Bisphenol analogs exposure in 4-year-old children and their intelligence quotient at 6 years: A prospective cohort study

Prenatal exposure to bisphenol A (BPA) has been shown to impact offspring cognition, behavior, and intelligence. However, whether co-exposure to bisphenol analogs (BPs) during childhood affects children's intelligence remains unclear. We included 465 mother-child pairs from the Shanghai Minhang Birth Cohort Study to examine the impact of children's exposure to BPs at 4 years of age on the intelligence quotient (IQ) measured at 6 years. BPs concentrations were measured in single-spot urine samples collected from 4-year-old children. The Wechsler Intelligence Scale for Children was used to evaluate IQ at 6 years. Multiple linear regression models were used to examine the associations between BPs and IQ. Bayesian Kernel Machine Regression (BKMR) models were used to evaluate the joint and single-exposure effects of BPs mixture. In girls, exposure to bisphenol F (BPF) was inversely associated with Full-Scale IQ (FSIQ) and Perceptual Reasoning Index (PRI) (β_FSIQ = -5.46, 95 % confidence interval [CI]: -9.97, -0.94; β_PRI = -5.14, 95 % CI: -9.95, -0.32). By BKMR, BPF contributed the most to the joint effect of BPs in girls. The association remained robust after adjusting for maternal IQ. In boys, exposure to tetrachlorobisphenol A seemed to be associated with an increase in FSIQ and PRI; however, the number of exposed boys was small. Our study suggests that BPs exposure at 4 years of age may be associated with a lower IQ at 6 years in girls. BPF may not be a safe substitute for BPA. Further epidemiological studies are required to confirm these findings.