Association between Arsenic and Gestational Diabetes Mellitus in Non-diabetic Mothers: A Meta-Analysis of Observational Studies

Abstract

Abstract Objective Environmental arsenic (As) exposure is a known risk factor for Gestational Diabetes Mellitus (GDM). However, there are inconsistent findings in exploring the relationship between As exposure and the occurrence of GDM. To clarify this issue, a systematic review and meta-analysis of epidemiological studies on the association between As and GDM in non-diabetic mothers are carried out. Methods PubMed, U.S. National Library of Medicine (MEDLINE), Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched, and time interval ranged from database establishment to February 2022, so as to find eligible studies on GDM caused by As exposure. Based on MOOSE guidelines, the characteristics and results were extracted from papers. The determined As in blood, urine, toenail or hair were analyzed. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated. Subgroup analysis and sensitivity analysis were performed to investigate the source of heterogeneity. Results Among 315 retrieved items, 1 cross-sectional study, 3 case-control studies, and 6 cohort studies were selected. The results showed a positive correlation between maximum and minimum exposure of As concentration with a pooled odds ratio (OR) of 1.35 (95% CI = 1.09–1.67) and a moderate heterogeneity (χ2 = 40.19, I2 = 72.6%). According to a subgroup analysis, there was a positive correlation between GDM and As levels in blood (OR = 1.35, 95% CI = 1.10–1.65) and urine (OR = 1.33, 95% CI = 1.03–1.71). Conclusion The results indicate that As exposure in non-diabetic mothers is associated with an increased risk of GDM. However, due to heterogeneity, the data needs to be interpreted with caution.