A prospective study of prepregnancy serum concentrations of perfluorochemicals and the risk of gestational diabetes
We observed in a prospective United States cohort study that higher environmentally relevant serum perfluorooctanoic acid concentrations before pregnancy were significantly associated with a greater risk of gestational diabetes.
Cuilin Zhang, M.D., Ph.D., Rajeshwari Sundaram, Ph.D., José Maisog, M.D., M.S., Antonia M. Calafat, Ph.D., Dana Boyd Barr, Ph.D., Germaine M. Buck Louis, Ph.D.
Volume 103, Issue 1, Pages 184-189
To examine preconception serum concentrations of perfluorooctanoic acid (PFOA) and six other PFCs in relation to gestational diabetes (GDM) risk.
Prospective cohort with longitudinal follow-up.
Among 501 women recruited upon discontinuing contraception for the purpose of becoming pregnant, 258 (51%) became pregnant and were eligible for the study, of which 28 (11%) reported having physician-diagnosed GDM during follow-up.
Main Outcome Measure(s):
The odds ratios (ORs) and 95% confidence intervals (CIs) of GDM associated with each standard deviation (SD) increment of preconception serum PFOA concentration (ng/mL, log-transformed) and six other PFCs were estimated with the use of logistic regression after adjusting for age, prepregnancy body mass index, smoking, and parity conditional on gravidity.
Preconception geometric mean (95% CI) PFOA concentrations (in ng/mL) were higher for women with than without GDM (3.94 [3.15–4.93] vs. 3.07 [2.83–3.12], respectively). Each SD increment in PFOA was associated with a 1.87-fold increased GDM risk (adjusted OR 1.86 [95% CI 1.14–3.02]). A slightly increased risk associated with each SD increment for the six other PFCs was observed as well (all ORs >1.0, range 1.06–1.27), although the associations were not statistically significant.
Our findings suggested that higher environmentally relevant concentrations of PFOA were significantly associated with an increased risk of GDM. If corroborated, these findings may be suggestive of a possible environmental etiology for GDM.