Diabetes in Pregnancy: National Guideline Feasibility in Local At-Risk Populations

Abstract

s / Can J Diabetes 37 (2013) S13eS84 S83 association between exposure to endocrine disrupting chemicals and gestational diabetes (GDM). Methods: 2001 pregnant women were recruited in the MIREC study (Maternal-Infant Research on Environmental Chemicals) at 10 sites across Canada. GDMwas assessed by chart review based on the Canadian Diabetes Association guidelines. Five heavy metals were measured in maternal first trimester blood, and phthalate metabolites and bisphenol A (BPA) weremeasured in first trimester urine. Urinary chemical concentrations were adjusted for specific gravity. The chemical exposures were log-transformed, and grouped into quartiles. We adjusted all analyses for maternal age, ethnicity and body mass index. Results: Of 1298 women with complete data on the variables used in the analysis, 46 (3.5%) were identified as GDM cases. In comparing rates of GDM in the highest vs. the lowest quartile for each exposure, elevated odds of GDM were found with 4 metals (mercury, manganese, cadmium and arsenic), but the association was statistically significant only for arsenic (OR1⁄43.9, 95% CI 1⁄4 1.4 to 10.9). No statistically significant associations were found between phthalates or BPA and GDM; however, for 6 phthalate metabolites an inverse association with GDM was suggested. Conclusions: Consistent with other studies, our results suggest exposure to arsenic may be associated with GDM. The trend toward an inverse relationship with phthalates, although not statistically significant, requires further investigation.