Association between maternal antimony exposure and risk of gestational diabetes mellitus: A birth cohort study

A small number of epidemiological studies have suggested the association of antimony (Sb) exposure with type 2 diabetes risk. However, little is known about the relationship between Sb exposure during pregnancy and risk of gestational diabetes mellitus (GDM). To investigate the associations of urinary Sb concentrations with GDM risk and blood glucose levels in pregnant women. We analyzed the baseline data of 1789 pregnant women enrolled in the Birth Cohort Study on Prenatal Environments and Offspring Health (PEOH) in Guangzhou, China. Sb concentrations in urine were measured by inductively coupled plasma mass spectrometry (ICP-MS). Logistic regression and analysis of covariance were used to evaluate associations of Sb exposure with GDM risk and blood glucose levels. A total of 437 (24.4%) women were diagnosed with GDM. The relative risk of GDM for women in the highest quartile of creatinine-corrected Sb (CC–Sb) concentrations was 1.55 [RR (95% CI) = 1.55 (1.12, 2.15), p-trend = 0.005], compared with women in the lowest quartile. Moreover, the women in the top quartile of CC-Sb levels had a 5.2% higher 1 h blood glucose and a 4.2% higher 2 h blood glucose than those in the bottom quartile. We also found an interactive effect between maternal age and CC-Sb on the risk of GDM (p-interaction < 0.001). This study suggested significant positive associations of Sb exposure with increased GDM risk and impaired blood glucose homeostasis in pregnant women, and the Sb-GDM association might be modified by maternal age.