Wang Dongying, Su Ting, Zhan Meiqi, Luo Sining, Tan Hongyu, Lin Jinglin, Lai Xin
Department of Traditional Chinese Medicine, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510000, China.
BMC Pregnancy Childbirth. 2025 Apr 14;25(1):448. doi: 10.1186/s12884-025-07551-x.
Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a major class of contaminants in recent years. Pregnant women are more susceptible to the influence of these compounds, which could heighten the risk of developing gestational diabetes mellitus (GDM). This study aims to conduct an updated systematic review and meta-analysis to determine the correlation between PFAS exposure during pregnancy and the risk of developing GDM and delve into their dose-response relationship.
Pubmed, EMBASE, Web of Science, and Cochrane Library databases were searched. Data were statistically analyzed using Stata 15.0. Fixed-effects (FEM) or random-effects (REM) models were used to combine STD mean difference (SMD) or odds ratio (OR) and 95% confidence intervals (CIs) according to heterogeneity. Dose-response meta-analyses were performed when applicable.
A total of 12 papers were included in this study. Meta-analysis results indicated significantly higher levels of PFOA, PFBS, and PFUnDA in GDM patients compared to healthy pregnant women. Pregnant women exposed to high levels of PFOA and PFBS had a significantly increased risk of developing GDM, with ORs of 1.513 and 1.436, respectively. Dose-response analyses indicated that for each 1 ng/ml increase in PFOA and PFBS exposure, the risk of GDM increased by 0.3% and 11.7%, respectively. In contrast, no significant associations were observed between high exposure to other PFAS compounds, such as PFNA, PFHxS, and PFOS, and the development of GDM. Subgroup analyses suggested that PFOA, PFBS, and PFOS levels were higher in GDM patients from China compared to those from Western countries. The differences in PFOA and PFOS levels between GDM and normal pregnant women were more pronounced during late pregnancy.
Exposure to PFOA, PFBS, and PFUnDA during pregnancy is associated with an increased risk of GDM. Given the elevated risk, particularly in the Chinese population, it is crucial to reduce exposure to these substances, especially from the preconception period onward.
全氟烷基和多氟烷基物质（PFAS）是近年来的一类主要污染物。孕妇更容易受到这些化合物的影响，这可能会增加患妊娠期糖尿病（GDM）的风险。本研究旨在进行一项更新的系统评价和荟萃分析，以确定孕期接触PFAS与患GDM风险之间的相关性，并深入探讨它们的剂量反应关系。
检索了PubMed、EMBASE、Web of Science和Cochrane图书馆数据库。使用Stata 15.0进行统计分析。根据异质性，采用固定效应（FEM）或随机效应（REM）模型合并标准化均数差（SMD）或比值比（OR）及95%置信区间（CI）。在适用时进行剂量反应荟萃分析。
本研究共纳入12篇论文。荟萃分析结果表明，与健康孕妇相比，GDM患者的全氟辛酸（PFOA）、全氟丁烷磺酸（PFBS）和全氟十一烷酸（PFUnDA）水平显著更高。暴露于高水平PFOA和PFBS的孕妇患GDM的风险显著增加，OR分别为1.513和1.436。剂量反应分析表明，PFOA和PFBS暴露每增加1 ng/ml，GDM风险分别增加0.3%和11.7%。相比之下，未观察到高暴露于其他PFAS化合物（如全氟萘酸（PFNA）、全氟己烷磺酸（PFHxS）和全氟辛烷磺酸（PFOS））与GDM发生之间存在显著关联。亚组分析表明，与西方国家的GDM患者相比，中国GDM患者的PFOA、PFBS和PFOS水平更高。GDM孕妇与正常孕妇之间PFOA和PFOS水平的差异在妊娠晚期更为明显。
孕期暴露于PFOA、PFBS和PFUnDA与GDM风险增加有关。鉴于风险升高，尤其是在中国人群中，减少接触这些物质至关重要，尤其是从孕前开始。
