keywords: Behavior; Dried blood spots; Endocrine disrupting chemicals; Neonates; Perfluoroalkyl substances.

MeSH terms

  • Adult
  • Alkanesulfonic Acids / blood*
  • Benzhydryl Compounds / blood*
  • Caprylates / blood*
  • Child
  • Child Behavior / drug effects*
  • Child, Preschool
  • Chromatography, Liquid
  • Dried Blood Spot Testing
  • Endocrine Disruptors / blood*
  • Female
  • Fluorocarbons / blood*
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Male
  • Mothers
  • New York
  • Phenols / blood*
  • Pregnancy
  • Prenatal Exposure Delayed Effects / blood*
  • Research Design
  • Surveys and Questionnaires


  • Alkanesulfonic Acids
  • Benzhydryl Compounds
  • Caprylates
  • Endocrine Disruptors
  • Fluorocarbons
  • Phenols
  • perfluorooctanoic acid
  • perfluorooctane sulfonic acid
  • bisphenol A