Lasher Emily, Trowbridge Jessica, Gemmill Alison, Morello-Frosch Rachel, DeMicco Erin, Kannan Kurunthachalam, Buckley Jessie P, Woodruff Tracey J
Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Franscisco, USA, CA.
Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J Expo Sci Environ Epidemiol. 2025 Jun 30. doi: 10.1038/s41370-025-00787-x.
Research suggests exposure to chemical and non-chemical stressors may increase the risk of pregnancy complications, including gestational diabetes mellitus (GDM). Exposure to melamine and aromatic amines (AAs) is ubiquitous among pregnant people. However, studies investigating the maternal and fetal health effects of prenatal exposure are limited.
This cross-sectional study aimed to (1) evaluate relationships between exposure to aromatic amines, melamine and its derivatives, and gestational diabetes in a pregnancy cohort in San Francisco, California, USA, (2) explore if non-chemical stressors modify these relationships, and (3) assess fetal sex differences using stratification.
We measured 36 AAs, melamine, and three of its derivatives in second-trimester urine samples (n = 607). Financial strain and psychosocial stress were assessed using self-reported questionnaires. GDM status was abstracted from medical records. We used unadjusted and adjusted logistic regression models to calculate the odds of GDM associated with an interquartile range increase in urinary concentrations of melamine and AAs or higher levels of non-chemical stress, overall and stratified by infant sex. Interaction terms between each chemical and non-chemical stressor were used to test for effect modification.
Eight analytes were detected in >65% of participants, with 100% detection of melamine and cyanuric acid. Among male infants, summed urinary concentrations of melamine and its analogs and o-Anisidine were associated with increased odds of GDM (OR: 1.08 [1.00, 1.17], OR: 1.18 [1.03, 1.36], respectively). Higher levels of perceived stress and discrimination were also associated with increased odds of GDM (OR: 1.41 [0.73, 2.70], OR: 2.33 [1.16, 4.67], respectively). We found limited evidence of interaction between chemical and non-chemical stressors.
This study revealed positive associations between melamine and its analogs, some aromatic amines, and gestational diabetes, especially among pregnant women carrying male fetuses. We also found that levels of perceived stress and discrimination were associated with gestational diabetes.
研究表明，接触化学和非化学应激源可能会增加妊娠并发症的风险，包括妊娠期糖尿病（GDM）。孕妇普遍接触三聚氰胺和芳香胺（AAs）。然而，关于产前接触对母婴健康影响的研究有限。
这项横断面研究旨在：（1）评估美国加利福尼亚州旧金山一个妊娠队列中芳香胺、三聚氰胺及其衍生物的接触与妊娠期糖尿病之间的关系；（2）探讨非化学应激源是否会改变这些关系；（3）通过分层评估胎儿性别差异。
我们测量了孕中期尿液样本（n = 607）中36种芳香胺、三聚氰胺及其三种衍生物的含量。使用自我报告问卷评估经济压力和心理社会压力。从医疗记录中提取GDM状态。我们使用未调整和调整后的逻辑回归模型，计算三聚氰胺和芳香胺尿液浓度增加四分位间距或更高水平非化学应激与GDM相关的比值比，总体情况以及按婴儿性别分层的情况。使用每种化学和非化学应激源之间的交互项来检验效应修正。
超过65%的参与者检测到8种分析物，三聚氰胺和氰尿酸的检测率为100%。在男婴中，三聚氰胺及其类似物和邻甲氧基苯胺的尿液总浓度与GDM几率增加相关（比值比分别为：1.08 [1.00, 1.17]，1.18 [1.03, 1.36]）。较高水平的感知压力和歧视也与GDM几率增加相关（比值比分别为：1.41 [0.73, 2.70]，2.33 [1.16, 4.67]）。我们发现化学和非化学应激源之间相互作用的证据有限。
这项研究揭示了三聚氰胺及其类似物、一些芳香胺与妊娠期糖尿病之间存在正相关，尤其是在怀有男胎的孕妇中。我们还发现感知压力和歧视水平与妊娠期糖尿病有关。
