Early life multiple exposures and child cognitive function: A multi-centric birth cohort study in six European countries

Jordi Julvez*, Mónica López-Vicente, Charline Warembourg, Lea Maitre, Claire Philippat, Kristine B. Gützkow, Monica Guxens, Jorunn Evandt, Sandra Andrusaityte, Miguel Burgaleta, Maribel Casas, Leda Chatzi, Montserrat de Castro, David Donaire-González, Regina Gražulevičienė, Carles Hernandez-Ferrer, Barbara Heude, Rosie Mceachan, Mark Mon-Williams, Mark NieuwenhuijsenOliver Robinson, Amrit K. Sakhi, Nuria Sebastian-Galles, Remy Slama, Jordi Sunyer, Ibon Tamayo-Uria, Cathrine Thomsen, Jose Urquiza, Marina Vafeiadi, John Wright, Xavier Basagaña, Martine Vrijheid

*Corresponding author for this work

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11 Citations (Scopus)

Abstract

Epidemiological studies mostly focus on single environmental exposures. This study aims to systematically assess associations between a wide range of prenatal and childhood environmental exposures and cognition. The study sample included data of 1298 mother-child pairs, children were 6–11 years-old, from six European birth cohorts. We measured 87 exposures during pregnancy and 122 cross-sectionally during childhood, including air pollution, built environment, meteorology, natural spaces, traffic, noise, chemicals and life styles. The measured cognitive domains were fluid intelligence (Raven's Coloured Progressive Matrices test, CPM), attention (Attention Network Test, ANT) and working memory (N-Back task). We used two statistical approaches to assess associations between exposure and child cognition: the exposome-wide association study (ExWAS) considering each exposure independently, and the deletion-substitution-addition algorithm (DSA) considering all exposures simultaneously to build a final multiexposure model. Based on this multiexposure model that included the exposure variables selected by ExWAS and DSA models, child organic food intake was associated with higher fluid intelligence (CPM) scores (beta = 1.18; 95% CI = 0.50, 1.87) and higher working memory (N-Back) scores (0.23; 0.05, 0.41), and child fast food intake (−1.25; −2.10, −0.40), house crowding (−0.39; −0.62, −0.16), and child environmental tobacco smoke (ETS) (−0.89; −1.42, −0.35), were all associated with lower CPM scores. Indoor PM2.5 exposure was associated with lower N-Back scores (−0.09; −0.16, −0.02). Additional associations in the unexpected direction were found: Higher prenatal mercury levels, maternal alcohol consumption and child higher perfluorooctane sulfonic acid (PFOS) levels were associated with better cognitive performance; and higher green exposure during pregnancy with lower cognitive performance. This first comprehensive and systematic study of many prenatal and childhood environmental risk factors suggests that unfavourable child nutrition, family crowdedness and child indoor air pollution and ETS exposures adversely and cross-sectionally associate with cognitive function. Unexpected associations were also observed and maybe due to confounding and reverse causality.

Original languageEnglish
Article number117404
JournalEnvironmental Pollution
Volume284
DOIs
Publication statusPublished - 1 Sep 2021

Bibliographical note

Funding Information:
This publication reflects only the author's views and the European Commission is not liable for any use that may be made of the information contained therein. The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007?206) under grant agreement no 308333 ? the HELIX project. The LifeCycle project, involved in this study, received funding from the European Union's Horizon 2020 research and innovation programme (Grant Agreement No. 733206 LifeCycle). This study has been funded by Instituto de Salud Carlos III through the projects ?CP14/00108 & PI16/00261? (Co-funded by European Regional Development Fund ?A way to make Europe?). Jordi Julvez held a Miguel Servet contract (MS14/00108) awarded by the Spanish Institute of Health Carlos III, Ministry of Economy and Competitiveness). Jordi Julvez holds Miguel Servet-II contract (CPII19/00015) awarded by the Instituto de Salud Carlos III (Co-funded by European Social Fund ?Investing in your future?). CW holds a Sara Borrell postdoctoral grant (CD18/00132) from the Instituto de Salud Carlos III. MC received funding from Instituto de Salud Carlos III, Ministry of Economy and Competitiveness) (MS16/00128). Project ?PI16/00118", funded by Instituto de Salud Carlos III and co-funded by European Union (FEDER) ?A way to make Europe?. INMA data collections were supported by grants from the Instituto de Salud Carlos III, CIBERESP, and the Generalitat de Catalunya- CIRIT (Spain). KANC was funded by the grant of the Lithuanian Agency for Science Innovation and Technology (6-04-2014_31V-66). The Norwegian Mother, Father and Child Cohort Study is supported by the Norwegian Ministry of Health and Care Services and the Ministry of Education and Research. The Rhea project was financially supported by European projects, and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011?2014; ?Rhea Plus?: Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012?15). The work was also supported by MICINN [MTM2015-68140-R] and Centro Nacional de Genotipado- CEGEN- PRB2- ISCIII (Spain). This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Collaboration for Applied Health Research and Care (CLAHRC) for Yorkshire and Humber (UK). Core support for Born in Bradford is also provided by the Wellcome Trust (WT101597MA, UK). The LIFE-CYCLE project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 733206. The EDEN study was supported by Foundation for medical research (FRM), National Agency for Research (ANR), National Institute for Research in Public health (IRESP: TGIR cohorte sant? 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A), and Human Nutrition National Research Programs, Paris-Sud University, Nestl?, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007?2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle G?n?rale de l'Education Nationale a complementary health insurance (MGEN), French national agency for food security, French-speaking association for the study of diabetes and metabolism (ALFEDIAM).

Funding Information:
This publication reflects only the author's views and the European Commission is not liable for any use that may be made of the information contained therein. The research leading to these results has received funding from the European Community's Seventh Framework Programme ( FP7/2007–206 ) under grant agreement no 308333 – the HELIX project. The LifeCycle project, involved in this study, received funding from the European Union’s Horizon 2020 research and innovation programme (Grant Agreement No. 733206 LifeCycle). This study has been funded by Instituto de Salud Carlos III through the projects “ CP14/00108 & PI16/00261 ” (Co-funded by European Regional Development Fund “A way to make Europe”). Jordi Julvez held a Miguel Servet contract (MS14/00108) awarded by the Spanish Institute of Health Carlos III, Ministry of Economy and Competitiveness ). Jordi Julvez holds Miguel Servet-II contract (CPII19/00015) awarded by the Instituto de Salud Carlos III (Co-funded by European Social Fund “Investing in your future”). CW holds a Sara Borrell postdoctoral grant ( CD18/00132 ) from the Instituto de Salud Carlos III . MC received funding from Instituto de Salud Carlos III, Ministry of Economy and Competitiveness ) ( MS16/00128 ). Project “PI16/00118", funded by Instituto de Salud Carlos III and co-funded by European Union (FEDER) “A way to make Europe”. INMA data collections were supported by grants from the Instituto de Salud Carlos III , CIBERESP, and the Generalitat de Catalunya- CIRIT (Spain). KANC was funded by the grant of the Lithuanian Agency for Science Innovation and Technology (6-04-2014_31V-66). The Norwegian Mother, Father and Child Cohort Study is supported by the Norwegian Ministry of Health and Care Services and the Ministry of Education and Research . The Rhea project was financially supported by European projects, and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011–2014; “Rhea Plus”: Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012–15). The work was also supported by MICINN [ MTM2015-68140-R ] and Centro Nacional de Genotipado- CEGEN- PRB2- ISCIII (Spain). This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Collaboration for Applied Health Research and Care (CLAHRC) for Yorkshire and Humber (UK). Core support for Born in Bradford is also provided by the Wellcome Trust (WT101597MA, UK). The LIFE-CYCLE project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 733206. The EDEN study was supported by Foundation for medical research ( FRM ), National Agency for Research ( ANR ), National Institute for Research in Public health (IRESP: TGIR cohorte santé 2008 program), French Ministry of Health ( DGS ), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A), and Human Nutrition National Research Programs, Paris-Sud University , Nestlé, French National Institute for Population Health Surveillance ( InVS ), French National Institute for Health Education ( INPES ), the European Union FP7 programmes (FP7/2007–2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients ( AFD )), French Agency for Environmental Health Safety (now ANSES ), Mutuelle Générale de l’Education Nationale a complementary health insurance ( MGEN ), French national agency for food security, French-speaking association for the study of diabetes and metabolism (ALFEDIAM).

Publisher Copyright:
© 2021 The Author(s)

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