title: A prospective study of prepregnancy serum concentrations of perfluorochemicals and the risk of gestational diabetes.
abstract: OBJECTIVE
  To examine preconception serum concentrations of perfluorooctanoic acid (PFOA) and six other PFCs in relation to gestational diabetes (GDM) risk.
  
  
  METHODS
  Prospective cohort with longitudinal follow-up.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Among 501 women recruited upon discontinuing contraception for the purpose of becoming pregnant, 258 (51%) became pregnant and were eligible for the study, of which 28 (11%) reported having physician-diagnosed GDM during follow-up.
  
  
  METHODS
  None.
  
  
  METHODS
  The odds ratios (ORs) and 95% confidence intervals (CIs) of GDM associated with each standard deviation (SD) increment of preconception serum PFOA concentration (ng/mL, log-transformed) and six other PFCs were estimated with the use of logistic regression after adjusting for age, prepregnancy body mass index, smoking, and parity conditional on gravidity.
  
  
  RESULTS
  Preconception geometric mean (95% CI) PFOA concentrations (in ng/mL) were higher for women with than without GDM (3.94 [3.15-4.93] vs. 3.07 [2.83-3.12], respectively). Each SD increment in PFOA was associated with a 1.87-fold increased GDM risk (adjusted OR 1.86 [95% CI 1.14-3.02]). A slightly increased risk associated with each SD increment for the six other PFCs was observed as well (all ORs >1.0, range 1.06-1.27), although the associations were not statistically significant.
  
  
  CONCLUSIONS
  Our findings suggested that higher environmentally relevant concentrations of PFOA were significantly associated with an increased risk of GDM. If corroborated, these findings may be suggestive of a possible environmental etiology for GDM.
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland. Electronic address: zhangcu@mail.nih.gov.
authors.forename: Cuilin
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland.
authors.forename: Rajeshwari
authors.initials: R
authors.lastname: Sundaram
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland.
authors.forename: José
authors.initials: J
authors.lastname: Maisog
authors.affiliation: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Calafat
authors.affiliation: Department of Occupational and Environmental Health and Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Dana Boyd
authors.initials: DB
authors.lastname: Barr
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland.
authors.forename: Germaine M
authors.initials: GM
authors.lastname: Buck Louis
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000453:epidemiology*; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008824:Michigan / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology
chemical_list: D004785:Environmental Pollutants; D005466:Fluorocarbons
keywords: Perfluorochemicals (PFCs); gestational diabetes; perfluorooctanoic acid (PFOA); pregnancy