title: Pre-pregnancy maternal exposure to polybrominated and polychlorinated biphenyls and gestational diabetes: a prospective cohort study.
abstract: BACKGROUND
  While several studies have shown an association between environmental pollutants and diabetes among non-pregnant adults, few studies have prospectively assessed the association among pregnant women. We estimated the association between maternal pre-pregnancy levels of a polybrominated biphenyl (PBB 153) and 36 polychlorinated biphenyls (PCBs) with gestational diabetes (GDM).
  
  
  METHODS
  Data are from women (18-40 years) participating in a prospective cohort who achieved pregnancy lasting ≥24 weeks gestation and completed monthly pregnancy journals (n = 258). Women were recruited between 2005 and 2007 from 16 counties in Michigan and Texas. Women who ever reported a physician diagnosis of high blood glucose in monthly pregnancy journals were categorized as having gestational diabetes (n = 28; 10.9 %). Multivariable binary logistic regression was used to estimate odds ratios (OR) and 95 % confidence intervals (CIs).
  
  
  RESULTS
  There was no association between PBB 153 and GDM or any of the PCB congeners and GDM in unadjusted models. All associations remained non-significant with stepwise adjustment for age and waist-to-height ratio. Only with further adjustment for total serum lipids did the associations become significant, with lower levels of nine PCB congeners associated with GDM: 138, 153, 156, 167, 170, 172, 178, 180, and 194. The adjusted ORs for PCBs 170 and 180 were the strongest: 0.40 (0.18, 0.88) and 0.41 (0.19, 0.87), respectively.
  
  
  CONCLUSIONS
  Pre-pregnancy levels of PCBs were not consistently associated with development of GDM in this prospective cohort of U.S. women. Interestingly, we found that although women with GDM had higher mean pre-pregnancy circulating lipid levels compared to women without GDM, they had lower wet weight circulating levels of many PCBs. More research is needed to understand the dynamic fluctuations of PCBs and other persistent organic pollutants between lipid compartments in women preparing to conceive and throughout pregnancy.
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Claudia Nance Rollins Building 7040-I, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA. ljaacks@emory.edu.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Jaacks
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. dbbarr@emory.edu.
authors.forename: Dana Boyd
authors.initials: DB
authors.lastname: Barr
authors.affiliation: Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA. sundaramr2@mail.nih.gov.
authors.forename: Rajeshwari
authors.initials: R
authors.lastname: Sundaram
authors.affiliation: Glotech, Inc, Rockville, MD, USA. jose.maisog@nih.gov.
authors.forename: José M
authors.initials: JM
authors.lastname: Maisog
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA. 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, MD, USA. louisg@mail.nih.gov.
authors.forename: Germaine M
authors.initials: GM
authors.lastname: Buck Louis
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D016640:Diabetes, Gestational / Q000139:chemically induced*; D004785:Environmental Pollutants / Q000633:toxicity*; D005260:Female; D006801:Humans; D018811:Maternal Exposure / Q000706:statistics & numerical data; D008824:Michigan; D016017:Odds Ratio; D011078:Polychlorinated Biphenyls / Q000633:toxicity*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*; D011446:Prospective Studies; D013781:Texas; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D011078:Polychlorinated Biphenyls