Abstract
BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) have recently garnered attention for their possible neurotoxic effects. This study was meticulously crafted to assess the influence of PAHs exposure on the emergence of perinatal anxiety symptoms. METHODS: From April 28, 2020, to July 20, 2021, a case-control study recruiting eligible pregnant women was conducted in two primary hospitals in Hefei City, China. Professionals employed the 7-item Generalized Anxiety Disorder Scale to assess the participants' anxiety symptoms during pregnancy and postpartum via WeChat. Urinary concentrations of 12 hydroxylated PAH metabolites during pregnancy and postpartum were quantified through gas chromatography-tandem triple quadrupole mass spectrometry. Logistic regression analysis and mixed exposure modeling (BKMR model) were employed in our study to probe into the associations between PAHs exposure and perinatal anxiety symptoms. RESULTS: Our study incorporated 642 participants (279 cases and 363 controls). Multivariable logistic regression models revealed significant dose-response relationships between the levels of individual PAH metabolites in urine and prenatal anxiety symptoms. Compared to pregnant women in the lowest exposure tertile, those in the highest tertiles of urinary concentrations of 2-OHNA, 9-OHFLU, ∑OHFLU, 2-OHDBF, and ∑OH-PAHs had increased risk of experiencing prenatal anxiety (OR = 1.915, 95%CI: 1.271-2.886; OR = 2.084, 95%CI: 1.358-3.199; OR = 2.055, 95%CI: 1.355-3.117; OR = 1.675, 95%CI: 1.119-2.507; OR = 1.870, 95%CI: 1.228-2.847, respectively). BKMR analysis indicated a significant trend of increasing likelihood of prenatal anxiety symptoms with higher levels of the OH-PAHs mixture. Meanwhile, follow-up of 230 pregnant women until 42 days postpartum revealed that increased prenatal urinary concentrations of 2-OHFLU and ∑OHFLU were associated with a higher risk of postpartum anxiety symptoms (OR = 2.101, 95%CI: 1.000-4.414 for the medium vs. low 2-OHFLU exposure; OR = 2.277, 95%CI: 1.080-4.799 for the high vs. low ∑OHFLU exposure, respectively). CONCLUSIONS: Our study brings to light a potentially strong positive link between PAHs exposure and perinatal anxiety symptoms.