Study Links Higher Radon Exposure to Increased Risk of Gestational Diabetes in First-Time Pregnant Women: JAMA

Researchers observed that pregnant individuals with higher exposure to radon were more likely to develop GD, a condition characterized by elevated blood sugar levels that can pose risks to both mother and baby.

Radon, a naturally occurring radioactive gas found in soil, rock, and water, is widely recognized for its long-term health risks, particularly its link to lung cancer. Understanding environmental risk factors, such as radon exposure, is crucial for addressing gestational diabetes (GD) and improving pregnancy outcomes. In this context, Yijia Zhang, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, and colleagues investigated the association between county-level radon exposure and the risk of GD in pregnant individuals.

For this purpose, the researchers used data from the Nulliparous Pregnancy Outcomes Study (nuMoM2b), a multicenter cohort study conducted across eight US clinical centers between 2010 and 2013. They excluded participants with pregestational diabetes or missing data on GD or county-level radon exposure. Radon exposure was categorized into three groups based on county-level radon data from the Lawrence Berkeley National Laboratory. The study assessed the association between radon exposure and gestational diabetes, using multiple logistic regression models to analyze glucose tolerance testing and medical record data.

The study led to the following findings:

• The study included 9,107 participants with a mean age of 27.0 years, and 41.6% (3,782 out of 9,101) reported ever using tobacco.
• The average county-level radon concentration was 1.6 pCi/L, and 4.2% (382 participants) had recorded gestational diabetes.
• After adjusting for confounders, individuals in counties with the highest radon levels (≥2 pCi/L) had higher odds of developing GD compared to those in counties with the lowest radon levels (<1 pCi/L) (odds ratio [OR], 1.37).
• After further adjustment for PM2.5, the odds ratio remained significant at 1.36.
• Ever smokers in counties with higher radon levels (≥2 pCi/L) had significantly higher odds of GD (OR, 2.09).
• Participants living in counties with both higher radon and PM2.5 levels had elevated odds of GD (OR, 1.93), though no statistically significant interactions were found.

"This cohort study suggests that radon exposure may be linked to a higher risk of gestational diabetes in first-time pregnant individuals and encourages further research on individual indoor radon levels to confirm these findings and understand the biological mechanisms," the researchers concluded.

Reference:

Zhang Y, Angley M, Lu L, et al. Radon Exposure and Gestational Diabetes. JAMA Netw Open. 2025;8(1):e2454319. doi:10.1001/jamanetworkopen.2024.54319