Introduction

The increase in the prevalence of gestational diabetes mellitus (GDM) and its consequences for mother and children prompts research on their risk factors including environmental factors. Studies on exposure to arsenic (As) in tap water and the risk of GDM have not provided conclusive evidence, particularly when levels of exposure were low (from 10 to 50 µg As/L). The main objective of this study was to assess the association between exposure to As in tap water and the risk of GDM.

Methods

A semi-ecological study was conducted from births recorded at the University Hospital of Clermont-Ferrand, France, in 2003, 2006 and 2010. Individual medical/obstetric data were available. As exposure was estimated from the concentrations of As measured during sanitary control of tap water supplied in the mothers’ commune of residence (aggregate data). French guidelines for As in tap water were used to identify groups potentially exposed, designated "As +" (≥ 10 µg As/L) and "As -" (< 10 µg As/L). Multivariate logistic regression analysis was performed.

Results

5053 women (5.7% with a GDM) were included. Overall, women in the As + group had a higher risk of GDM than those in the As - group (adjusted OR = 1.62; 95%CI: 1.01–2.53). Stratified analysis of pre-pregnancy body mass index (BMI) showed a positive association only for obese or overweight women (adjusted OR = 2.30; 95%CI: 1.13–4.50).

Conclusion

This French semi-ecological study provides additional arguments for an association between As exposure and the risk of GDM in particular in a context of low exposure. Further studies are needed to assess a potential interaction between As exposure and body mass index.

中文翻译：

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法国半生态研究表明，自来水和妊娠糖尿病中砷的暴露

介绍

妊娠糖尿病（GDM）的患病率上升及其对母亲和儿童的后果促使人们对其危险因素（包括环境因素）进行研究。关于自来水中砷（As）暴露和GDM风险的研究尚未提供确凿的证据，尤其是当暴露水平较低（从10到50 µg As / L）时。这项研究的主要目的是评估自来水中砷暴露与GDM风险之间的关系。

方法

从2003年，2006年和2010年在法国克莱蒙费朗的大学医院记录的婴儿出生进行了半生态学研究。可获得单独的医学/产科数据。根据对母亲居住区提供的自来水进行卫生控制期间测得的As浓度估算暴露量（汇总数据）。法国关于自来水中砷的准则被用来识别可能暴露的组，分别命名为“ As +”（≥10 µg As / L）和“ As-”（<10 µg As / L）。进行多元逻辑回归分析。

结果

包括5053名妇女（5.7％患有GDM）。总体而言，As +组的女性发生GDM的风险高于As-组的女性（校正后OR = 1.62； 95％CI：1.01-2.53）。孕前体重指数（BMI）的分层分析显示，仅对于肥胖或超重的女性存在正相关（校正后的OR = 2.30； 95％CI：1.13-4.50）。

结论

这项法国的半生态研究为砷暴露与GDM风险之间的关联提供了更多的论据，尤其是在低暴露的情况下。需要进一步的研究来评估砷暴露与体重指数之间的潜在相互作用。