Associations between prenatal exposure to environmental phenols and child neurodevelopment at two years of age in a South African birth cohort

Terry Zhou; Sarina Abrishamcar; Grace Christensen; Stephanie M Eick; Dana Boyd Barr; Aneesa Vanker; Nadia Hoffman; Kirsten A Donald; Catherine J Wedderburn; Syam S Andra; Robert O Wright; Heather J Zar; Dan J Stein; Anke Hüls

doi:10.1016/j.envres.2024.120325

Associations between prenatal exposure to environmental phenols and child neurodevelopment at two years of age in a South African birth cohort

Environ Res. 2024 Nov 9;264(Pt 1):120325. doi: 10.1016/j.envres.2024.120325. Online ahead of print.

Authors

Affiliations

¹ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
² Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
³ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
⁴ Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
⁵ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁶ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.
⁷ Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
⁸ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa.
⁹ Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa.
¹⁰ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: anke.huels@emory.edu.

PMID: 39528036
DOI: 10.1016/j.envres.2024.120325

Abstract

Objective: Evidence suggests that prenatal environmental phenol exposures negatively impact child neurodevelopment, however there is little research on the effects of mixtures of multiple phenol exposures. We analyzed associations between prenatal exposure to phenol mixtures and cognitive neurodevelopment at two years of age among 545 mother-child pairs from the South African Drakenstein Child Health Study.

Material and methods: We measured maternal urine environmental phenol concentrations once during the second trimester of pregnancy. We used the Bayley Scales of Infant and Toddler Development III to assess cognitive development at two years of age. We used linear regression models adjusted for maternal HIV status, maternal age, ethnicity, prenatal tobacco exposure, child sex, and socioeconomic status (SES) to examine individual associations. We compared four mixture methods: self-organizing maps (SOM), Bayesian kernel machine regression (BKMR), quantile-based G-computation (qgcomp) and weighted quantile sum (WQS) regression to explore joint effects of the exposure mixture. We assessed effect modification by SES, sex, prenatal tobacco exposure, and ethnicity.

Results: Across all methods, we found no association between individual phenol exposures or the joint exposure mixture with the cognitive score. Prenatal tobacco exposure modified the association between pentachlorophenol (PCP) and cognitive neurodevelopment (interaction p-value = 0.012), with higher PCP concentrations associated with lower cognitive scores among non-smokers (beta = - 2.17; 95% CI: -3.83, -0.51). Sex modified the association between bisphenol A (BPA) and cognitive neurodevelopment (interaction p-value = 0.021), with males having a significant adverse association (beta = -1.39; 95% CI: -2.54, -0.23). SES modified the association between bisphenol S (BPS) and cognitive neurodevelopment (interaction p-value = 0.003), with individuals of moderate-high SES having a significant adverse association (beta = -1.84; 95% CI: -3.26, 0.06) CONCLUSION: While we found no main effects of prenatal phenol exposure on cognitive neurodevelopment, the associations with PCP, BPA, and BPS were more pronounced among certain subgroups.