Prenatal Exposure to Chemical Mixtures and Cognitive Flexibility among Adolescents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Chemical Exposure Assessment
2.3. Cognitive Flexibility Assessment
2.4. Covariate Assessment
2.5. Statistical Analysis
3. Results
3.1. Study Population
3.2. Chemical Exposure Measures
3.3. Executive Function Measures
3.4. BKMR Analysis of Cognitive Flexibility Scaled Scores and Prenatal Chemical Mixture Exposures
3.5. Linear Regression Analyses of Cognitive Flexibility and Prenatal Chemical Mixture Exposures
3.6. Assessment of Effect Modification by Sex and PNSDI
3.7. Secondary Analyses: Negative Binomial and Logistic Regression Analyses of Cognitive Flexibility and Prenatal Chemical Mixture Exposures
3.8. Secondary Analyses: Seven-Chemical Mixture
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Descriptive Characteristic | Main Analysis Group, n = 373 | Excluded Group, n = 415 | |||||
---|---|---|---|---|---|---|---|
Cognitive Flexibility Measures 2 | n (%) | Mean (SD) | Range | n (%) | Mean (SD) | Range | p-Value 3 |
Trail-Making | |||||||
Completion time scaled score | 373 | 9.6 (2.8) | 1–14 | 155 | 9.1 (2.8) | 1–14 | 0.1 |
Total errors | 373 | 0.9 (1.1) | 0–5 | 154 | 1.0 (1.4) | 0–13 | 0.5 |
Overall Trail-Making performance | |||||||
Best performance | 113 (30.3) | 45 (10.8) | 0.9 | ||||
Poor performance | 260 (69.7) | 109 (26.3) | |||||
Missing | 0 | 261 (62.9) | |||||
Verbal Fluency | |||||||
Switching accuracy scaled score | 373 | 9.2 (2.8) | 2–17 | 155 | 9.0 (2.8) | 1–17 | 0.3 |
Total errors | 373 | 0.8 (1.2) | 0–7 | 155 | 0.9 (1.3) | 0–7 | 0.4 |
Design Fluency | |||||||
Total correct scaled score | 373 | 9.9 (2.8) | 2–18 | 155 | 9.6 (2.6) | 2–17 | 0.3 |
Total errors | 373 | 2.6 (3.1) | 0–22 | 155 | 2.6 (2.6) | 0–16 | 0.2 |
Color-Word Interference | |||||||
Completion time scaled score | 373 | 9.9 (2.6) | 1–15 | 154 | 9.8 (2.7) | 1–14 | 0.7 |
Total errors | 373 | 2.6 (2.4) | 0–19 | 154 | 2.8 (2.4) | 0–11 | 0.4 |
Overall Color-Word performance | |||||||
Best performance | 83 (22.3) | 34 (8.2) | 1.0 | ||||
Poor performance | 290 (77.7) | 120 (28.9) | |||||
Missing | 0 | 261 (62.9) | |||||
Exposure Measures 4 | |||||||
Cord serum DDE (ng/g) | 373 | 0.6 (1.2) | 0.02–14.9 | 378 | 0.4 (0.4) | 0.0–4.2 | <0.01 * |
Cord serum HCB (ng/g) | 373 | 0.03 (0.02) | 0.0–0.1 | 378 | 0.03 (0.05) | 0.0–0.7 | 0.1 |
Cord serum ΣPCB4 (ng/g) | 373 | 0.3 (0.3) | 0.01–4.4 | 378 | 0.2 (0.2) | 0.01–1.9 | 0.05 |
Cord blood Pb (μg/dL) | 373 | 1.4 (0.9) | 0.0–9.4 | 375 | 1.7 (1.7) | 0.0–17.4 | <0.01 * |
Cord blood Mn (µg/dL) | 373 | 4.2 (1.6) | 0.7–14.6 | 335 | 4.3 (2.0) | 0.2–22.1 | 0.6 |
Covariate Measures 5 | |||||||
Child Characteristics | |||||||
Race/Ethnicity | 0.09 | ||||||
Non–Hispanic White | 263 (70.5) | 268 (64.6) | |||||
Hispanic | 33 (8.8) | 56 (13.5) | |||||
Other | 77 (20.6) | 89 (21.4) | |||||
Missing | 0 | 2 (0.5) | |||||
Sex | 0.05 | ||||||
Male | 179 (48.0) | 229 (55.2) | |||||
Female | 194 (52.0) | 186 (44.8) | |||||
Age at Exam | 373 | 15.5 (0.6) | 14.4–17.8 | 155 | 15.7 (0.7) | 13.9–17.9 | <0.01 * |
Home Score | 373 | 43.9 (6.3) | 21–56 | 118 | 42.7 (6.0) | 27–53 | 0.07 |
Year of Birth | <0.01 * | ||||||
1993–1994 | 100 (26.8) | 159 (38.3) | |||||
1995–1996 | 153 (41.0) | 147 (35.4) | |||||
1997–1998 | 120 (32.2) | 109 (26.3) | |||||
Maternal Characteristics | |||||||
Marital status at birth | <0.01 * | ||||||
Not married | 136 (36.5) | 195 (47.0) | |||||
Married | 237 (63.5) | 165 (39.8) | |||||
Missing | 0 | 55 (13.3) | |||||
Maternal IQ | 373 | 99.4 (10.4) | 57–124 | 262 | 95.8 (10.2) | 72–126 | <0.01 * |
Seafood during pregnancy (serv/day) | 373 | 0.5 (0.6) | 0–5.3 | 260 | 0.6 (0.7) | 0–6 | 0.6 |
Smoking during pregnancy | 0.1 | ||||||
No | 272 (72.9) | 210 (50.6) | |||||
Yes | 101 (27.1) | 103 (24.8) | |||||
Missing | 0 | 102 (24.6) | |||||
Household Characteristics at Birth | |||||||
Maternal education | <0.01 * | ||||||
≤High School | 190 (50.9) | 231 (55.7) | |||||
>High School | 183 (49.1) | 127 (30.6) | |||||
Missing | 0 | 57 (13.7) | |||||
Paternal Education | <0.01 * | ||||||
≤High School | 246 (66.0) | 266 (64.1) | |||||
>High School | 127 (34.0) | 81 (19.5) | |||||
Missing | 0 | 68 (16.4) | |||||
Annual Household Income | <0.01 * | ||||||
<$20,000 | 115 (30.8) | 150 (36.1) | |||||
≥$20,000 | 258 (69.2) | 201 (48.4) | |||||
Missing | 0 | 64 (15.4) | |||||
Examination Characteristics | |||||||
Examiner | 0.4 | ||||||
1 | 277 (74.3) | 121 (29.2) | |||||
2 | 96 (25.7) | 34 (8.2) | |||||
Missing | 0 | 260 (62.7) |
Exposure | Trail-Making Completion Time Difference (95% CI) | Verbal Fluency Switching Accuracy Difference (95% CI) | Design Fluency Total Correct Difference (95% CI) | Color-Word Interference Completion Time Difference (95% CI) |
---|---|---|---|---|
Log2 DDE | −0.23 (−0.52, 0.06) | −0.10 (−0.40, 0.20) | −0.01 (−0.32, 0.30) | 0.06 (−0.22, 0.34) |
Log2 HCB | 0.11 (−0.20, 0.42) | −0.06 (−0.38, 0.26) | 0.24 (−0.09, 0.58) | 0.05 (−0.26, 0.35) |
Log2 ΣPCB4 | 0.02 (−0.30, 0.34) | 0.05 (−0.27, 0.38) | −0.09 (−0.44, 0.25) | −0.21 (−0.52, 0.10) |
Log2 Pb | 0.14 (−0.16, 0.43) | 0.27 (−0.03, 0.57) | 0.05 (−0.27, 0.36) | 0.04 (−0.24, 0.33) |
Log2 Mn | −0.60 (−1.16, −0.05) * | −0.28 (−0.85, 0.29) | −0.10 (−0.70, 0.50) | −0.53 (−1.08, 0.01) |
Exposure | Trail-Making Completion Time | Verbal Fluency Switching Accuracy | ||||
Difference (95% CI) | Difference (95% CI) | |||||
Males | Females | p for Interaction | Males | Females | p for Interaction | |
Log2 DDE | −0.31 (−0.73, 0.12) | −0.14 (−0.58, 0.30) | 0.6 | −0.24 (−0.65, 0.16) | 0.02 (−0.45, 0.50) | 0.3 |
Log2 HCB | 0.09 (−0.37, 0.55) | 0.14 (−0.31, 0.59) | 0.6 | −0.22 (−0.67, 0.22) | −0.07 (−0.56, 0.42) | 0.9 |
Log2 ΣPCB4 | 0.18 (−0.29, 0.65) | −0.16 (−0.63, 0.32) | 0.6 | 0.10 (−0.35, 0.55) | −0.04 (−0.55, 0.48) | 0.4 |
Log2 Pb | 0.44 (−0.10, 0.97) | −0.01 (−0.37, 0.35) | 0.1 | 0.64 (0.12, 1.15) * | 0.09 (−0.30, 0.48) | 0.2 |
Log2 Mn | −0.15 (−0.95, 0.66) | −0.80 (−1.59, 0.00) | 0.3 | −0.47 (−1.25, 0.31) | −0.05 (−0.91, 0.81) | 0.6 |
Exposure | Design Fluency Total Correct Difference (95% CI) | Color-Word Interference Completion Time | ||||
Difference (95% CI) | ||||||
Males | Females | p for Interaction | Males | Females | p for Interaction | |
Log2 DDE | 0.20 (−0.27, 0.67) | −0.10 (−0.57, 0.36) | 0.4 | 0.09 (−0.34, 0.52) | 0.10 (−0.31, 0.51) | 0.9 |
Log2 HCB | −0.15 (−0.67, 0.36) | 0.73 (0.26, 1.20) * | 0.01 * | −0.02 (−0.49, 0.44) | 0.07 (−0.34, 0.49) | 0.6 |
Log2 ΣPCB4 | −0.04 (−0.56, 0.48) | −0.29 (−0.79, 0.21) | 0.7 | −0.37 (−0.84, 0.10) | −0.08 (−0.53, 0.36) | 0.2 |
Log2 Pb | 0.29 (−0.31, 0.88) | −0.10 (−0.47, 0.28) | 0.2 | 0.03 (−0.51, 0.57) | −0.03 (−0.36, 0.31) | 0.8 |
Log2 Mn | −0.45 (−1.35, 0.44) | 0.40 (−0.43, 1.23) | 0.2 | −0.54 (−1.35, 0.27) | −0.31 (−1.05, 0.43) | 0.8 |
Exposure | Trail-Making Completion Time | Verbal Fluency Switching Accuracy | ||||
Difference (95% CI) | Difference (95% CI) | |||||
PNSDI < 3 | PNSDI ≥ 3 | p for Interaction | PNSDI < 3 | PNSDI ≥ 3 | p for Interaction | |
Log2 DDE | −0.13 (−0.46, 0.20) | −0.36 (−0.97, 0.25) | 0.3 | −0.12 (−0.48, 0.25) | −0.15 (−0.71, 0.41) | 0.9 |
Log2 HCB | 0.23 (−0.14, 0.60) | −0.22 (−0.82, 0.38) | 0.1 | 0.06 (−0.35, 0.46) | −0.36 (−0.92, 0.19) | 0.2 |
Log2 ΣPCB4 | −0.10 (−0.47, 0.26) | 0.42 (−0.25, 1.09) | 0.2 | 0.10 (−0.30, 0.50) | 0.16 (−0.46, 0.78) | 0.9 |
Log2 Pb | −0.01 (−0.37, 0.35) | 0.09 (−0.49, 0.67) | 0.7 | 0.20 (−0.19, 0.60) | 0.26 (−0.27, 0.80) | 0.6 |
Log2 Mn | −0.65 (−1.31, 0.02) | −0.37 (−1.44, 0.70) | 0.8 | −0.27 (−1.00, 0.45) | −0.22 (−1.21, 0.77) | 0.7 |
Exposure | Design Fluency Total Correct Difference (95% CI) | Color-Word Interference Completion Time | ||||
Difference (95% CI) | ||||||
PNSDI < 3 | PNSDI ≥ 3 | p for interaction | PNSDI < 3 | PNSDI ≥ 3 | p for Interaction | |
Log2 DDE | 0.05 (−0.35, 0.45) | −0.18 (−0.71, 0.35) | 0.4 | 0.20 (−0.12, 0.53) | −0.08 (−0.65, 0.49) | 0.2 |
Log2 HCB | 0.59 (0.15, 1.04) * | −0.38 (−0.90, 0.14) | 0.01 * | 0.13 (−0.23, 0.50) | −0.12 (−0.68, 0.44) | 0.3 |
Log2 ΣPCB4 | −0.29 (−0.73, 0.15) | 0.42 (−0.17, 1.00) | 0.1 | −0.35 (−0.71, 0.00) | 0.21 (−0.41, 0.84) | 0.2 |
Log2 Pb | −0.07 (−0.51, 0.36) | 0.12 (−0.38, 0.62) | 0.5 | −0.18 (−0.54, 0.18) | 0.20 (−0.34, 0.74) | 0.3 |
Log2 Mn | −0.12 (−0.92, 0.68) | −0.26 (−1.19, 0.67) | 0.8 | −0.50 (−1.16, 0.15) | −0.50 (−1.51, 0.50) | 0.9 |
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Oppenheimer, A.V.; Bellinger, D.C.; Coull, B.A.; Weisskopf, M.G.; Korrick, S.A. Prenatal Exposure to Chemical Mixtures and Cognitive Flexibility among Adolescents. Toxics 2021, 9, 329. https://doi.org/10.3390/toxics9120329
Oppenheimer AV, Bellinger DC, Coull BA, Weisskopf MG, Korrick SA. Prenatal Exposure to Chemical Mixtures and Cognitive Flexibility among Adolescents. Toxics. 2021; 9(12):329. https://doi.org/10.3390/toxics9120329
Chicago/Turabian StyleOppenheimer, Anna V., David C. Bellinger, Brent A. Coull, Marc G. Weisskopf, and Susan A. Korrick. 2021. "Prenatal Exposure to Chemical Mixtures and Cognitive Flexibility among Adolescents" Toxics 9, no. 12: 329. https://doi.org/10.3390/toxics9120329