Table 1 Characteristics of included studies investigating the association between environmental endocrine disruptors and gestational diabetes mellitus

Zhang et al. 2015 [30] (2005–2009)

China

Cohort

Serum

HPLC–MS/MS

258

Age (y), BMI (kg/m 2), parity conditional on gravidity (never pregnant/ pregnant without live birth/pregnant with previous birth), race/ethnicity (white/ nonwhite) and smoking (yes/no)

Self-report

Per SD increment

PFOS

1.13 (0.75–1.72)

PFNA

1.06 (0.70–1.60)

PFDA

1.04 (0.70–1.53)

PFOA

1.86 (1.14–3.02)

Eslami et al. 2016 [31] (2013.09–2015.08)

Iran

Case–control

Serum

GC/MS

140

Maternal age (yrs), pre-pregnancy BMI (kg/m 2), gestational age (wks), and total lipids in maternal serum (mg/dL)

GDM diagnoses were made when two or more of the fast plasma glucose ≥ 92 mg/dL, ≥ 180 mg/dL at 1 h-OGTT or ≥ 153 mg/dL at 2 h-OGTT

Per unit increase in ln

PBDEs

2.21 (1.48–3.30)

PBDE-99

2.14 (1.99–3.83)

PBDE-28

2.73 (1.22–6.11)

PCBs

1.75 (1.35–2.27)

PCB-118

8.13 (2.78–23.73)

PCB-153

2.41 (1.21–4.81)

PCB-28

0.31 (0.14–0.67)

Vafeidi et al. 2017 [32] (2007.02–2008.02)

Spain

Cohort

Serum

GC–MS/MS

939

Gestational age at sampling (weeks), maternal age (b30 years, 30 years), pre-pregnancy BMI (kilograms per meter squared), parity (primiparous, multiparous), ma- ternal educational level [low ( 9 years of mandatory schooling), medium (N9 years of schooling up to attending postsecondary school education), high (attending university or having a university/technical college degree)], smoking during pregnancy (never, ever), gestational weight gain (kilograms) and maternal serum triglycerides and cholesterol

GDM diagnoses were made when two or more of the fast plasma glucose ≥ 95 mg/dL, ≥ 180 mg/dL at 1 h-OGTT, ≥ 155 mg/dL at 2 h-OGTT, or ≥ 140 mg/dL at 3 h-OGTT

Per tenfold increase

PCBs

4.56 (1.02–20.36)

Wang et al. 2018a [33] (2013.01–2013.03)

China

Case–control

Serum

UPLC

252

BMI, gestational weight gain, ethnic groups, maternal education, parity, maternal drinking during pregnancy, and household income

GDM diagnoses were made when the fast plasma glucose ≥ 95 mg/dL, ≥ 180 mg/dL at 1 h-OGTT, ≥ 155 mg/dL at 2 h-OGTT, or ≥ 140 mg/dL at 3 h-OGTT

Per 1 ng/mL increase in serum PFASs

PFOA

1.31 (0.95–1.80)

PFNA

1.25 (0.37–4.28)

PFDA

0.85 (0.30–2.92)

PFOS

0.96 (0.85–1.09)

PFUnDA

1.79 (0.65–4.96)

PFHxS

1.07 (0.86–1.35)

Liu et al. 2018 [34] (2013.08–2015.06)

China

Case–control

Serum

GC-HRMS

439

Pregnancy BMI, serum triglyceride and total cholesterol

GDM was defined if a woman had any of the following plasma glucose values: (1) Fasting: ≥ 5.1 mmol/L; (2) 1 h: ≥ 10.0 mmol/L; and (3) 2 h: ≥ 8.5 mmol/L in the 75-g oral glucose tolerance test (OGTT)

Q4 vs. Q1

PBDE-28

2.39 (1.03–5.57)

PBDE-47

2.01 (0.88–4.60)

PBDE-99

2.01 (0.88–4.58)

PBDE-100

2.04 (0.89–4.70)

PBDE-153

3.42 (1.49–7.89)

PBDE-154

1.70 (0.73–3.99)

PBDEs

2.23 (1.04–5.00)

Zhang et al. 2018 [35] (2013.08–2015.06)

China

Case–control

Serum

GC-HRMS

231

no

GDM diagnoses were made when the fast plasma glucose ≥ 5.1 mmol/L, ≥ 10 mmol/L at 1 h-OGTT, ≥ 8.5 mmol/L at 2 h-OGTT

Na

PCB-28

1.86(1.05–3.27)

PCB-52

1.90(1.28–2.82)

PCB-101

1.85(1.22–2.82)

PCB-138

1.51(0.90–2.53)

PCB-153

1.45(0.88–1.88)

PCB-180

1.25(0.83–1.88)

PCBs

4.70(1.02–21.70)

Shapiro et al. 2015 [19] (2008–2010)

Canada

Cohort

Urine

LC–MS/MS

1274

Maternal age, race, pre-pregnancy BMI, education and specific gravity

GDM was defined if ≥ 2 of the following plasma glucose values: (1) Fasting: ≥ 5.3 mmol/L; (2) 1 h: ≥ 10.6 mmol/L; (3) 2 h: ≥ 9.2 mmol/L in the 75-g oral glucose tolerance test (OGTT)

Q4 vs. Q1

MEP

0.50 (0.20–1.40)

MBP

0.60 (0.10–2.20)

MBzP

1.50 (0.50–4.70)

MCPP

0.60 (0.20–1.90)

DEHP

0.90 (0.30–2.90)

Shapiro et al. 2016 [36] (2008–2010)

Canada

Cohort

Urine

GC/MSMS and UPLC-MS–MS

1274

Maternal age, race, pre-pregnancy BMI and education; analyses for organophosphorus pesticide metabolites are additionally adjusted for urinary specific gravity; analyses for PCBs and organochlorine pesticides are additionally adjusted for total lipids

GDM was defined if ≥ 2 of the following plasma glucose values: (1) Fasting: ≥ 5.3 mmol/L; (2) 1 h: ≥ 10.6 mmol/L; (3) 2 h: ≥ 9.2 mmol/L in the 75-g oral glucose tolerance test (OGTT)

Q4 vs. Q1

PFOA

0.90 (0.30–2.30)

PFOS

0.70 (0.30–1.70)

PFHxS

1.20 (0.40–3.50)

PCB-118

1.40 (0.50–3.50)

PCB-138

1.50 (0.50–4.20)

PCB-153

1.40 (0.50–4.10)

PCB-180

1.30 (0.50–3.50)

PCBs

1.00 (0.30–2.70)

Jaacks et al. 2016 [37] (2005–2007)

USA

Cohort

Serum

HPLC–MS/MS

258

Total serum lipids estimated, age, and waist-to-height ratio, all specified continuously

GDM was identified from medical record

Na

PCBs

0.68 (0.31–1.49)

PCB-28

0.90 (0.24–3.31)

PCB-101

1.00 (0.69–1.47)

PCB-118

0.81 (0.51–1.29)

PCB-138

0.53 (0.29–0.99)

PCB-153

0.48 (0.24–0.98)

PCB-180

0.41 (0.19–0.87)

Smarr et al. 2016 [38] (2005–2009)

USA

Cohort

Serum

GC/MS

258

Serum lipids, age, BMI, non-white race, smoking, and the sum of remaining chemicals in the relevant class of compounds

GDM was identified from medical record

Na

PBDE-28

0.47 (0.17–1.26)

PBDE-47

0.32 (0.10–1.01)

PBDE-99

0.44 (0.15–1.33)

PBDE-100

2.22 (0.96–5.17)

PBDE-153

1.79 (1.18–2.74)

PBDE-154

1.04 (0.34–3.17)

Rahman et al. 2019 [39] (2009.07–2013.01)

USA

Cohort

Plasma

UPLC

2334

Maternal age (continuous), enrollment BMI (19–24.9; 25–29.9), education (< college; some college/undergraduate; graduate/post graduate), parity (nulliparous; multiparous), race/ethnicity (white, African American, Hispanic, Asian), family history of type 2 diabetes among first degree relatives, serum cotinine level (continuous), and serum total lipids (continuous, mg/dL)

GDM was defined if fasting plasma glucose (FPG) ≥ 5.3 mmol/L, or 1-h plasma glucose (1 h-PG) ≥ 10.0 mmol/L, or 2-h plasma glucose (2 h-PG) ≥ 8.6 mmol/L, or 3-h plasma glucose ≥ 7.8 mmol/L

Per SD increment

PCB-101

1.03 (0.75–1.41)

PCB-118

0.98 (0.71–1.36)

PCB-138

0.99 (0.72–1.34)

PCB-153

1.01 (0.77–1.32)

PCB-180

1.08 (0.83–1.39)

PCB-28

1.06 (0.89–1.27)

PCB-52

1.13 (0.74–1.71)

PCBs

0.99 (0.73–1.35)

PFDA

0.72 (0.39–1.32)

PFHxS

0.87 (0.52–1.46)

PFNA

0.80 (0.50–1.27)

PFOA

0.70 (0.43–1.14)

PFOS

0.86 (0.60–1.23)

PFUnDA

0.66 (0.37–1.19)

PBDE-28

1.08 (0.94–1.23)

PBDE-100

0.90 (0.49–1.66)

PBDE-153

0.64 (0.26–1.57)

PBDE-154

1.23 (1.12–1.34)

PBDE-47

1.18 (1.08–1.29)

PBDE-99

1.04 (0.92–1.15)

Matilla-Santander et al. 2017 [40] (2003–2008)

Spain

Cohort

Serum

HPLC–MS/MS

1240

Subcohort, country of birth, prepregnancy body mass index, previous breastfeeding, parity, gestational week at blood extraction, physical activity, and relative Mediterranean Diet Score

Results of the OGTT are routinely used to classify women as having GDM if two or more of the baseline or postchallenge blood glucose concentrations exceed National Diabetes Data Group (NDDG) reference values

Per tenfold increase

PFOA

1.20 (0.62–2.30)

PFOS

2.40 (0.93–6.18)

PFHxS

1.58 (0.73–3.44)

PFNA

0.85 (0.40–1.80)

Valvi et al. 2017 [41] (1997–2000)

Norway

Cohort

Serum

HPLC–MS/MS

604

Maternal age at delivery, education, parity, pre-pregnancy BMI (continuous) and smoking during pregnancy

GDM was identified from medical record

Per unit increase

PCBs

0.97 (0.71–1.33)

PFOS

0.86 (0.43–1.70)

PFOA

0.79 (0.44–1.41)

PFHxS

1.03 (0.80–1.33)

PFDA

1.20 (0.73–1.96)

PFNA

0.88 (0.53–1.47)

Neblett et al. 2020 [42] (2012–2015)

USA

Cross-sectional

Serum

GC/MS

254

Age (current age & age at pregnancy), BMI, and total lipid levels

Self-report

Na

PCBs

1.06 (0.59–1.87)

Fisher et al. 2018 [43] (2001–2009)

UK

Case–control

Serum

LC–MS

232

Age, pre-pregnancy body mass index (log-transformed), IMD (log-transformed), and parity

GDM was diagnosed if they meet one or more of the following criteria: Fasting plasma glucose ≥ 5.1 mmol/l, 60-min plasma glucose ≥ 10.0 mmol/l, or 120-min plasma glucose ≥ 8.5 mmol/l

Q4 vs. Q1

MEP

1.19 (0.42–3.37)

MIBP

4.89 (1.32–18.14)

MBP

1.42 (0.52–3.88)

Shaffer et al. 2019 [21] (2010–2012)

USA

Cohort

Urine

HPLC–MS/MS

Na

GDM is diagnosed in women with two or more abnormal values in the OGTT: fasting: 95 mg/dL; 1 h: 180 mg/dL; 2 h: 155 mg/dL; and 3 h: 140 mg/dL

Per interquartile-range increase

MEP

1.61 (1.10–2.36)

MBP

1.13 (0.80–1.55)

MCPP

1.06 (0.70–1.55)

MBzP

1.03 (0.67–1.52)

DEHP

1.05 (0.71–1.44)

MEHP

1.03 (0.38–2.79)

MIBP

1.15 (0.80–1.60)

Zhang et al. 2017 [44] (2013.05–2014.09)

China

Cohort

Urine

HPLC–MS/MS

3009

The FPG level of early stages pregnancy, maternal age, pre-pregnancy BMI, monthly household income, reproductive history, gestational weeks, concentration of urinary creatinine

GDM was diagnosed if fasting plasma glucose (FPG) ≥ 5.1 mmol/L (≥ 92 mg/dL), or 1 h plasma glucose (1 h-PG) ≥ 10.0 mmol/L (≥ 180 mg/dL), or 2 h plasma glucose (2 h-PG) ≥ 8.5 mmol/L (≥ 153 mg/dL)

Na

MEP

1.12 (0.83–1.52)

MBP

1.49 (1.09–2.04)

MBzP

0.93 (0.69–1.25)

Xu et al. 2020 [45] (2017.01–2019.01)

China

Case–control

Serum

UPLC-Q/TOF MS

1575

Maternal age, sampling time, parity, BMI, educational level, and serum lipids

GDM was diagnosed if fasting plasma glucose (FPG) ≥ 5.1 mmol/L, or 1 h plasma glucose (1 h-PG) ≥ 10.0 mmol/L, or 2 h plasma glucose (2 h-PG) ≥ 8.5 mmol/L

Per tenfold increase

PFOA

1.51 (0.63–3.84)

PFOS

0.61 (0.42–1.65)

PFDA

0.81 (0.21–2.01)

PFNA

1.11 (0.49–2.85)

PFHxS

1.09 (0.49–3.01)

PFBS

1.69 (1.20–2.01)

PFDoA

2.49 (1.07–3.72)

Preston et al. 2020 [46] (1999–2002)

USA

Cohort

Plasma

HPLC–MS/MS

1540

Maternal age, pre-pregnancy BMI, prior history of GDM, parity, race, ethnicity, smoking, education

GDM is diagnosed in women with two or more abnormal values in the OGTT: fasting: 95 mg/dL; 1 h: 180 mg/dL; 2 h: 155 mg/dL; and 3 h: 140 mg/dL

Q4 vs. Q1

PFOA

1.40 (0.70–2.90)

PFOS

1.50 (0.70–3.00)

PFNA

1.00 (0.50–2.00)

PFHxS

1.00 (0.50–2.20)

Wang et al. 2018b [47] (2013.09–2014.12)

China

Cohort

Serum

UPLC-Q/TOF MS

560

Pregnant age, diabetes mellitus history of relatives, husband smoking status, family per capita income, baby sex, averaged intake of meat, vegetable,and aquatic products, averaged physical activity, averaged energy intake and pre-pregnant maternal BMI

GDM was diagnosed if fasting plasma glucose (FPG) ≥ 5.1 mmol/L, or 1 h plasma glucose (1 h-PG) ≥ 10.0 mmol/L, or 2 h plasma glucose (2 h-PG) ≥ 8.5 mmol/L

Q3 vs. Q1

PFOS

2.11 (0.76–5.86)

PFOA

0.71 (0.29–1.75)

Gao et al. 2021 [48] (2013.05–2019.05)

China

Cohort

Urine

LC–MS

3273

Maternal age, pre-pregnancy BMI, income and primiparous

GDM was diagnosed if fasting plasma glucose (FPG) ≥ 5.1 mmol/L (≥ 92 mg/dL), or 1 h plasma glucose (1 h-PG) ≥ 10.0 mmol/L (≥ 180 mg/dL), or 2 h plasma glucose (2 h-PG) ≥ 8.5 mmol/L (≥ 153 mg/dL)

Per tenfold increase

MEP

1.18(0.96–1.46)

MBP

1.20(0.95–1.53)

MBzP

0.99(0.86–1.15)

MEHP

0.96 (0.77–1.20)

DEHP

0.95(0.68–1.33)

Guo et al. 2020 [49] (2013.07–2014.07)

China

Cross-sectional

Meconium

LC–MS/MS

251

Mother’s age, pre-pregnancy BMI and gestational age

GDM was diagnosed if fasting plasma glucose (FPG) ≥ 5.1 mmol/L (≥ 92 mg/dL), or 1 h plasma glucose (1 h-PG) ≥ 10.0 mmol/L (≥ 180 mg/dL), or 2 h plasma glucose (2 h-PG) ≥ 8.5 mmol/L (≥ 153 mg/dL)

Per unit increase in ln

MEP

1.40 (0.39–4.95)

MBP

3.10 (0.87–11.21)

MIBP

2.34 (1.01–5.43)

MEHP

3.51 (1.24–9.92)

Zukin et al. 2021 [50] (1999–2000)

USA

Cohort

Urine

415

Maternal age, income, maternal education, marital status, sugar-sweetened beverage consumption, country of birth, and maternal pre-pregnancy BMI

GDM was diagnosis if either (1) maternal plasma glucose levels on the OGTT exceeded at least two of the following plasma levels: fasting 95 mg/dL (5.3 mmol/L), 1 h 180 mg/dL (10.0 mmol/L); 2 h 155 mg/dL (8.6 mmol/L); 3 h 140 mg/dL (7.8 mmol/L) or (2) a diagnosis of GDM in the maternal medical records

Na

MEP

1.10 (0.90–1.40)

MBP

1.00 (0.80–1.50)

MIBP

1.10 (0.80–1.40)

MBzP

1.10 (0.80–1.50)

DEHP

1.20 (0.80–1.70)

MCPP

1.00 (0.70–1.40)

Liu et al. 2019 [51] (2013.08–2015.06)

China

Case–control

Serum

GC-HRMS

439

Maternal age, pregnancy BMI, fetal sex, and serum triglyceride and total cholesterol

GDM was defined if a woman had any of the following plasma glucose values: (1) Fasting: ≥ 5.1 mmol/L; (2) 1 h: ≥ 10.0 mmol/L; and (3) 2 h: ≥ 8.5 mmol/L in the 75-g oral glucose tolerance test (OGTT)

Per unit increase in ln

PFOS

1.36 (0.88–2.11)

PFOA

1.23 (0.92–1.64)

Yu et al. 2021 [52] (2013–2016)

China

Cohort

Plasma

HPLC–MS/MS

2747

Maternal age, pre-pregnant BMI, maternal education, smoking status, parity, averaged physical activity and economic status

GDM was diagnosed if fasting plasma glucose (FPG) ≥ 5.1 mmol/L, or 1 h plasma glucose (1 h-PG) ≥ 10.0 mmol/L, or 2 h plasma glucose (2 h-PG) ≥ 8.5 mmol/L

Per tenfold increase

PFOA

1.11 (0.83–1.15)

PFOS

1.10 (0.88–1.36)

PFNA

1.03 (0.81–1.30)

PFDA

0.95 (0.78–1.16)

PFHxS

1.15 (0.86–1.54)

PFUnDA

0.91 (0.74–1.12)

PFDoA

0.99 (0.78–1.26)

PFBS

1.23 (1.05–1.44)