Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, United States; Silent Spring Institute, Newton, MA, United States.
Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, United States; Department of Health Sciences, Northeastern University, Boston, MA, United States.
Environ Int. 2024 Jun;188:108711. doi: 10.1016/j.envint.2024.108711. Epub 2024 May 1.
Multiple lines of evidence suggest that exposure to per- and polyfluoroalkyl substances (PFAS) may alter glucose homeostasis, particularly during pregnancy, and may affect risk for developing gestational diabetes mellitus (GDM). While previous systematic reviews have been conducted on this topic, they did not assess internal validity of the included studies and their search strategies were narrowly focused.
The objective of this study is to assess the effect of higher PFAS exposure (defined by individual compounds or mixtures measured before or during pregnancy) on GDM and subclinical measures of impaired glucose homeostasis (measured during pregnancy) compared to lower PFAS exposure in pregnant.
We developed our systematic review protocol in accordance with the Navigation Guide. Peer-reviewed journal and grey literature searches were piloted in to identify relevant studies and refine our search terms and strategy. We also piloted the study screening criteria and data extraction form in DistillerSR, and refined our protocol accordingly. The risk of bias assessment protocol was adapted from Navigation Guide guidance and will be piloted and performed in DistillerSR. Pending the identification of comparable studies, quantitative meta-analyses will be performed where possible. Study results that cannot be quantitatively synthesized will be included in a narrative synthesis. The quality and strength of the body of evidence will be evaluated using Navigation Guide methodology, which is informed by guidance from the Cochrane Collaboration and Grading of Recommendations Assessment, Development and Evaluation (GRADE). We also made refinements to the quality of evidence considerations based on guidance from the National Institute of Environmental Health Sciences (NIEHS) Office of Health Assessment and Translation (OHAT).
This work was supported by the Systematizing Data on Per- and Polyfluoroalkyl Substances and Health Northeastern University TIER 1 Award.
多项证据表明，接触全氟和多氟烷基物质（PFAS）可能会改变葡萄糖稳态，尤其是在怀孕期间，并且可能会影响妊娠糖尿病（GDM）的发病风险。虽然之前已经就这一主题进行了系统评价，但它们没有评估纳入研究的内部有效性，而且它们的搜索策略重点狭窄。
本研究旨在评估较高的 PFAS 暴露（通过在怀孕前或怀孕期间测量的个体化合物或混合物来定义）与较低的 PFAS 暴露相比，对 GDM 和妊娠期间受损葡萄糖稳态的亚临床测量（怀孕期间测量）的影响。
我们按照导航指南制定了我们的系统评价方案。经过试点审查，同行评议的期刊和灰色文献搜索已确定相关研究，并改进了我们的搜索术语和策略。我们还在 DistillerSR 中试点了研究筛选标准和数据提取表，并相应地修改了我们的方案。偏倚风险评估方案改编自导航指南指南，并将在 DistillerSR 中进行试点和执行。在确定可比研究之前，将在可能的情况下进行定量荟萃分析。无法进行定量综合的研究结果将包含在叙述性综合中。将使用导航指南方法评估证据体的质量和强度，该方法由 Cochrane 协作和推荐评估、制定和评估（GRADE）的指导意见提供信息。我们还根据国家环境卫生科学研究所（NIEHS）健康评估和翻译办公室（OHAT）的指导意见对证据质量考虑因素进行了改进。
这项工作得到了系统评估全氟和多氟烷基物质与健康关系的东北大学 TIER 1 奖的支持。
