Exposure to Organophosphate Ester Flame Retardants and Plasticizers during Pregnancy and Autism-Related Outcomes in the ECHO Cohort.
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Ames Jennifer L, Ferrara Assiamira, Feng Juanran, Alexeeff Stacey, Avalos Lyndsay A, Barrett Emily S, Bastain Theresa M, Bennett Deborah H, Buckley Jessie P, Carignan Courtney C, Cintora Patricia, Ghassabian Akhgar, Hedderson Monique M, Hernandez-Castro Ixel, Kannan Kurunthachalam, Karagas Margaret R, Karr Catherine J, Kuiper Jordan R, Liang Donghai, Lyall Kristen, McEvoy Cindy T, Morello-Frosch Rachel, O'Connor Thomas G, Oh Jiwon, Peterson Alicia K, Quiros-Alcala Lesliam, Sathyanarayana Sheela, Schantz Susan, Schmidt Rebecca J, Starling Anne P, Woodruff Tracey J, Volk Heather E, Zhu Yeyi, Croen Lisa A, ECHO Cohort Consortium
Аннотация
METHODS: We included 4159 mother-child pairs from 15 cohorts in the NIH Environmental influences on Child Health Outcomes (ECHO) Consortium, with children born from 2006-2020 (median age [interquartile range]: 6 [4,10] years). Nine OPE biomarkers were measured in urine samples collected mid- to late pregnancy. Dilution-adjusted biomarkers were modeled continuously, categorically (high [>median], moderate [≤median], nondetect), or as detect/nondetect depending on their detection frequency. We assessed child autism-related traits via a) parent report on the Social Responsiveness Scale (SRS) and b) clinical autism diagnosis. We examined associations of OPEs with child outcomes, including modification by child sex, using generalized estimating equations to account for clustering by ECHO cohort.
RESULTS: Compared with nondetectable concentrations, high exposure to bis-(butoxyethyl) phosphate (BBOEP) was associated with higher autistic trait scores (adj-β 0.97, 95% confidence interval [CI]: 0.42, 1.52) and greater odds of autism diagnosis (adjusted odds ratio [adj-OR]: 1.27, 95% CI: 1.07, 1.50). Bis-(1-chloro-2-propyl) phosphate (BCPP) showed associations with autistic trait scores (BCPP adj-β for high exposure vs nondetect: 0.34, 95% CI: -0.46, 1.13; BCPP adj-β for moderate exposure vs nondetect: 0.72, 95% CI: 0.24, 1.20). High exposure to bis-(2-chloroethyl) phosphate (BCETP) was associated with lower odds of autism diagnosis (adj-OR: 0.76, 95% CI: 0.60, 0.95). Other OPEs showed no associations in adjusted models. Associations between BBOEP and higher autistic trait scores were stronger in males than females.
DISCUSSION: Prenatal exposure to OPEs, specifically BCPP and BBOEP, may be associated with a higher risk of autism diagnosis and related traits in childhood.