Gestational diabetes & diabetes in pregnancy
Per- and Polyfluoroalkyl Substances During Pregnancy and Gestational Diabetes: The Environmental Influences on Child Health Outcomes (ECHO) Cohort
Main finding · GDMResult — go to the resultPrevalence ratio 0.75 95% CI 0.58–0.96Authors' conclusion
In a large, pooled sample of U.S. pregnant women, greater concentrations of PFAS were not associated with higher prevalence of GDM.
Study context
- Population
- U.S. women with singleton pregnancies from 16 ECHO cohorts; PFAS quantified in a single plasma or serum sample during pregnancy (1999–2021)
- Participants
- 5,229 women16 cohorts
- Exposure
- PFAS concentrations during pregnancy and gestational diabetes mellitus (GDM)
- Outcome
- GDM diagnosis based on self-report or medical record documentation
Methodological details16 cohorts, quantile-based g-computation for mixture
- 16 cohorts
- Quantile-based g-computation for mixture
Main finding
GDM
Prevalence ratio
0.75
95% CI 0.58–0.96
Six-PFAS mixture, per quartile increase
prevalence ratio 0.75 (95% CI 0.58–0.96)
Per quartile increase, as printed
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
GDM by prepregnancy BMI
- Certain PFAS more strongly negatively associated with GDM among participants with BMI <25 kg/m²
Fasting glucose (n = 1,213)
- Associations between PFAS and fasting glucose largely null; positive and negative associations in specific race and ethnicity strata
Original publication
Per- and Polyfluoroalkyl Substances During Pregnancy and Gestational Diabetes: The Environmental Influences on Child Health Outcomes (ECHO) Cohort. Diabetes Care. Published 24 March 2026. doi:10.
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