Per- and polyfluoroalkyl substances during pregnancy and gestational diabetes: The Environmental influences on Child Health Outcomes (ECHO) Cohort

Résumé fourni par la source

Objective: Exposure to per- and polyfluoroalkyl substances (PFAS) may increase the risk of gestational diabetes mellitus (GDM), with adverse consequences for pregnant women and their offspring. However, epidemiologic studies have shown inconsistent results. We addressed this question in a large, pooled sample of US women. Research Design and Methods: Participants (n=5,229) from 16 cohorts had singleton pregnancies. PFAS were quantified in a single plasma or serum sample during pregnancy (1999-2021); six PFAS detected in ≥60% of participants were analyzed. The primary outcome was GDM diagnosis based on self-report or medical record documentation. The secondary outcome, among 1,213 participants, was fasting glucose. We estimated associations between each PFAS and GDM using generalized estimating equations (GEE) models with Poisson distribution and robust variance, and estimated associations between each PFAS and fasting glucose using GEE models for linear regression. Effect modification by pre-pregnancy BMI or race/ethnicity was evaluated via interaction terms and stratification. We quantified the combined effect of the PFAS mixture using quantile-based g-computation. Results: Associations between individual PFAS and GDM were null or weakly inverse; the association with the six-PFAS mixture was negative (prevalence ratio [95% CI] per quartile increase: 0.75 [0.58, 0.96]). Certain PFAS were more strongly negatively associated with GDM among participants with BMI <25 kg/m2. Associations between PFAS and fasting glucose were largely null, although both positive and negative associations were observed in specific race/ethnicity strata. Conclusions: In a large, pooled sample of US pregnant women, greater concentrations of PFAS were not associated with higher prevalence of GDM.

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