Association between prenatal exposure to perfluoroalkyl substances and respiratory tract infections in preschool children

Heyu Huang; Kan Yu; Xinxin Zeng; Qian Chen; Quanhua Liu; Yanjun Zhao; Jun Zhang; Xi Zhang; Lisu Huang

doi:10.1016/j.envres.2020.110156

Association between prenatal exposure to perfluoroalkyl substances and respiratory tract infections in preschool children

Environ Res. 2020 Dec:191:110156. doi: 10.1016/j.envres.2020.110156. Epub 2020 Aug 30.

Authors

Heyu Huang¹, Kan Yu¹, Xinxin Zeng¹, Qian Chen², Quanhua Liu³, Yanjun Zhao⁴, Jun Zhang², Xi Zhang⁵, Lisu Huang⁶

Affiliations

¹ Department of Pediatric Infectious Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Department of Pediatric Respiratory Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁴ Department of Developmental Behavior Pediatrics & Child Primary Care, Children's Hospital of Shanghai Jiao Tong University, China.
⁵ Clinical Research Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: zhangxi@xinhuamed.com.cn.
⁶ Department of Pediatric Infectious Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: huanglisu@xinhuamed.com.cn.

PMID: 32871147
DOI: 10.1016/j.envres.2020.110156

Abstract

Background: Prenatal exposure to perfluoroalkyl substances (PFAS) is considered to affect adversely the immune function. However, the effect of prenatal PFAS exposure on respiratory tract infections (RTIs) in children is unclear. Thus, we evaluated whether cord blood PFAS levels were associated with RTI in the first 5 years of life.

Methods: The Shanghai Prenatal Cohort is an on-going birth cohort, which included all the mothers during pregnancy. Children were followed by paediatricians once a year after birth. The levels of 10 PFAS in cord blood were tested using liquid chromatography-mass spectrometry. RTIs were diagnosed based on face-to-face interviews with the parents and review of medical records. Immunoglobulin G (IgG) and immunoglobulin E (IgE) levels, as biomarkers of humoral immunity, were assessed using enzyme-linked immunosorbent assay at age 5 years. Multivariable logistic and linear regression models were applied to study the association between prenatal PFAS exposure and RTIs.

Results: A total of 743 children completed the follow-up, 344 of them had detail information of cord blood PFAS, IgG, and IgE concentrations. Eight PFAS were detected in more than 90% of the cord blood samples, except for perfluoroheptanoic acid (PFHpA) and perfluorooctane sulfonamide (FOSA). During the 5-year follow-up period, the frequency of RTIs increased with age, reaching a peak at age 4. Moreover, 20.6% of the children were diagnosed with recurrent RTIs. Children with recurrent RTIs had higher prenatal perfluorobutane sulfonic acid (PFBS) concentration. Higher prenatal PFBS concentration was positively associated with total RTI frequency (β = 6.05, 95% CI [0.84, 11.26]) in first 5 years of life and negatively associated with IgG level (β = -0.82, 95% CI [-1.67, -0.01]) at age 5.

Conclusions: Children with higher prenatal PFBS were more vulnerable to RTIs in early life, which may be attributed to immunosuppression of IgG production. These findings need to be further verified in larger prospective studies.

Keywords: Immunoglobulin G; Perfluoroalkyl substances; Prenatal exposure; Prospective birth cohort study; Respiratory tract infections.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Alkanesulfonic Acids* / toxicity
Child, Preschool
China / epidemiology
Environmental Pollutants*
Female
Fluorocarbons* / toxicity
Humans
Pregnancy
Prenatal Exposure Delayed Effects* / chemically induced
Prenatal Exposure Delayed Effects* / epidemiology
Prospective Studies
Respiratory Tract Infections*

Substances

Alkanesulfonic Acids
Environmental Pollutants
Fluorocarbons