{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:08Z","timestamp":1788419768435,"version":"build-2803163510"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Few studies have investigated the relationship between maternal exposure to per- and polyfluoroalkyl substances (PFAS) and the co-occurrence of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy, particularly preeclampsia\/eclampsia (PE\/E). The present study aimed to explore whether PFAS exposure is associated with the co-occurrence of GDM and PE\/E.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study enrolled 333 pregnant women diagnosed with both GDM and PE\/E, and 360 healthy controls. First-trimester plasma concentrations of 18 PFAS were determined by ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry (UPLC-MS\/MS). The associations of individual and combined maternal PFAS exposure with the odds of co-occurrence were assessed by restricted cubic spline (RCS) analysis, multivariable logistic regression, and Bayesian kernel machine regression (BKMR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The concentrations of perfluoroheptanoic acid (PFHpA), perfluorobutanesulfonic acid (PFBS), and perfluorotridecanoic acid (PFTrDA) differed significantly between the two groups; however, after false discovery rate (FDR) correction, only PFHpA and PFTrDA remained significantly different. RCS analysis showed significant associations of PFHpA and PFBS with the co-occurrence (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>overall<\/jats:sub>\n                      =\u202f0.026 and 0.014, respectively), without nonlinearity (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>non-linear<\/jats:sub>\n                      =\u202f0.619 and 0.206, respectively); However, the overall associations were no longer significant after FDR correction. In multivariable logistic regression models, after FDR correction, each log10-unit increment in PFHpA and PFBS was significantly associated with increased odds of the co-occurrence, with adjusted odds ratios (aORs) of 2.439 (95% CI: 1.269\u20134.689) and 1.688 (95% CI: 1.161\u20132.453), respectively. For perfluoroheptane sulfonic acid (PFHpS), a positive association was also observed (aOR\u202f=\u202f1.712, 95% CI: 1.051\u20132.788); however, the association was not significant after FDR correction. BKMR analysis revealed a positive association between PFAS mixture exposure and the co-occurrence, with the association strengthening progressively at higher mixture concentrations. Among the individual PFAS, PFHpA, PFBS and PFHpS exhibited positive trends, whereas PFTrDA displayed inverse trends.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PFHpA, PFBS, and the 10 PFAS mixture were all positively associated with increased odds of co-occurrence of GDM and PE\/E.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1929511","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:41:19Z","timestamp":1788417679000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal per- and polyfluoroalkyl substances exposure and the co-occurrence of gestational diabetes mellitus and preeclampsia\/eclampsia: a nested case\u2013control study"],"prefix":"10.3389","volume":"14","author":[{"given":"Nana","family":"Li","sequence":"first","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Li","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Deng","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meixian","family":"Wang","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuting","family":"Li","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Liu","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Kang","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhu","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Yu","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Wang","sequence":"additional","affiliation":[{"name":"National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, Sichuan, 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