Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, People's Republic of China.
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, People's Republic of China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, People's Republic of China.
Environ Pollut. 2018 Apr;235:850-856. doi: 10.1016/j.envpol.2018.01.016. Epub 2018 Feb 21.
Gestational diabetes mellitus (GDM) is a common obstetric complication with adverse effects on both mothers and their children. Previous studies revealed the link between Arsenic (As) exposure and incidence of diabetes mellitus (DM), but the data on the association between maternal As exposure and GDM is scarce. We examined this association among a population-based birth cohort. As concentrations were determined at multiple time points during pregnancy by ICP-MS. The association between As levels and GDM prevalence was examined using logistic regression model after adjustment for confounders. A total of 419 (12.85%) women were diagnosed with GDM. The incidences of GDM gradually increased with increasing quartiles of As levels with significant trend. As levels were associated with the GDM (95%CI: 1.29-2.43) at only the 4th quartile in the first trimester. After adjustment for maternal age, prepregnancy body mass index (BMI), monthly income, gestational age and parity, the association remains significant (95%CI: 1.22-2.38). Stratified analyses showed the associations were largely limited to normal maternal age (95%CI: 1.19-3.04) and normal weight women (95%CI: 1.18-2.66). Our study showed an association between As and GDM in a birth cohort and explored first trimester may be the critical period for As associated GDM. This association was universal in the general pregnant population of normal age and of normal weight.
妊娠期糖尿病（GDM）是一种常见的产科并发症，对母亲及其子女都有不良影响。先前的研究表明，砷（As）暴露与糖尿病（DM）的发生之间存在关联，但关于母体 As 暴露与 GDM 之间的关系的数据却很少。我们在一个基于人群的出生队列中研究了这种关联。通过 ICP-MS 在怀孕期间的多个时间点测定 As 浓度。在调整混杂因素后，使用逻辑回归模型检查 As 水平与 GDM 患病率之间的关联。共有 419 名（12.85%）女性被诊断为 GDM。随着 As 水平四分位数的增加，GDM 的发生率逐渐增加，呈显著趋势。仅在孕早期的第四四分位数时，As 水平与 GDM 相关（95%CI：1.29-2.43）。在调整了母亲的年龄、孕前体重指数（BMI）、月收入、孕周和产次后，这种关联仍然显著（95%CI：1.22-2.38）。分层分析表明，这种关联主要局限于正常年龄（95%CI：1.19-3.04）和正常体重的女性（95%CI：1.18-2.66）。我们的研究在一个出生队列中显示了 As 与 GDM 之间的关联，并探讨了孕早期可能是与 As 相关的 GDM 的关键时期。这种关联在正常年龄和正常体重的一般孕妇人群中普遍存在。
