Persistent organic pollutant exposure as a risk factor of gestational diabetes mellitus: A systematic review and meta-analysis

Malak Kouiti; María Ángeles Castillo-Hermoso; Ibtissam Youlyouz-Marfak; Khalid Saeed Khan; Shakila Thangaratinam; Rocío Olmedo-Requena; Javier Zamora; José Juan Jiménez-Moléon

doi:10.1111/1471-0528.17725

Persistent organic pollutant exposure as a risk factor of gestational diabetes mellitus: A systematic review and meta-analysis

Malak Kouiti, María Ángeles Castillo-Hermoso, Ibtissam Youlyouz-Marfak, Khalid Saeed Khan, Shakila Thangaratinam, Rocío Olmedo-Requena^*, Javier Zamora, José Juan Jiménez-Moléon

^*Corresponding author for this work

Metabolism and Systems Research

Research output: Contribution to journal › Review article › peer-review

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Abstract

Background: Findings related to the association between persistent organic pollutants (POPs) and gestational diabetes mellitus (GDM) are inconclusive.

Objectives: To estimate the strength of the association between POP exposure and GDM in a systematic review with meta-analysis.

Search strategy: MEDLINE, Scopus and Web of Science were searched until July 2023.

Selection criteria: Cohort and case–control studies analysing the association between POPs and GDM.

Data collection and analysis: We assessed the risk of bias using the Quality in Prognosis Studies scale (QUIPS). Standardised mean differences were pooled using random-effect models.

Main results: Sixteen articles including 12 216 participants were selected. The risk of bias was high in four articles (25%), moderate in 11 (68.75%) and low in one (6.25%). Small mean difference between GDM cases and controls was observed for PFHpA (0.26, 95% confidence interval [CI] 0.1–0.35, I² = 0.0%), PCB180 (0.37, 95% CI 0.19–0.56; I² = 25.3%), BDE47 (0.23, 95% CI 0.0–0.45, I² = 0%), BDE99 (0.36, 95% CI 0.14–0.59; I² = 0%), BDE100 (0.42, 95% CI 0.19–0.64; I² = 0%) and HCB (0.22, 95% CI 0.01–0.42, I² = 39.6%). No considerable difference was observed for the rest of POPs.

Conclusion: Small mean differences between GDM cases and controls were observed for some POPs. However, evidence shows mostly moderate quality and results were heterogeneous. Improved research methodology is needed to assess POPs and GDM risk.

Original language	English
Number of pages	10
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Early online date	4 Dec 2023
DOIs	https://doi.org/10.1111/1471-0528.17725
Publication status	E-pub ahead of print - 4 Dec 2023

Bibliographical note

Funding Information:
The results of this study are part of the doctoral thesis of Malak Kouiti. Funding for open access charge: Universidad de Garanada/CBUA.

Funding Information:
This work was conceptualised and supervised by J.J.J.‐M., J.Z., R.O.‐R. and M.K. The methodology was developed by J.J.J.‐M., J.Z., M.K., M.A.C.‐H., I.Y.‐M. and R.O.‐R. All analyses and data curation were performed by M.K. and M.A.C.‐H., and supervised by J.Z., J.J.J.‐M., R.O.‐R. and I.Y.‐M. The interpretation of data was realised by all authors. The original draft was written by M.K. and J.J.J.‐M. Critical review and editing of the article was provided by J.J.J.‐M., M.K., J.Z., I.Y.‐M., S.T., K.S.K., M.A.C.‐H. and R.O.‐R. All other authors provided final approval of this manuscript. K.S.K. is a distinguished investigator at the University of Granada funded by the Beatriz Galindo (senior modality) programme of the Spanish Ministry of Education.

Publisher Copyright:
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

Keywords

exposure
gestational diabetes mellitus
meta-analysis
persistent organic pollutants
risk factor
systematic review
meta‐analysis

ASJC Scopus subject areas

Obstetrics and Gynaecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/1471-0528.17725Licence: Creative Commons: Attribution-NonCommercial-NoDerivs (CC BY-NC-ND)

KouitiM2023PersistentFinal published version, 1.45 MBLicence: Creative Commons: Attribution-NonCommercial-NoDerivs (CC BY-NC-ND)

Cite this

Kouiti, M., Castillo-Hermoso, M. Á., Youlyouz-Marfak, I., Khan, K. S., Thangaratinam, S., Olmedo-Requena, R., Zamora, J., & Jiménez-Moléon, J. J. (2023). Persistent organic pollutant exposure as a risk factor of gestational diabetes mellitus: A systematic review and meta-analysis. BJOG: An International Journal of Obstetrics and Gynaecology. Advance online publication. https://doi.org/10.1111/1471-0528.17725

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abstract = "Background: Findings related to the association between persistent organic pollutants (POPs) and gestational diabetes mellitus (GDM) are inconclusive.Objectives: To estimate the strength of the association between POP exposure and GDM in a systematic review with meta-analysis. Search strategy: MEDLINE, Scopus and Web of Science were searched until July 2023. Selection criteria: Cohort and case–control studies analysing the association between POPs and GDM. Data collection and analysis: We assessed the risk of bias using the Quality in Prognosis Studies scale (QUIPS). Standardised mean differences were pooled using random-effect models. Main results: Sixteen articles including 12 216 participants were selected. The risk of bias was high in four articles (25%), moderate in 11 (68.75%) and low in one (6.25%). Small mean difference between GDM cases and controls was observed for PFHpA (0.26, 95% confidence interval [CI] 0.1–0.35, I2 = 0.0%), PCB180 (0.37, 95% CI 0.19–0.56; I2 = 25.3%), BDE47 (0.23, 95% CI 0.0–0.45, I2 = 0%), BDE99 (0.36, 95% CI 0.14–0.59; I2 = 0%), BDE100 (0.42, 95% CI 0.19–0.64; I2 = 0%) and HCB (0.22, 95% CI 0.01–0.42, I2 = 39.6%). No considerable difference was observed for the rest of POPs. Conclusion: Small mean differences between GDM cases and controls were observed for some POPs. However, evidence shows mostly moderate quality and results were heterogeneous. Improved research methodology is needed to assess POPs and GDM risk.",

keywords = "exposure, gestational diabetes mellitus, meta-analysis, persistent organic pollutants, risk factor, systematic review, meta‐analysis",

author = "Malak Kouiti and Castillo-Hermoso, {Mar{\'i}a {\'A}ngeles} and Ibtissam Youlyouz-Marfak and Khan, {Khalid Saeed} and Shakila Thangaratinam and Roc{\'i}o Olmedo-Requena and Javier Zamora and Jim{\'e}nez-Mol{\'e}on, {Jos{\'e} Juan}",

note = "Funding Information: The results of this study are part of the doctoral thesis of Malak Kouiti. Funding for open access charge: Universidad de Garanada/CBUA. Funding Information: This work was conceptualised and supervised by J.J.J.‐M., J.Z., R.O.‐R. and M.K. The methodology was developed by J.J.J.‐M., J.Z., M.K., M.A.C.‐H., I.Y.‐M. and R.O.‐R. All analyses and data curation were performed by M.K. and M.A.C.‐H., and supervised by J.Z., J.J.J.‐M., R.O.‐R. and I.Y.‐M. The interpretation of data was realised by all authors. The original draft was written by M.K. and J.J.J.‐M. Critical review and editing of the article was provided by J.J.J.‐M., M.K., J.Z., I.Y.‐M., S.T., K.S.K., M.A.C.‐H. and R.O.‐R. All other authors provided final approval of this manuscript. K.S.K. is a distinguished investigator at the University of Granada funded by the Beatriz Galindo (senior modality) programme of the Spanish Ministry of Education. Publisher Copyright: {\textcopyright} 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.",

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Kouiti, M, Castillo-Hermoso, MÁ, Youlyouz-Marfak, I, Khan, KS, Thangaratinam, S, Olmedo-Requena, R, Zamora, J & Jiménez-Moléon, JJ 2023, 'Persistent organic pollutant exposure as a risk factor of gestational diabetes mellitus: A systematic review and meta-analysis', BJOG: An International Journal of Obstetrics and Gynaecology. https://doi.org/10.1111/1471-0528.17725

TY - JOUR

T1 - Persistent organic pollutant exposure as a risk factor of gestational diabetes mellitus

T2 - A systematic review and meta-analysis

AU - Kouiti, Malak

AU - Castillo-Hermoso, María Ángeles

AU - Youlyouz-Marfak, Ibtissam

AU - Khan, Khalid Saeed

AU - Thangaratinam, Shakila

AU - Olmedo-Requena, Rocío

AU - Zamora, Javier

AU - Jiménez-Moléon, José Juan

N1 - Funding Information: The results of this study are part of the doctoral thesis of Malak Kouiti. Funding for open access charge: Universidad de Garanada/CBUA. Funding Information: This work was conceptualised and supervised by J.J.J.‐M., J.Z., R.O.‐R. and M.K. The methodology was developed by J.J.J.‐M., J.Z., M.K., M.A.C.‐H., I.Y.‐M. and R.O.‐R. All analyses and data curation were performed by M.K. and M.A.C.‐H., and supervised by J.Z., J.J.J.‐M., R.O.‐R. and I.Y.‐M. The interpretation of data was realised by all authors. The original draft was written by M.K. and J.J.J.‐M. Critical review and editing of the article was provided by J.J.J.‐M., M.K., J.Z., I.Y.‐M., S.T., K.S.K., M.A.C.‐H. and R.O.‐R. All other authors provided final approval of this manuscript. K.S.K. is a distinguished investigator at the University of Granada funded by the Beatriz Galindo (senior modality) programme of the Spanish Ministry of Education. Publisher Copyright: © 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

PY - 2023/12/4

Y1 - 2023/12/4

N2 - Background: Findings related to the association between persistent organic pollutants (POPs) and gestational diabetes mellitus (GDM) are inconclusive.Objectives: To estimate the strength of the association between POP exposure and GDM in a systematic review with meta-analysis. Search strategy: MEDLINE, Scopus and Web of Science were searched until July 2023. Selection criteria: Cohort and case–control studies analysing the association between POPs and GDM. Data collection and analysis: We assessed the risk of bias using the Quality in Prognosis Studies scale (QUIPS). Standardised mean differences were pooled using random-effect models. Main results: Sixteen articles including 12 216 participants were selected. The risk of bias was high in four articles (25%), moderate in 11 (68.75%) and low in one (6.25%). Small mean difference between GDM cases and controls was observed for PFHpA (0.26, 95% confidence interval [CI] 0.1–0.35, I2 = 0.0%), PCB180 (0.37, 95% CI 0.19–0.56; I2 = 25.3%), BDE47 (0.23, 95% CI 0.0–0.45, I2 = 0%), BDE99 (0.36, 95% CI 0.14–0.59; I2 = 0%), BDE100 (0.42, 95% CI 0.19–0.64; I2 = 0%) and HCB (0.22, 95% CI 0.01–0.42, I2 = 39.6%). No considerable difference was observed for the rest of POPs. Conclusion: Small mean differences between GDM cases and controls were observed for some POPs. However, evidence shows mostly moderate quality and results were heterogeneous. Improved research methodology is needed to assess POPs and GDM risk.

AB - Background: Findings related to the association between persistent organic pollutants (POPs) and gestational diabetes mellitus (GDM) are inconclusive.Objectives: To estimate the strength of the association between POP exposure and GDM in a systematic review with meta-analysis. Search strategy: MEDLINE, Scopus and Web of Science were searched until July 2023. Selection criteria: Cohort and case–control studies analysing the association between POPs and GDM. Data collection and analysis: We assessed the risk of bias using the Quality in Prognosis Studies scale (QUIPS). Standardised mean differences were pooled using random-effect models. Main results: Sixteen articles including 12 216 participants were selected. The risk of bias was high in four articles (25%), moderate in 11 (68.75%) and low in one (6.25%). Small mean difference between GDM cases and controls was observed for PFHpA (0.26, 95% confidence interval [CI] 0.1–0.35, I2 = 0.0%), PCB180 (0.37, 95% CI 0.19–0.56; I2 = 25.3%), BDE47 (0.23, 95% CI 0.0–0.45, I2 = 0%), BDE99 (0.36, 95% CI 0.14–0.59; I2 = 0%), BDE100 (0.42, 95% CI 0.19–0.64; I2 = 0%) and HCB (0.22, 95% CI 0.01–0.42, I2 = 39.6%). No considerable difference was observed for the rest of POPs. Conclusion: Small mean differences between GDM cases and controls were observed for some POPs. However, evidence shows mostly moderate quality and results were heterogeneous. Improved research methodology is needed to assess POPs and GDM risk.

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KW - gestational diabetes mellitus

KW - meta-analysis

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KW - risk factor

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KW - meta‐analysis

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DO - 10.1111/1471-0528.17725

M3 - Review article

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SN - 1470-0328

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

ER -

Persistent organic pollutant exposure as a risk factor of gestational diabetes mellitus: A systematic review and meta-analysis

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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