Maternal exposure to bisphenols, phthalates, perfluoroalkyl acids, and trace elements and their associations with gestational diabetes mellitus in the APrON cohort

Reprod Toxicol. 2024 Aug:127:108612. doi: 10.1016/j.reprotox.2024.108612. Epub 2024 May 21.

Abstract

The increasing global prevalence of gestational diabetes mellitus (GDM) has been hypothesized to be associated with maternal exposure to environmental chemicals. Here, among 420 women participating in the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study, we examined associations between GDM and second trimester blood or urine concentrations of endocrine disrupting chemicals (EDCs): bisphenol-A (BPA), bisphenol-S (BPS), twelve phthalate metabolites, eight perfluoroalkyl acids (PFAAs), and eleven trace elements. Fifteen (3.57%) of the women were diagnosed with GDM, and associations between the environmental chemical exposures and GDM diagnosis were examined using multiple logistic and LASSO regression analyses in single- and multi-chemical exposure models, respectively. In single chemical exposure models, BPA and mercury were associated with increased odds of GDM, while a significant inverse association was observed for zinc. Double-LASSO regression analysis selected mercury (AOR: 1.51, CI: 1.12-2.02), zinc (AOR: 0.017, CI: 0.0005-0.56), and perfluoroundecanoic acid (PFUnA), a PFAAs, (AOR: 0.43, CI: 0.19-0.94) as the best predictors of GDM. The combined data for this Canadian cohort suggest that second trimester blood mercury was a robust predictor of GDM diagnosis, whereas blood zinc and PFUnA were protective factors. Research into mechanisms that underlie the associations between mercury, zinc, PFUnA, and the development of GDM is needed.

Keywords: APrON study; Endocrine disrupting chemicals; Environmental chemical exposure; Gestational diabetes mellitus; LASSO regression; Pregnancy.

MeSH terms

  • Adult
  • Alkanesulfonic Acids / blood
  • Benzhydryl Compounds* / blood
  • Benzhydryl Compounds* / urine
  • Cohort Studies
  • Diabetes, Gestational* / blood
  • Diabetes, Gestational* / epidemiology
  • Endocrine Disruptors* / blood
  • Endocrine Disruptors* / urine
  • Environmental Pollutants* / blood
  • Female
  • Fluorocarbons* / blood
  • Humans
  • Maternal Exposure* / adverse effects
  • Phenols* / blood
  • Phenols* / urine
  • Phthalic Acids* / blood
  • Phthalic Acids* / urine
  • Pregnancy
  • Sulfones
  • Trace Elements / blood
  • Trace Elements / urine
  • Young Adult

Substances

  • Fluorocarbons
  • Phenols
  • Benzhydryl Compounds
  • Phthalic Acids
  • Endocrine Disruptors
  • Environmental Pollutants
  • bisphenol A
  • Trace Elements
  • Alkanesulfonic Acids
  • bisphenol S
  • Sulfones