Examining the association between gestational phenol exposure and infant non-nutritive suck in two Environmental influences on Child Health Outcomes cohorts

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Background: Non-nutritive suck (NNS) is a measure of neurofunction sensitive to environmental exposures in utero. This study aimed to evaluate the relationship between gestational phenol exposure and NNS patterning. Methods: Mother-infant pairs from two diverse prospective cohorts were enrolled in the Environmental influences on Child Health Outcomes Program. Phenols were measured in prenatal maternal urine samples and adjusted for specific gravity. NNS was sampled in 1-8-week-old infants using a custom pacifier for ~5 minutes. Associations of 11 phenols and triclocarban with 5 NNS outcomes were assessed individually and as a mixture using generalized linear models adjusted for cohort, child sex and assessment age, and maternal age and education. Results: Altogether, 215 mother-infant pairs were included. Bisphenol-F was related to a lower NNS frequency. Triclosan was associated with a higher NNS frequency. Propylparaben, 2,4-dichlorophenol, and 2,5-dichlorophenol were associated with lower NNS amplitude. Benzophenone-3, 2,4-dichlorophenol, and 2,5-dichlorophenol were related to more NNS bursts/minute. Propylparaben was associated with more NNS cycles/bursts. Seven phenols were included in mixture analyses: 2,4-dichlorophenol, 2,5-dichlorophenol, benzophenone-3, bisphenol-A, bisphenol-S, methylparaben, and propylparaben. Both Bayesian kernel machine regression and quantile g-computation showed that higher concentrations of the mixture were associated with lower amplitude but more bursts/minute and cycles/burst. Propylparaben was important in the overall mixture effect on amplitude, whereas benzophenone-3 was important in the relationship with bursts/minute. Conclusions: Gestational phenol exposure is linked to altered NNS patterning in neonates. Future work should further investigate phenol mixture effects, potential mechanisms, and the association of altered NNS with neurodevelopment.

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