A comprehensive meta-analysis of 28 studies reveals that prenatal exposure to specific PFAS compounds—including PFOA, PFOS, PFNA, PFDA, and PFUnDA—significantly disrupts glucose tolerance testing and increases gestational diabetes mellitus (GDM) risk. The analysis found PFOS paradoxically lowered fasting glucose while multiple PFAS elevated 1-hour and 2-hour oral glucose tolerance test results, with PFOA, PFNA, and PFDA specifically associated with higher GDM incidence rates.
This finding consolidates previously inconsistent epidemiological evidence into a clearer picture of PFAS metabolic toxicity during pregnancy. The implications extend beyond individual pregnancies, as gestational diabetes creates long-term diabetes risk for both mothers and offspring, potentially contributing to the intergenerational diabetes epidemic. The mechanistic basis—PFAS interference with pancreatic beta-cell function and insulin sensitivity—suggests these "forever chemicals" may represent an underappreciated driver of metabolic dysfunction. However, the observational nature of included studies limits causal inference, and the relatively modest effect sizes indicate PFAS likely interact with other risk factors rather than serving as primary GDM drivers. This research strengthens the case for reducing PFAS exposure during reproductive years.
