Comprehensive Evaluation of Gestational Diabetes Patients Against Exposure on PFAS and Its Derivatives: An Updated Systematical Review and Meta-Analysis

<strong>Background and Aims: </strong>Gestational diabetes mellitus (GDM) is characterised by insulin resistance that first manifests during pregnancy. This study aimed to evaluate PFAS exposure as a risk factor for GDM. <strong>Methods: </strong>Descriptive Boolean queries were used to search PubMed, Scopus, and Web of Science for articles published between January 2015 to 2023 with “PFAS” OR “per- and polyfluoro alkyl” AND “gesta tional diabetes” keywords. A total of 10 studies were included. <strong>Results:</strong> There were no statistically significant difference between the patient and control groups for PFOS (MD = 0.36, 95% CI = [0.30, 1.02], Z=1.06, P=0.29), PFHxS (MD = −0.02, 95% CI = [−0.11, 0.07], Z=0.39, P=0.69), PFNA (MD = 0.00, 95% CI = [−0.02, 0.04], Z=0.10, P=0.92), PFHpA (MD = 0.01, 95% CI = [−0.00, 0.02], Z=1.63, P=0.10) and PFDA (MD = 0.00, 95% CI = [−0.03, 0.03], Z=0.15, P=0.88). A statistically significant difference was observed between the patient and control groups for PFOA (MD = 1.79, 95% CI = [0.99, 2.58], Z=4.42, P&lt;0.001) and PFUnDA (MD = 0.10, 95% CI = [0.01, 0.19], Z=2.23, P=0.03). <strong>Conclusion: </strong>Our meta-analysis has shown a strong correlation between PFUnDA and PFOA levels in connection with GDM. A total of 10 randomised controlled trials (RCTs) were assessed to investigate the relationship between GDM and PFAS. Consistent with previous research, the presence of long-chain chemicals such as PFUnDA and PFOA may disrupt the normal functioning of β cells, leading to the development of GDM. These results can enhance future research on the relationship between GDM and hazardous exposures.