Prenatal Persistent Halogenated EDCs and Gestational Glucose Levels in a Racially Diverse Pregnancy Cohort of Overweight Women

摘要

Background: Animal and human studies suggest certain endocrine disrupting chemicals (EDCs) affect glucose regulation; however, the impact of these chemicals during pregnancy on maternal glucose levels and gestational diabetes (GD) risk has been sparsely examined. Objective: To examine the role of prenatal EDC exposure on fasting plasma glucose (FPG) and GD during pregnancy in overweight women. Methods: A racially diverse, low-income cohort of 103 overweight pregnant women participated in a healthy weight gain behavioral intervention. Single serum measurements of poly- and perfluoroalkyl substances (PFASs), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs), and FPG (collected via a fasting blood draw) were taken at late first or second trimester. Physician-diagnosis of GD was determined through medical chart abstraction. We used generalized linear models to assess cross-sectional associations between exposure to EDCs and FPG, and logistic regression to examine associations with incidence of GD after adjusting for age, race/ethnicity, BMI, education, and gestational age at blood draw. Results: The mean FPG was 4.43 ±0.39 mmol/L. GD or a FPG ≥ 5.1 mmol/L was seen in 11.7% of women. A twofold increase of PCB-138 and PCB-153 were associated with 8.17% (95% CI: 1.02, 15.82) and 11.38% (95% CI: 0.65, 23.25) increase in FPG, respectively. A doubling of PBDE-153 significantly decreased FPG by 6.82% (95% CI: -12.50, -0.78). A doubling of PFNA and PFOS was associated with decreased FPG (-8.87% [95% CI: -17.57, 0.76], and -8.50% [95% CI: -16.71, 0.52], respectively). Persistent EDC exposure was not associated with GD or FPG ≥ 5.1 mmol/L. Discussion: Preliminary analyses suggest prenatal PCB exposure is associated with higher FPG among pregnant overweight women, whereas certain PBDEs and PFASs were inversely associated with FPG. Further analysis will account for EDC mixtures and repeated measures of FPG across pregnancy and postpartum.