Exposure to perfluoroalkyl substances during pregnancy and child behaviour at 5 to 9 years of age

Research output: Contribution to journalArticle


We examined associations between prenatal exposure to perfluorohexane sulfonic acid (PFHxS), perfluoroheptanoic acid (PFHpA), perfluorononanoic acid (PFNA), and perfluorodecanic acid (PFDA) - and child behaviour (SDQ-total) and hyperactivity (sub-scale) at 5–9 years of age in birth cohorts from Greenland and Ukraine. Pregnancy serum samples (N = 1023) were analysed for perfluoroalkyl substances (PFASs) and categorised into tertiles and also used as continuous exposure variables. Problem behaviour and hyperactivity were assessed, using the Strength and Difficulties Questionnaire (SDQ) and categorised as normal/borderline and abnormal. Associations were analysed using multiple logistic and linear regression. High compared to low prenatal PFHxS exposure was associated with 1.16 (95% confidence interval (CI): 0.08; 2.25) point higher SDQ-total (more problem behaviour) in Greenland and 0.80 (CI: 0.06; 1.54) point higher SDQ-total in the combined analyses, whereas no association was present in Ukraine alone. One natural log-unit increase in prenatal PFNA exposure was associated with 0.90 (CI: 0.10; 1.71) points higher SDQ-total in Greenland and 0.72 (CI: 0.13; 1.31) points higher in the combined analysis and no association in Ukraine. Prenatal PFAS exposure was unrelated to problem behaviour (abnormal SDQ-total). In the combined analysis, odds ratio (OR) (CI) for hyperactivity was 1.8 (1.0; 3.2) for one natural log-unit increase in prenatal PFNA and 1.7 (1.0; 3.1) for one natural log-unit increase in prenatal PFDA exposure. Findings are compatible with weak effects on child behaviour of prenatal exposure to some PFASs although spurious results are not entirely unlikely. The associations were strongest in Greenland.


  • Birgit Bjerre Høyer
  • Jens Peter Bonde
  • Sandra Søgaard Tøttenborg
  • Cecilia Høst Ramlau-Hansen
  • Christian Lindh
  • Henning Sloth Pedersen
  • Gunnar Toft
External organisations
  • Frederiksberg Hospital
  • Aarhus University
  • Aarhus University Hospital
  • Primary Health Care Clinic, Nuuk
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Environmental Health and Occupational Health
  • Pediatrics


  • Behaviour, Child, Child development, Cohort study, Fluorocarbons, Prenatal exposure, delayed effects
Original languageEnglish
Pages (from-to)105-112
JournalHormones and Behavior
Early online date2018
Publication statusPublished - 2018
Publication categoryResearch